APA Dictionary of Clinical Psychology PDF

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Library of Congress Cataloging-in-Publication Data
APA dictionary of clinical psychology. — 1st ed.

p. cm.
ISBN 978-1-4338-1207-1 -- ISBN 1-4338-1207-X 1. Clinical psychology--Dictionaries. 2.
Psychotherapy—Dictionaries. I. American Psychological Association. II. Title: A.P.A. dictionary of
clinical psychology. III. Title: Dictionary of clinical psychology.
RC467.A63 2013
616.89’1403--dc23
2012022203
British Library Cataloguing-in-Publication Data

A CIP record is available from the British Library.
The citation for this publication is American Psychological Association. (2013).

APA dictionary of clinical psychology. Washington, DC: Author.
Printed in the United States of America

First Edition
DOI: 10.1037/13945-000
Contents
Preface vii
Editorial Staff ix
Quick Guide to Format xi
APA Dictionary of Clinical Psychology 1
Appendixes
Biographical Entries 633
Psychotherapy and Psychotherapeutic 634

Approaches Entries
v
Preface
This dictionary is the fourth in a family of lexicographical works published by the

American Psychological Association (APA). The parent reference, the 25,000-entries APA
Dictionary of Psychology—the culmination of some ten years of research and lexicographic
activity—was released in 2006, winning wide critical endorsement and recognition from
both the publishing and reference library communities. We are pleased to note that a
considerably revised and expanded second edition of this work is well under way and will
be available in 2014.
An abridgment of the parent dictionary in 10,000 entries, the APA Concise Dictionary
of Psychology, was released in 2008. Whereas the original dictionary offered a deeply
layered approach to the lexicon of the field, Concise, through an editorial process of
reduction and synthesis, offered an equally informative exploration of the fundamental
vocabulary, but with broader general appeal. This version is now available both in print
and as an app for iPhone, iPad, and Android.
A collegiate version, the popular APA College Dictionary of Psychology, in 5,000 entries,
followed in 2009, offering an even more highly concentrated, easily portable, and
economical alternative for the student of psychology—whether he or she is at the
advanced placement level in high school, a college undergraduate enrolled in Intro
Psych, or an undergraduate considering or making psychology his or her major field of
study.
Thus, the APA Dictionary of Clinical Psychology is the latest offspring in the dictionary
branch of the APA Reference family—one that we hope will prove a convenient and
highly focused alternative for the women and men at the very heart of the psychological
enterprise: the clinicians who interpret the theory, read the research, and who,
ultimately, are directly involved in the care and treatment of patients, whether they work
in health and mental health clinics; in independent and group practices; or as
consultants to professionals in such fields as medicine, law, social work, and consumer
relations. Students—especially those in training as clinicians—will likewise find this
dictionary a well-focused and economical alternative to the broader coverage of the
parent work.
As with Concise and College, the APA Dictionary of Clinical Psychology is primarily a
derivative: In order to delimit an appropriately representative universe of terms for
inclusion in a clinical dictionary, APA reference staff culled those entries (largely in the
2006 parent work) that either directly or closely relate to clinical psychology—whether
they are terms specific to the assessment, evaluation, diagnosis, prevention, and
treatment of emotional and behavioral disorders; to clinical training and supervision, or
to clinical research and practice; or they are terms more generally relevant to various
biological, cognitive, developmental, and personality/social psychological underpinnings
of physical and mental health. As with the two previous derivatives, we have retained
much of the historical lexicon in this first edition of Clinical on the assumption that it
remains useful for reading in the older literature of the late 19th and early and mid-20th
centuries.
In addition, we have slightly expanded coverage, with some updating of
pharmacological entries and of etymological information, as well as a very limited
“preview” of some of the new clinical entries that will appear in the second edition of the
full APA Dictionary of Psychology.
Finally, we take another opportunity to recognize the earlier contributions of the full
editorial board of the APA Dictionary of Psychology, whose efforts remain the foundation
upon which this clinical psychology dictionary rests.
Gary R. VandenBos, PhD
Editor in Chief
APA Publisher
vii
Editorial Staff
Editor in Chief
Gary R. VandenBos, PhD
Senior Editors (American Psychological Association)
Theodore J. Baroody
Julia Frank-McNeil
Patricia D. Mathis
Marion Osmun
Senior Editors (Market House Books, Ltd.)
Jonathan Law
Elizabeth Martin
Editorial Board
Mark Appelbaum, PhD

Elizabeth D. Capaldi, PhD
Debra L. Dunivin, PhD
Alan E. Kazdin, PhD
Joseph D. Matarazzo, PhD
Susan H. McDaniel, PhD
Susan K. Nolen-Hoeksema, PhD
Suparna Rajaram, PhD
Editorial Contributors
John G. Albinson, PhD Erica L. Fener, PhD

Mark Appelbaum, PhD Donelson R. Forsyth, PhD
Bernard J. Baars, PhD Robert G. Frank, PhD
Andrew S. Baum, PhD Donald K. Freedheim, PhD
Roy F. Baumeister, PhD Charles J. Golden, PhD
Daniel S. Beasley, PhD Maria A. Gomez, DVM, PhD
Leonard Berkowitz, PhD Kenji Hakuta, PhD
David F. Bjorklund, PhD Dennis C. Harper, PhD
C. Alan Boneau, PhD Curtis P. Haugtvedt, PhD
Marc N. Branch, PhD Morton A. Heller, PhD
Laura S. Brown, PhD John W. Jacobson, PhD
Joseph J. Campos, PhD Robert J. Kastenbaum, PhD
Daniel Cervone, PhD John F. Kihlstrom, PhD
Stanley H. Cohen, PhD Bruce E. Kline, PsyD
Deborah J. Coon, PhD Debra L. Kosch, PhD
James C. Coyne, PhD Michael J. Lambert, PhD
Robert L. Dipboye, PhD Joseph LoPiccolo, PhD
Maria L. Dittrich, PhD George F. Luger, PhD
Gail Donaldson, PhD Raelynn Maloney, PhD
Deborah K. Elliott-DeSorbo, PhD A. David Mangelsdorff, PhD
David G. Elmes, PhD Colin Martindale, PhD
Gary W. Evans, PhD Kenneth I. Maton, PhD
Leandre R. Fabrigar, PhD Randi E. McCabe, PhD, CPsych
ix
Editorial Contributors (continued)
Katharine McGovern, PhD Tonya L. Smith-Jackson, PhD

Barbara G. Melamed, PhD Charles T. Snowdon, PhD
Theodore Millon, PhD, DSc Michael A. Stadler, PhD
Bryan P. Myers, PhD Robert J. Sternberg, PhD
Peter E. Nathan, PhD Cheryl V. Tan, PhD
Raymond S. Nickerson, PhD W. Scott Terry, PhD
Andrea Farkas Patenaude, PhD J. Kevin Thompson, PhD
Christopher Peterson, PhD Mieke H. Verfaellie, PhD
Robert W. Proctor, PhD Neal F. Viemeister, PhD
Stacey M. Rosenfeld, PhD Kathleen D. Vohs, PhD
Robert Rosenthal, PhD Kim-Phuong L. Vu, PhD
Mark R. Rosenzweig, PhD Leighton C. Whitaker, PhD
Preeti Saigal, PhD Richard N. Williams, PhD
Morgan T. Sammons, PhD Abraham W. Wolf, PhD
Julie H. Sandell, PhD Charles E. Wright, PhD
Thomas R. Scott, PhD Josef Zihl, PhD
Anderson D. Smith, PhD
x
Quick Guide to Format
Headword bariatrics n. a field of medicine that focuses on Part-of-speech label

the study of overweight: its causes, prevention,
and treatment.
Beck Anxiety Inventory (BAI) a self-report, Abbreviation

21-item measure used to assess the severity of
anxiety in adults and to discriminate anxiety
from depression. [Aaron T. Beck (1921– ), U.S.
Etymology Psychiatrist]
Plural form benny n. (pl. bennies) slang for an ampheta-

mine tablet. See amphetamines.
behavior hierarchy a ranking of possible re-

sponses based on the relative probabilities of
their being elicited, with more probable behav-
iors ranked higher than less probable behaviors.
Alternative name Also called behavioral hierarchy.
behaviorism n. an approach to psychology, for-

mulated in 1913 by U.S. psychologist John B.
Etymology Watson (1878–1958), based on the study of ob-
jective, observable facts rather than subjective,
qualitative processes, such as feelings, motives,
and consciousness. To make psychology a natu-
ralistic science, Watson proposed to limit it to
quantitative events, such as stimulus–response
relationships, effects of conditioning, physiolog-
ical processes, and a study of human and animal
behavior, all of which can best be investigated
through laboratory experiments that yield ob-
jective measures under controlled conditions.
Historically, behaviorists held that mind was not
a proper topic for scientific study since mental
events are subjective and not independently ver-
ifiable. With its emphasis on activity as an adap-
tive function, behaviorism is seen as an
outgrowth of functionalism. See descriptive
behaviorism; methodological behavior-
ism; neobehaviorism; radical behaviorism. Cross-references
biogenesis n. the origin of living things from
Hidden entry other living things. Biogenetics is the scientific
study of the principles and processes governing
the production of living organisms from other
living organisms, including the mechanisms of
heredity. —biogenetic adj. Derived word
Sense number body narcissism 1. an exaggerated preoccupa-

tion or fascination with one’s own body and its
Sense number erogenous zones. See also narcissism. 2. in psy-
choanalytic theory, the primary narcissism of Cross-reference
the young infant.
xi
Aa
AA abbreviation for alcoholics anonymous. Abandonment reaction is also experienced by
AAAP abbreviation for american association adults who have lost a loved one on whom they
of applied psychology. have depended.
AAAPP abbreviation for american association abasement need a need to surrender oneself to
of applied and preventive psychology. another person, accept blame or punishment, or
AACP abbreviation for american association confess and atone. See also masochism. [de-
of clinical psychologists. fined by U.S. psychologist Henry A. Murray
(1893–1988)]
AACS abbreviation for american academy of
clinical sexologists. abasia n. severe impairment or complete loss of
AAI abbreviation for adult attachment inter- the ability to walk due to problems in motor co-
view. ordination. —abasic adj.
AAIDD see american association on intel- abatement n. a reduction or lessening in the se-
lectual and developmental disabilities. verity of pain or other symptoms of illness or dis-
order.
AAMI abbreviation for age-associated memory
impairment. ABCDE technique a procedure used in ratio-
AAMR abbreviation for American Association of nal emotive behavior therapy, on the basis of
Mental Retardation. See american association abc theory, which suggests that Activating
on intellectual and developmental dis- events (i.e., adversities) are mediated by irratio-
abilities. nal Beliefs in determining inappropriate emo-
tional and behavioral Consequences. ABCDE
AAP abbreviation for association for the ad-
technique involves Disputing these beliefs (i.e.,
vancement of psychology.
under the guidance of a therapist), which results
AASECT abbreviation for american associa- in several types of Effects (e.g., rational beliefs,
tion of sex educators, counselors and appropriate feelings, desirable behaviors).
therapists.
ABC theory the theory underlying rational
ABA abbreviation for applied behavior analy- emotive behavior therapy, which suggests
sis.
that Activating events (i.e., adversities) are medi-
A-B-A-B design a single-case experimental ated by irrational Beliefs in determining inap-
design in which a baseline or other initial con- propriate behavioral Consequences. See also
dition (A) is followed by a different condition abcde technique. [devised by U.S. psychologist
(B), which is followed by a return to the initial Albert Ellis (1913–2007)]
condition (A), which is then followed by a return
to the second condition (B). A-B design the simplest single-case experi-
mental design, in which the dependent vari-
A-B-A design a single-case experimental de- able is measured throughout the pretreatment
sign in which a baseline or other initial condi- or baseline period (the A phase) and then again
tion (A) is followed by a different condition (B) following the treatment period (the B phase).
and then by a return to the initial condition (A). Numerous variations of this basic design exist,
abaissement n. a mental state in which the such as the A-B-A design, A-B-A-B design, A-B-B-
threshold of consciousness lowers and uncon- A design, and A-B-BC-B design. The latter in-
scious thoughts become conscious, as when slip- volves two treatment periods (the B phase and
ping into sleep and becoming aware of dream the C phase) and is intended to assess the effect
content. [from French, in full: abaissement du of B both in combination with C and apart from
niveau mental, first recognized and defined by C.
French physician and psychologist Pierre Janet
(1859–1947)] abdominal migraine recurrent, severe epi-
sodes of abdominal pain that may be accompa-
abandonment n. desertion of a dependent by a nied by nausea and vomiting. The episodes last
parent or primary caregiver. Dependents are usu- from 1 to 72 hours and occur most frequently in
ally children but may be entire families or indi- children.
viduals who are ill. —abandon vb.
abandonment reaction a feeling of emo- aberrant response an abnormal or atypical be-
havior, commonly targeted during a behavioral
tional deprivation, loss of support, and loneli-
intervention.
ness experienced by children who have been
deserted or neglected by one or both parents. aberration n. any deviation, particularly a sig-
1
abience
nificant or undesirable one, from the normal or (French, “barking”) is a symptom sometimes
A typical. See also mental aberration. occurring in schizophrenia and Tourette’s disor-
abience n. a response or behavior that results in der.
movement away from a stimulus, either by phys- abortifacient n. any agent that induces abor-
ical withdrawal from the stimulus or by an action. Also called abortient.
tion designed to avoid the stimulus entirely. abortion n. the expulsion from the uterus of an
Compare adience. —abient adj. embryo or fetus before it is able to survive inde-
Abilify n. a trade name for aripiprazole. pendently. An abortion may be either spontane-
ability level an index of achievement or perfor- ous, in which case it occurs naturally and is also
mance that reports the absolute or relative abil- called a miscarriage, or induced, in which case
ity of the organism being evaluated. it is produced deliberately by artificial means
such as drugs or surgery and done for therapeu-
ability trait a personality trait that involves an
tic reasons or as an elective decision. The prac-
individual’s capacity to attain his or her goals. It
tice is controversial and may involve abortion
is one of three classes of source traits in
counseling, the provision of guidance, advice,
cattell’s personality trait theory, the other
information, and support on issues concerning
two being dynamic traits and temperament
termination of pregnancy and the alternatives of
traits.
adoption or raising the child.
abiotrophy n. loss of function or loss of resis-
tance to a disease through degeneration or fail-
aboulia n. see abulia.
ure of body tissues, organs, or systems. ABPP abbreviation for american board of pro-
Abiotrophy is used particularly to refer to prema- fessional psychology.
ture degeneration caused by a genetic defect, as abreaction n. the therapeutic process of bring-
in Huntington’s disease. —abiotrophic adj. ing forgotten or inhibited material (i.e., experi-
ablation n. the removal or destruction of part of ences, memories) from the unconscious into
a biological tissue or structure by a surgical pro- consciousness, with concurrent emotional re-
cedure or a toxic substance, usually for treat- lease and discharge of tension and anxiety. See
ment or to study its function. When the entire also catharsis.
tissue or structure is excised, the process is called ABS abbreviation for the American Association
extirpation. on Intellectual and Developmental Disabilities’
ablution n. 1. a largely obsolete therapeutic (formerly American Association on Mental Re-
technique utilizing water (such as wrapping wet tardation’s) Adaptive Behavior Scale, in separate
towels around the body or immersing in water) editions for school and adult service settings. See
to calm agitated patients. It was abandoned with adaptive behavior scale.
the advent of psychotropic drugs. 2. a symbolic abscess n. a contained but often enlarging area of
cleansing of the body, or of possessions, with the infection that includes pus and dead tissue. A
intent of purification. brain abscess raises intracranial pressure and
abnormal adj. relating to any deviation from can cause substantial neurological deficits, such
what is considered typical, usual, or healthy, par- as poor coordination, decreased sensation, con-
ticularly if the deviation is considered harmful fusion, and other altered mental states.
or maladaptive. In statistics, for example, abnor- absence n. a brief loss of consciousness or pe-
mal scores are those that are outside the usual or riod of mental inattentiveness, particularly when
expected range. The term, however, is most associated with a seizure (see absence seizure),
often applied to behavior that differs from a cul- with no memory for the event afterward.
turally accepted norm, especially when indi-
absence seizure a type of generalized sei-
cative of a mental disorder. —abnormality n.
zure, formerly called petit mal seizure, in which
—abnormally adv.
the individual abruptly ceases activity and can-
abnormal behavior behavior that is atypical not afterward remember the event. The absences
or statistically uncommon within a particular usually last from 5 to 15 s, during which the indi-
culture or that is maladaptive or detrimental to vidual is unresponsive and motionless, staring
an individual. Such behavior is often regarded as blankly. Seizures of this type typically begin be-
evidence of a mental or emotional disturbance, tween ages 4 and 12 and rarely persist into adult-
ranging from minor adjustment problems to se- hood.
vere mental disorder.
absent-mindedness n. a state of heedlessness
abnormality n. 1. the state or condition of or inattention marked by a tendency to be occu-
being abnormal. 2. a defect or malformation in pied by one’s own thoughts and not to be fully
structure or function. aware of concurrent situations or the external re-
abnormal psychology the branch of psychol- ality of the moment.
ogy devoted to the study, prevention, assess- absolute error the degree to which an observa-
ment, and treatment of maladaptive behavior. tion is inaccurate without specification of
See also psychopathology. whether it errs by being too high or too low. Ab-
aboiement n. the involuntary, uncontrollable solute error is computed as the average absolute
production of animalistic sounds. Aboiement difference between the intended or expected
2
academic skills disorder
value and the actual value. This measure may abstract intelligence the intellectual ability
also describe the overall accuracy of a set of to think in terms of abstract concepts. Also A
movements with a well-defined goal. Compare called abstract ability. See abstract think-
constant error; random error. ing. Compare concrete intelligence.
absolute judgment a psychophysical judg- abstraction n. 1. the formation of general ideas
ment in which a single stimulus is placed in a or concepts by extracting similarities from par-
particular category (e.g., “bright,” “loud”), as op- ticular instances. The precise cognitive processes
posed to one in which several stimuli are com- by which this occurs remain a subject of inves-
pared to one another or to a given standard (e.g., tigation. 2. such a concept, especially a wholly
“brighter,” “louder”). intangible one, such as “goodness” or “truth.”
—abstract vb.
absorption n. 1. the uptake of fluid and dis-
solved substances into a cell across the plasma abstract representation in cognitive theory,
membrane. For example, an administered drug a mental representation of a stimulus in an
moves through various biological membranes abstract or essential form that is not tied to any
from its site of administration to its target organ. one of its variable surface forms. For example,
Absorption into the target organ is dependent the letter A can be thought about at an abstract
on a number of factors, including the method of level with no reference to specific surface forms,
administration (e.g., oral, intravenous); the such as a, A, or a.
properties of the drug (e.g., molecular size, abil- abstract thinking thinking characterized by
ity to cross lipid membranes); the amount of the use of abstractions and generalizations.
drug administered; and the characteristics or Compare concrete thinking. See also ab-
state of the individual (e.g., body mass, sex, age, stract attitude; categorical thought.
presence of disease, presence of other drugs). 2. abulia (aboulia) n. extreme loss of initiative
an extreme involvement or preoccupation with and willpower, resulting in an inability to make
one object, idea, or pursuit, with inattention to decisions or initiate voluntary actions. —abulic
other aspects of the environment. See also adj.
tellegen absorption scale.
abuse 1. n. interactions in which one person be-
abstinence n. the act of refraining from the use haves in a cruel, violent, demeaning, or invasive
of something, particularly alcohol or drugs, or manner toward another person or an animal.
from participation in sexual or other activity. In The term most commonly implies physical mis-
most instances, abstinence from drugs or alcohol treatment but also encompasses sexual and psy-
is the primary goal of substance abuse treatment. chological (emotional) mistreatment. 2. vb. to
See also substance withdrawal. —abstinent subject a person or animal to such treatment.
adj. 3. n. see substance abuse. 4. n. colloquially, the
abstinence delirium a form of delirium that misuse of a substance to an extent that it causes
occasionally accompanies withdrawal from al- the individual difficulty, whether or not it meets
cohol or drugs of abuse. See alcohol with- the DSM–IV–TR definition of substance abuse.
drawal delirium; delirium tremens. See also alcohol abuse. —abuser n.
abstinence rule see rule of abstinence. abuse potential the ability of a drug to rein-
force drug-taking behavior. Factors that deter-
abstinence syndrome the characteristic set of mine abuse potential include route of drug
physiological and behavioral events that accom- administration (e.g., intravenous, inhalation,
panies withdrawal from dependence-inducing oral) and the speed of onset, duration, and na-
substances. ture of the drug effect. These factors are them-
abstract attitude a cognitive style that in- selves determined by complex interactions
volves the ability to grasp essentials and com- between the individual, the substance, and the
mon properties, to keep different aspects of a social environment. Substances with a high
situation in mind and shift from one to another, abuse potential include intravenous heroin,
to predict and plan ahead, and to think symboli- crack cocaine, morphine, and smoked opium.
cally and draw conclusions. These capacities are Substances with a low abuse potential include
often impaired in people with certain neurolo- the hallucinogens and marijuana. Also called
gical or psychological disorders. Also called cat- abuse liability.
egorical attitude. Compare concrete atti- academic intervention the active involve-
tude. See also abstract thinking. [defined by ment of school officials and teachers in develop-
German-born U.S. neurologist Kurt Goldstein ing and implementing an effective plan for the
(1878–1965)] prevention or remediation of inappropriate and
abstract conceptualization the process of disruptive student behavior. Successful pro-
forming abstract concepts, which may be gen- grams of intervention are most often individual-
eral and apply to numerous particular instances ized, child focused, and minimally restrictive.
(e.g., “dog” or “fish”) or wholly intangible and Academic intervention is the antithesis of reac-
have no specific material referent (e.g., “liberty” tive strategies, such as loss of privileges and time
or “youth”). See abstraction; conceptualiza- out.
tion. academic skills disorder in DSM–III and ear-
3
acalculia
lier editions, a disorder that in DSM–IV–TR is to accept that he or she has a problem before any
A classified as a learning disorder. interventions can be effective.
acalculia n. loss of the ability to perform simple acceptance and commitment therapy
arithmetic operations that results from brain in- (ACT) a form of cognitive behavior therapy
jury or disease, usually to the parietal lobe. It is based on the premise that ineffective strategies
an acquired condition, whereas dyscalculia is to control thoughts and feelings actually lead to
developmental. problem behaviors. It helps clients to abandon
acamprosate n. an analog of the inhibitory these ineffective control strategies and instead
neurotransmitter gamma-aminobutyric acid willingly experience difficult thoughts and feel-
(GABA) used in the management of alcohol de- ings as a necessary part of a worthy life. Clients
pendence. Although exact mechanisms of action then clarify their personal values and life goals,
are unclear, acamprosate may act by directly and learn to make life-enhancing behavioral
binding to the GABA receptor complex (see changes accordingly. ACT has been applied to a
gabaa receptor; gabab receptor); it may also wide variety of problems, including depression,
act by inhibiting the actions of the excitatory anxiety, stress, and substance abuse.
amino acid glutamate, for example by inhibit- access vb. to retrieve or recall a memory.
ing nmda receptors. When administered in
combination with behavioral treatments, it has accessible adj. 1. receptive or responsive to per-
some efficacy in reducing alcohol intake or in- sonal interaction and other external stimuli. A
creasing alcohol-free periods in people recover- client in psychotherapy, for example, is thought
ing from alcohol dependence. U.S. trade name: to be accessible if he or she responds to the thera-
Campral. pist in a way that facilitates the development of
rapport and, ultimately, fosters the examination
acarophobia n. a persistent and irrational fear of cognitive, emotional, and behavioral issues.
of skin parasites (mites), ants, worms, and, by ex- 2. retrievable through memory or other cogni-
tension, small objects such as pins and needles. tive processes. 3. a characteristic of a building
The condition is believed to be related to the sen- and its facilities and fixtures, or of any site, that
sation of insects crawling on or under the skin, makes it easy to approach, enter, or use, particu-
which occurs in alcoholism, cocaine use, nar- larly by people with disabilities. 4. in a tissue,
cotic addiction, and delirium resulting from reachable by means of standard surgical or diag-
meningitis, encephalitis, rheumatic fever, or nostic procedures. —accessibility n.
diphtheria. See also formication; lilliputian
hallucination. —acarophobic adj. accessory symptoms see secondary symp-
toms.
acataphasia (akataphasia) n. the use of inap-
propriate or grammatically incorrect words and accidental stimulus any stimulus that in-
expressions. It is a speech disturbance frequently trudes into a dream, such as the sound of a tele-
found in individuals with schizophrenia or phone ringing or a muscle cramp. Such stimuli
aphasia. See also agrammatism. may be incorporated into dreams. Compare
acathisia n. see akathisia. dream stimulus.
accelerated interaction the intensification accident prevention the use of scientifically
of group processes and emotional interaction tested methods to reduce the number and sever-
that occurs in experiential groups when the ity of accidents. These include the systematic
group sessions are continuous and secluded. See study of accidents and the circumstances in
marathon group; time-extended therapy. which they occur; the identification and control
of workplace hazards; the evaluation and rede-
acceleration–deceleration injury a form of
sign of systems and processes; and the use of
head injury caused by the head suddenly being
training programs, instruction, and other forms
placed into motion or abruptly stopped, as, for
of safety education.
example, when the individual is in a car acci-
dent. The sudden motion or stop causes dif- accident proneness a chronic susceptibility to
fuse stretching and tearing of white matter tracts accidents. This concept has been heavily de-
in addition to bleeding and other neurological bated since its introduction around 1920, and
effects. The injury may have a variety of conse- many question the existence of a fixed accident-
quences, including personality change, atten- prone personality. However, several individual
tion problems, memory disorders, and execu- variables and sociological and situational factors
tive dysfunction. have been identified as important predictors of
acceptance n. 1. a favorable attitude toward an accident involvement, including aggressiveness,
idea, situation, person, or group. In the context impulsiveness, thrill and adventure seeking,
of psychotherapy and counseling, it is the recep- workload and cognitive demand, and stress.
tive, nonjudgmental attitude of therapists or acclimatization n. adjustment or adaptation
counselors, which conveys an implicit respect to new circumstances or environmental condi-
and regard for their clients as individuals. 2. will- tions, particularly the physiological changes
ing acknowledgment of validity or correctness. that improve an individual’s ability to tolerate
In the context of recovery from substance abuse environmental alterations. Also called acclima-
and other addictions, it is essential for a person tion. —acclimatize vb.
4
achievement drive
accommodation n. 1. adjustment or modifica- patients with bleeding disorders). It is also sold

tion. For example, regarding individuals with in combination with other analgesics, antihista- A
disabilities, it refers to reasonable accommo- mines, decongestants, or cough suppressants.
dations made to meet their needs, whereas in However, acute overdose or chronic daily dosing
the theory of cognitive development proposed of acetaminophen may cause liver damage
by Jean piaget it refers to the adjustment of (hepatotoxicity), and consumption of alcohol
mental schemas according to information ac- increases the risk of liver damage. Rapid in-
quired through experience; and in the context of tervention, including the administration of
bargaining and interpersonal negotiations it re- N-acetylcysteine, is required to prevent fatal
fers to modification of the various parties’ de- hepatotoxicity after acetaminophen poison-
mands or actions in order to achieve agreement ing. Also called APAP; paracetamol. U.S.
or a mutually beneficial outcome. 2. the process trade name (among others): Tylenol.
by which the focus of the eye is changed to allow acetanilide n. see anilides.
near or distant objects to form sharp images on
the retina. —accommodate vb. acetazolamide n. see carbonic anhydrase in-
hibitor.
accountability n. in health care, the responsi-
bility of individual providers, clinics, or hospi- acetylcholine (ACh) n. a major, predominantly
tals to document their efforts, their resource excitatory but also inhibitory, neurotransmitter
utilization, and the outcome of their services in the central nervous system, where it plays an
and to report this information to insurance com- important role in memory formation and learn-
panies or state or federal agencies. —accounting and is implicated in Alzheimer’s disease; and
able adj. in the peripheral nervous system, where it medi-
ates skeletal, cardiac, and smooth muscle con-
accreditation n. the formal process in which an traction and is implicated in myasthenia
agency or organization evaluates and approves gravis and other movement disorders.
an institution or program of study as meeting
predetermined standards. Accreditation applies acetylcholine receptor (AChR) any of cer-
to institutions as certification applies to indi- tain protein molecules in cell membranes in the
viduals. —accredited adj. central and peripheral nervous systems that are
stimulated by acetylcholine or acetylcholine-like
accuracy standards criteria used to assess the substances. There are two main types: musca-
scientific value of the information and conclu- rinic receptors and nicotinic receptors.
sions presented in an evaluation report. Such
standards include ensuring the completeness of acetylcholinesterase inhibitors drugs that
data collection and the reliability and validity of block the ability of the enzyme acetylcholin-
procedures and measures, conducting appropri- esterase (see cholinesterase) to degrade the
ate qualitative and quantitative analyses, and neurotransmitter acetylcholine in the synaptic
impartially reporting results to arrive at justified cleft of cholinergic neurons. Some acetyl-
conclusions. See also feasibility standards; cholinesterase inhibitors are used clinically as
propriety standards; utility standards. nootropics to slow the progression of demen-
tia in Alzheimer’s disease. Also called anti-
Accutane n. a trade name for isotretinoin. cholinesterases; cholinesterase inhibi-
acenesthesia n. 1. loss of the sensation of physi- tors. See donepezil; galantamine; rivastig-
cal existence. 2. a lack of awareness of one’s own mine; tacrine. See also carbamate.
body. See depersonalization. acetylsalicylic acid (ASA) the chemical name
acetaldehyde n. a toxic and volatile initial for aspirin.
product of alcohol (ethanol) metabolism that is acetylureas pl. n. drugs that are analogs of
responsible for the variety of unpleasant effects hydantoins used in the treatment of partial sei-
associated with a hangover, including nausea, zures.
vomiting, and headache. It is produced when al-
cohol is broken down by a liver enzyme called al- ACh abbreviation for acetylcholine.
cohol dehydrogenase and is itself further broken acheiria (achiria) n. 1. the condition of being
down by another liver enzyme (acetaldehyde born with only one or no hands. See also
dehydrogenase) into acetate and, ultimately, apodia. 2. a disorder of sensation in which an
into carbon dioxide and water. Acetaldehyde is individual cannot tell which side of the body is
widely studied to determine its relationship to being touched. It is considered a dyscheiria, a
and influence upon the development and pro- disordered representation of one side of the
gression of alcoholism. See also disulfiram. body.
acetaminophen n. a common analgesic and achievement drive a strong impulse to do
antipyretic agent with an efficacy similar to as- one’s best to achieve a goal and, often, to be rec-
pirin, except that it does not possess anti- ognized and approved for attaining it. Students
rheumatic or anti-inflammatory properties. It is with a strong achievement drive have been
rapidly distributed in the body and has a short found to earn better grades than equally gifted
half-life (around 2 hours). Acetaminophen is students with a weaker achievement drive.
a widely used alternative to aspirin, especially Studies of the literature of different societies in-
when usage of the latter is inadvisable (e.g., in dicate that achievement themes predominate
5
achievement motivation
during periods of rapid economic growth. See tors rather than being the result of inheritance.
A also achievement motivation. Also called acquired character.
achievement motivation 1. the desire to per- acquired dyspraxia dyspraxia that is mani-
form well and be successful. In this sense, the fested as the loss of a previously acquired ability
term often is used synonymously with need for to perform coordinated movements. It usually
achievement. 2. the desire to overcome obsta- follows or is associated with brain injury or
cles and master difficult challenges. High scorers stroke. Compare developmental dyspraxia.
in achievement motivation are likely to set acquired immune deficiency syndrome
higher standards and work with greater persever- see aids.
ance than equally gifted low scorers. David
acquisition n. the attainment by an individual
mcclelland found a significant relationship
of new behavior, information, or skills or the
between high achievement motivation and early
process by which this occurs. Although often
independence in childhood; in addition, there is
used interchangeably with learning, acquisi-
a positive correlation between high achievement
tion tends to be defined somewhat more con-
motivation and actual achievement in later life.
cretely as the period during which progressive,
See achievement drive; need for achieve-
measurable increases in response strength are
ment. [first described by U.S. psychologist Henry
seen. —acquire vb.
Alexander Murray (1893–1988)]
acquisitiveness n. the tendency or desire to ac-
achiria n. see acheiria. quire and accumulate objects or possessions.
acid n. slang for lsd. See also hallucinogen. Compare hoarding. —acquisitive adj.
acid flashback the experience reported by acroanesthesia n. an absence of sensitivity in
some users of lsd in which some part of the LSD the extremities.
experience recurs later when the individual has acrocephalosyndactyly n. any of several re-
not been using the drug. lated inherited disorders (all dominant traits)
acid head slang for a user of lsd. that cause abnormalities of the skull, face,
acidosis n. an abnormally high level of acidity hands, and feet. apert’s syndrome, Apert–
(hydrogen ion concentration) in the blood and Crouzon syndrome, and pfeiffer’s syndrome
tissues, which upsets the body’s acid–base bal- (acrocephalosyndactyly Types I, II, and V) are
ance. The condition has numerous causes and due to different mutations in the FGFR2 gene
symptoms vary with each, potentially including (encoding fibroblast growth factor receptor) on
such neurological abnormalities as confusion, chromosome 10. chotzen’s syndrome (Type
fatigue or lethargy, and irritability. Rapid breath- III) is due to a mutation in the TWIST gene on
ing is often seen as well. Compare alkalosis. chromosome 7 (locus 7p21.3–21.2), which af-
—acidotic adj. fects the expression of FGFR2.
acid trip slang for an episode of lsd intoxica- acrocinesis n. excessive motion or movement.
Also called acrocinesia; acrokinesia.
tion.
acroesthesia n. an abnormal sensitivity to stim-
acme n. the highest point of sexual pleasure. Also
uli applied to the extremities.
called summa libido.
acromegaloid-hypertelorism-pectus ca-
acmesthesia n. a form of paresthesia in which rinatum syndrome a congenital condition,
a cutaneous stimulus normally sensed as pain is
believed to be hereditary, marked by short stat-
perceived instead as sharp touch or pressure.
ure, mental retardation, widely set eyes, and
ACOA abbreviation for adult children of al- skeletal anomalies, including an enlarged head
coholics. and a deformed sternum. Only males are known
aconuresis n. involuntary passage of urine. It is to be affected. All show slow psychomotor devel-
a rare synonym of enuresis. opment and IQs estimated in the 20s.
acoria (akoria) n. a form of polyphagia marked acromegaloid personality a personality pat-
by an excessive appetite and a loss of the sensa- tern observed in a large proportion of patients
tion of satiety. See also bulimia nervosa. with acromegaly. The chief features are fre-
quent changes in mood, impulsiveness, temper
acquaintance rape see date rape. outbursts, impatience, and, in advanced cases,
acquiescence n. agreement or acceptance, typi- loss of initiative, egocentricity, and somnolence.
cally without protest or argument. —acquiesce acromegaly n. an abnormal enlargement of the
vb. —acquiescent adj. bones in the hands, feet, face, and skull due
acquired adj. denoting a response, behavior, to excessive secretion of growth hormone by
idea, or information that has been learned or de- the pituitary gland during adulthood. —acro-
veloped on the basis of experience rather than megalic adj.
being innate or inborn. acroparesthesia n. a feeling of numbness,
acquired characteristic a structural or func- tingling, or other abnormal sensation in the ex-
tional characteristic or a psychological feature tremities. Kinds of acroparesthesia include
(e.g., a trait or behavior) of a organism that arises Nothnagel’s acroparesthesia, which is accompa-
from experience or through environmental fac- nied by circulatory disorders, and Schultze’s
6
activation hypothesis
acroparesthesia, marked by peripheral-nerve ir- transmission of a nerve impulse or the contrac-

ritability but without circulatory abnormalities. tion of a muscle. It is marked by a rapid, tran- A
acrophobia n. an excessive, irrational fear of sient depolarization of the cell’s plasma mem-
heights, resulting in the avoidance of elevations brane, from a resting potential of about –70 mV
or marked distress when unable to avoid high (inside negative) to about +30 mV (inside posi-
places. —acrophobic adj. tive), and back again, after a slight hyperpolar-
ization, to the resting potential. Each action
acrotomophilia n. pathological interest in am- potential takes just a few milliseconds. Also
putations. It may be expressed as a paraphilia called action current; spike potential.
in which the person is sexually aroused by peo-
ple whose body parts, typically arms or legs, action readiness a state of preparedness for ac-
have been amputated or by amputation sites in tion that is elicited as part of an emotional re-
the body. Also called acrotophilia; apotem- sponse and associated with such physiological
nophilia. indicators as changes in heart rate, respiratory
rate, and muscle tension. The term is often used
ACT 1. abbreviation for acceptance and com- synonymously with action tendency but also
mitment therapy. 2. abbreviation for atropine- refers to a general readiness for action that does
coma therapy. 3. abbreviation for attention- not involve an urge to carry out a specific behav-
control training. 4. abbreviation for audi- ior.
tory consonant trigram.
action slip any error that involves some kind of
acting in 1. in psychoanalysis, a form of resis- cognitive lapse and results in an unintended ac-
tance in which the patient defends against re- tion, as in putting one’s spectacles in the re-
pressed wishes, memories, or both by using frigerator. Action slips are commonly referred to
actions (e.g., getting up and walking about) to as “absent-minded” mistakes. See absent-
impede the flow of free association. 2. the pa- mindedness.
tient’s reenactment of past relationships in the
transference relationship with the analyst. action tendency an urge to carry out certain
expressive or instrumental behaviors that is
acting out 1. the uncontrolled and inappropri- linked to a specific emotion. For example, the ac-
ate behavioral expression of denied emotions tion tendency of fear involves an urge to escape,
that serves to relieve tension associated with and that of anger involves an urge to attack.
these emotions or to communicate them in a Some theorists argue that the action tendency of
disguised, or indirect, way to others. Such behav- an emotional reaction should be regarded as its
iors may include arguing, fighting, stealing, essential defining characteristic. Compare ac-
threatening, or throwing tantrums. Acting out is tion readiness.
often assumed to underlie antisocial or delin-
quent behavior in children and adolescents. 2. action theory all those theories, collectively,
in psychoanalytic theory, reenactment of past that explain behavior in terms of goal-directed
events as an expression of unconscious emo- human beings acting intentionally with refer-
tional conflicts, feelings, or desires—often sexual ence to the environment and present situation.
or aggressive—with no attempt to understand Action theory was known originally as will psy-
the origin or meaning of these behaviors. chology, founded in Germany by Wilhelm
wundt, who emphasized and distinguished be-
action disorganization syndrome (ADS) a tween motivation and volition of human behav-
cognitive deficit resulting from damage to the ior.
frontal lobes of the brain and causing individ-
uals to make errors on multistepped but familiar Actiq n. a trade name for fentanyl.
or routine tasks. Types of errors include omis- activated sleep see rem sleep.
sions or additions of steps, disordered sequenc- activating event in rational emotive be-
ing of steps, and object substitutions or misuse. havior therapy, an event—current, past, or an-
action interpretation the nonverbal reaction ticipated—that triggers irrational beliefs and
of a therapist to a patient’s behavior or remarks. disruptive emotions.
action-oriented therapy any therapy that activation n. 1. in many theories of memory, an
emphasizes doing and taking action rather than attribute of the representational units that varies
verbal communication or discussion. from weaker to stronger, with more strongly ac-
action painting a form of painting, often used tivated representations competing to control
in art therapy, in which individuals spontane- processing. 2. the process of alerting an organ or
ously create unplanned abstract works using un- body system for action, particularly arousal of
conventional techniques, for example, splashing, one organ or system by another. —activate vb.
dribbling, trickling, or slapping the paint more —activational adj.
or less randomly onto the canvas. When used activation–elaboration a dual-process the-
therapeutically, these productions are reviewed ory of memory holding that concepts stored in
and incorporated into treatment. Also called memory vary in their levels both of activation
tachisme. and elaboration.
action potential (AP) the change in electric activation hypothesis 1. the principle that
potential that propagates along a cell during the numerical weightings on the links or nodes of
7
activation–synthesis hypothesis
cognitive network models can represent their de- tualization of the concept has occurred; this is
A gree of activity or processing. Consciousness is the most advanced level of active concretization.
sometimes attributed to the subset of most [defined by Italian-born U.S. psychiatrist Silvano
highly weighted elements in such models. 2. the Arieti (1914–1982)]
hypothesis that high metabolic activity reflects active coping a stress-management strategy in
activation of brain areas subserving mental which a person directly works to control a
tasks. stressor through appropriately targeted behav-
activation–synthesis hypothesis a hypoth- ior, embracing responsibility for resolving the
esis that explains dreams as a product of cortical situation using one’s available internal re-
interpretation of random activation rising from sources. This type of coping strategy may take
the lower brain structures, including the pons. various forms, including getting answers to
See pgo spikes. [originated by U.S. psychiatrists questions or changing established habits. Active
J. Allan Hobson (1933– ) and Robert W. Mc- coping generally is considered adaptive, having
Carley] been associated with fewer mood disturbances,
activation theory of emotion the theory enhanced self-efficacy, and other favorable
that emotion is measurable as change in the in- consequences. It is similar to the earlier concep-
dividual’s level of neural excitation of the tualization of problem-focused coping but
reticular formation and associated degree of distinguished by its focus upon one’s internal re-
cortical and thalamic alertness, as revealed via sources. Compare passive coping. [identified in
electroencephalography. It was a refine- 1987 by Gregory K. Brown and Perry M. Nicassio
ment of an earlier activation–arousal theory (1947– ), U.S. clinical psychologists]
equating emotion to change in the difficult-to- active deception the process of intentionally
measure level of an individual’s energy expendi- misleading research participants, for example,
ture. Also called arousal theory. by giving them false information about the pur-
active algolagnia arousal of sexual excitement pose of the research or by having them unwit-
by causing pain to another person. See sexual tingly interact with confederates. Also called
sadism. deception by commission. Compare passive
deception.
active analytic psychotherapy the thera-
peutic approach of German psychoanalyst Wil- active euthanasia direct action performed to
helm Stekel (1868–1940) in which the analyst terminate the life of a person (or animal) who is
takes a much more active role than prescribed in suffering greatly and is considered to have no
classical psychoanalysis and gives more at- chance for recovery. Administering a lethal in-
tention to the intrapsychic conflicts in the pa- jection is the most common method of active
tient’s current life than to exploring early euthanasia today. This practice is distinguished
childhood experiences. The therapist intervenes from passive euthanasia, in which treatments
in the process of free association to discuss are withheld but no direct action to terminate
important issues, confronts the patient’s resis- the life is taken. See also assisted death.
tances directly, offers advice and exhortation, active learning 1. learning that occurs through
and helps the patient interpret his or her the actual performance of behavior or acting out
dreams intuitively in the light of current at- of an idea. Also called action learning. 2. the
titudes and problems. Through these methods, active seeking out of new information, rather
and by avoiding many of the Freudian steps than simply being a passive recipient of a learn-
such as analysis of the transference, Stekel ing experience. Active learners set goals, select
sought to shorten the therapeutic process con- strategies, recognize when they understand, and
siderably. Also called active analysis. work with others to further learning.
active avoidance a type of operant condi- active listening a psychotherapeutic tech-
tioning in which an explicit act prevents or nique in which the therapist listens to a client
postpones the delivery of an aversive stimu- closely and attentively, asking questions as
lus, such as when pressing a lever blocks the de- needed, in order to fully understand the content
livery of an electric shock. That is, avoidance is of the message and the depth of the client’s emo-
achieved by an overt action. Compare passive tion. The therapist typically restates what has
avoidance. been said to ensure accurate understanding.
Active listening is particularly associated with
active concretization in schizophrenia, the client-centered therapy.
process of transforming abstract concepts into
concrete representations or forms. For example, active memory a memory that is currently the
an individual with paranoid schizophrenia who focus of consciousness or was recently in aware-
experiences feelings that the whole world is hos- ness, as distinct from the vast body of stored
tile may later become convinced that the neigh- memories that are currently inactive. Activation
bors are trying to harm him or her. If this occurs through retrieval, cuing (see cue), or
individual should then begin to have specific prompting. According to one theory, an item in
perceptual experiences that support this convic- short-term memory is an item from long-term
tion, such as auditory hallucinations of threat- memory that has been activated.
ening remarks made by the neighbors, percep- active negativism see negativism.
8
act psychology
active performance the actual performance understand how their immediate problems
of behavior or acting out an idea, in contrast to (e.g., fears) are affecting their behavior and at- A
mentally rehearsing or imagining the action. titudes. [introduced by 20th-century Russian-
active placebo an agent used in double-blind born U.S. psychotherapist Samuel Richard
controlled trials of pharmacological products Slavson]
that has no therapeutic effect but—unlike a activity–passivity in psychoanalytic theory,
completely inert dummy placebo—may produce polarities characterizing instinctual aims (see
side effects characteristic of the drug under in- aim of the instinct). Sigmund freud asserted
vestigation. Active placebos are therefore consid- that instincts are always active but that their
ered by some to be more likely to reveal true aims can be either active (e.g., sadism and voy-
differences in drug–placebo responding. eurism) or passive (e.g., exhibitionism and
active scopophilia pathological interest in masochism). Freud’s equation of activity with
viewing other people engaged in sexual activity masculinity and passivity with femininity was
or in viewing their genitals. It may be expressed much criticized early on by women analysts, in-
as a paraphilia in which the person is sexually cluding Melanie klein and German-born U.S.
aroused by these actions. See also scopophilia. psychoanalyst Karen Horney (1885–1952), and
active therapy any form of psychotherapy in has been rejected by many theorists, researchers,
which the therapist departs from classic psycho- and therapists since.
analytic practice by assuming an active, directive activity-play therapy a controlled play tech-
role. An active therapist may express opinions, nique in which a child is given a set of dolls and
offer interpretations, make suggestions and rec- other play materials and encouraged to express
ommendations, give advice about the client’s ac- and explore his or her feelings about them—
tions and decisions, issue injunctions and such as sadness, guilt, and hostility—based on
prohibitions, or urge the client to take a particu- the theory that the child will then become less
lar action, such as facing an anxiety-provoking afraid of these emotions and will express them
situation directly. more freely.
activities of daily living (ADLs) activities es- activity theory 1. a school of thought, devel-
sential to an individual’s personal care, such as oped primarily by Soviet psychologists, that fo-
getting into and out of bed and chairs, dressing, cuses on activity in general—rather than the
eating, toileting and bathing, and grooming. A distinct concepts of behavior or mental states—
person’s ability to perform ADLs is often used as as the primary unit of analysis. In this context,
a measure of functional capabilities during the an activity is a nonadditive unit that orients an
course of a disease or following an injury. See organism in the world; it is essentially a system
also instrumental activities of daily living. comprising an operation (a routine behavior re-
activity analysis the objective evaluation of quiring little thought, e.g., typing) that serves to
activity engaged in by an individual over a speci- accomplish an action (a behavior that involves
fied period, usually by breaking it down into planning, e.g., creating a bibliography) in the
smaller components, such as eating, working, minimum meaningful context that provides un-
social activities, resting, and so on. derstanding of the function of the individual in
activity drive an organism’s hypothetical in- interacting with the environment (e.g., prepar-
nate desire or urge to be physically active, often ing a paper for a university course as part of a
expressed as a need to move about, even in the network of students). The theory emphasizes
absence of any apparent stimuli motivating a hierarchical structure of activity, object-
movement, such that activity deprivation may orientedness, internalization and externaliza-
cause distress. tion, mediation (by tools, language, and other
activity-group therapy a form of group cultural artifacts or instruments), and continu-
therapy for children and young adolescents ous development. Also called activity psy-
that emphasizes active participation in games, chology. 2. a theory proposing that old age is
crafts, and other age-appropriate activities and a lively, creative experience characterized by
interplay. Activity-group therapy provides chil- maintaining existing social roles, activities, and
dren with opportunities to express their feelings relationships or replacing any lost ones with
in a permissive, nonthreatening atmosphere. new ones. Compare disengagement theory.
[introduced in the 1930s by 20th-century Rus- activity therapy any type of therapy centered
sian-born U.S. psychotherapist Samuel Richard around various activities, such as arts and crafts,
Slavson] exercise, music, and dramatics groups.
activity-interview group psychotherapy act psychology a philosophical and psycholog-
a form of analytic group psychotherapy for ical approach based on the proposition that the
children in the latency period (i.e., between act and content of psychological processes are
infancy and adolescence). Hobbies and rec- separate functions; for example, the act of seeing
reational activities are used to stimulate com- color leads to a perception of the visual content,
munication and the expression of conflicts or image. Historically, proponents of act psy-
and fantasies. During the process, the therapist chology held that acts (mental representation
asks questions that encourage the children to and transformation, judgment, emotion), rather
9
actualization
than contents, are the proper subject of psychol- are unable to explain specifically how acupunc-
A ogy, in contrast to Wilhelm wundt’s emphasis ture produces its effects but theorize that the
on introspection and conscious contents. Com- needling sites may be related to trigger points in
pare content psychology. See also inten- the gate-control theory of pain or may stim-
tionality. ulate the release of endogenous opioids. The
actualization n. the process of mobilizing one’s technique is highly popular in many Western so-
potentialities and realizing them in concrete cieties and has been deemed appropriate by the
form. According to U.S. psychologist Carl Rog- World Health Organization for use in treating
ers (1902–1987), all humans have an innate ac- more than 40 medical conditions. Compare
tualizing tendency to grow and actualize the self acupressure. See also complementary and
fully. See also self-actualization. —actual- alternative medicine. —acupuncturist n.
ize vb. acupuncture anesthesia the loss of sensa-
actualizing tendency in the humanistic per- tion, often of pain, that results from the in-
sonality theory of Carl rogers, the innate ten- sertion of acupuncture needles into the body
dency of humans to develop and actualize the at specific points. The technique may be used
self fully. See actualization; self-actualiz- alone or in combination with other pain-
ation. management techniques during surgery.
acute adj. 1. denoting conditions or symptoms of
actual neurosis in the classical psychoanalytic
sudden onset, short duration, and often great in-
theory of Sigmund freud, a neurosis that stems
tensity. Compare chronic. 2. sharp, keen, or
from current sexual frustrations (e.g., coitus in-
very sensitive (e.g., acute hearing).
terruptus, otherwise incomplete sexual experi-
ence, or forced abstinence), as contrasted with acute alcoholic hallucinosis the rapid or
one that stems from past experiences or psycho- sudden onset of alcoholic hallucinosis (see al-
logical conflicts. The term, which was applied cohol-induced psychotic disorder), usually
primarily to anxiety neurosis and neurasthe- either during a heavy drinking episode or during
nia, is now rarely used. withdrawal. See also alcohol withdrawal.
actual self in various psychodynamic writings, acute alcoholic myopathy a condition of se-
the real self or true self as it exists at a partic- vere pain, tenderness, and swelling of the mus-
ular point in time, as opposed to an idealized, cles, accompanied by cramps and muscular
grandiose, or otherwise distorted self. weakness, that develops after a period of heavy
drinking. The effects may be general or focused
actuarial prediction prediction based on in one body area. In some cases, muscle fibers
quantified experience and data rather than on may undergo necrosis (death of constituent
more subjective (e.g., clinical) experience. See cells). Recovery may require several weeks to sev-
also actuarial risk assessment. eral months.
actuarial risk assessment a statistically cal- acute alcoholism the unusually rapid onset of
culated prediction of the likelihood that an indi- the symptoms of alcohol dependence.
vidual will pose a threat to others or engage in a
acute anxiety a sudden feeling of dread and ap-
certain behavior (e.g., violence) within a given
prehension accompanied by somatic symptoms
period. Unlike clinical risk assessment, it re-
of tension, usually precipitated by a threatening
lies on data from specific, measurable variables
situation, such as an examination or court hear-
(e.g., age, gender, prior criminal activity) that
ing. The feeling typically subsides as soon as the
have been validated as predictors and uses math-
situation is over. See performance anxiety.
ematical analyses and formulas to calculate the
probability of dangerousness or violent behav- acute anxiety attack see panic attack.
ior. acute brain disorder any pattern of symp-
aculalia n. nonsensical speech associated with toms resulting from temporary, reversible im-
lack of comprehension of written or spoken lan- pairment of brain functioning.
guage, as occurs in wernicke’s aphasia. acute cerebellar ataxia a disorder that occurs
acupressure n. a form of complementary and suddenly, most often in children, following a
alternative medicine in which pressure is ap- viral infection. It is characterized by slurred
plied with the fingers or thumbs to specific speech, muscular incoordination (ataxia), rapid,
points on the body to relieve pain, treat symp- involuntary eye movements (nystagmus), and
toms of disease, or improve overall health. body tremors. Also called acute cerebral
tremor.
acupuncture n. a form of complementary
acute cerebrovascular accident see
and alternative medicine in which fine nee-
cerebrovascular accident.
dles are inserted into the body at specific points
to relieve pain, induce anesthesia (acupunc- acute confusional state severe confusion
ture anesthesia), or treat disease. It is based on that can include symptoms of agitation, mem-
the concept in traditional Chinese medicine that ory disturbance, disorientation, and delirium.
“meridians,” or pathways, conduct life-force en- It often occurs as a result of severe mental or
ergy known as chi between places on the skin physical illness.
and the body’s organ systems. Western scientists acute delirium a disorder of brain function, of
10
adaptive behavior
sudden onset and brief duration, characterized ADAMHA abbreviation for alcohol, drug
by a disturbance in consciousness that ranges abuse and mental health administration. A
from extreme hyperactivity to near coma. Re- adaptability n. 1. the capacity to make appro-
sulting from metabolic disturbance (e.g., high priate responses to changed or changing situa-
fever) or toxic agents (e.g., excessive amounts of tions. 2. the ability to modify or adjust one’s
alcohol), it is marked by illusions, hallucina- behavior in meeting different circumstances or
tions, delusions, excitement, restlessness, and different people. —adaptable adj.
incoherence.
adaptation n. 1. modification to suit different
acute delusional psychosis a diagnostic en- or changing circumstances, as in behavior that
tity specific to French psychiatry, in which it is enables an individual to adjust to the environ-
known as bouffée délirante (French, “delirious ment effectively and function optimally in vari-
outburst”), involving the sudden onset of ous domains, such as coping with daily stressors.
schizophrenic symptoms in response to a stress- Compare maladaptation. 2. adjustments to
ful life event. It is temporary (lasting no longer the demands, restrictions, and mores of society,
than 3 months), has no strong evidence of a including the ability to live and work harmoni-
genetic link, and has a favorable prognosis; ously with others and to engage in satisfying so-
spontaneous resolution of symptoms is not cial interactions and relationships. Also called
uncommon. Acute delusional psychosis is es- social adaptation. 3. in Jean piaget’s theory
sentially equivalent to schizophreniform dis- of cognitive development, the process of ad-
order. See also acute schizophrenic justing one’s cognitive structures to meet envi-
episode. ronmental demands, which involves the com-
acute depression 1. a recent, sudden onset of plementary processes of assimilation, in which
depression. 2. a severe episode of depression, new information is incorporated into already ex-
characterized by many more symptoms than are isting cognitive structures, and accommoda-
necessary to meet the criteria for a major de- tion in which new information that does not fit
pressive episode. into already existing cognitive structures is used
to create new cognitive structures. —adapt vb.
acute hallucinosis the sudden onset of hallu- —adaptational adj. —adaptive adj.
cinations resulting from alcohol or drug intoxi-
adaptational approach a form of psychoana-
cation or withdrawal. The condition usually
lytic psychiatry that avoids the orthodox ana-
remits within hours, though it may persist for a
lytic emphasis on childhood experience and
few days. See substance-induced psychotic
focuses instead on the nature and development
disorder.
of the patient’s maladaptive behavior and the
acute mania the manic phase of bipolar I disor- steps he or she should take to develop new, more
der (see bipolar disorder), characterized by an effective patterns. Also called adaptational
extremely unstable euphoric or irritable mood psychodynamics. [developed by Hungarian-
with hyperactivity, excessively rapid thought born U.S. psychoanalyst Sandor Rado (1890–
and speech, uninhibited and reckless behavior, 1972)]
and flight of ideas. See manic episode.
adaptation syndrome see general adapta-
acute onset a sudden, rapid, or unanticipated tion syndrome.
development of a disease or its symptoms. adapted child one of the child ego states in
acute psychotic episode an appearance of transactional analysis, characterized as
florid (blatant) psychotic symptoms, such as hal- compliant, orderly, and manipulative. Compare
lucinations, delusions, and disorganized speech, natural child.
that is of sudden onset and usually short dura- adaptive act the process whereby an organism
tion. learns to make the appropriate responses that are
acute schizophrenic episode an appearance needed for an adjustment to the environment.
of florid (blatant) schizophrenic symptoms, such adaptive behavior 1. the level of everyday
as disordered thinking and disturbances in emo- performance of tasks that is required for a person
tional responsiveness and behavior, that is of to fulfill typical roles in society, including main-
sudden onset and usually short duration. taining independence and meeting cultural
acute stress disorder (ASD) a disorder repre- expectations regarding personal and social re-
senting the immediate psychological aftermath sponsibility. Specific categories in which adap-
of exposure to a traumatic stressor. Symptoms tive behavior is usually assessed include self-
are the same as those of posttraumatic stress help, mobility, health care, communication,
disorder but do not last longer than 4 weeks. domestic skills, consumer skills, community
This disorder also includes elements of dissocia- use, practical academic skills, and vocational
tion, such as depersonalization and dereal- skills. Limitations in adaptive behavior are
ization. one of the criteria for diagnosis or classifica-
acute tolerance a type of tolerance (physical tion of mental retardation. See also adap-
dependence) that develops rapidly, sometimes tive behavior scale. 2. any behavior that
in response to a single small dose of a particular enables an individual to adjust to the environ-
drug. See also tachyphylaxis. ment appropriately and effectively. It is often
11
adaptive behavior scale
discussed in the context of evolution. See also participating in the activity. See also compul-
A adaptive act; adjustment process. sive exerciser.
adaptive behavior scale 1. any standardized addiction n. a state of psychological or physical
assessment protocol with established psycho- dependence (or both) on the use of alcohol or
metric properties used to document and quan- other drugs. The equivalent term substance de-
tify everyday performance of skills necessary for pendence is preferred to describe this state be-
personal independence and social responsibility, cause it refers more explicitly to the criteria by
consistent with cultural expectations (see adap- which it is diagnosed, which include tolerance,
tive behavior). Examples include the American withdrawal, loss of control, and compulsive use
Association on Intellectual and Developmental of the substance. Chemical substances with sig-
Disabilities’ (formerly American Association on nificant potential for producing dependence are
Mental Retardation’s) Adaptive Behavior Scale called addictive drugs. —addictive adj.
(ABS), Vineland Adaptive Behavior Scales (VABS), addictive alcoholism see gamma alcohol-
and Scales of Independent Behavior (SIB). 2. any ism.
protocol assessing behavioral and social perfor-
addictive drugs drugs or other substances that
mance that is based on developmental norms,
cause substance dependence. They include al-
with domains structured in developmental se-
cohol, amphetamines and amphetamine-like
quence or degree of ascending task complexity
cns stimulants, caffeine, cocaine and crack,
or difficulty. 3. a component of the bayley
hallucinogens, inhalants, nicotine, opi-
scales of infant and toddler development.
oids, pcp (phencyclidine) and phencyclidine-
adaptive hypothesis the view that the func- like substances, and cns depressants.
tion of the primary autonomous ego is to cope addictive personality a hypothetical person-
with an “average expectable environment” ality pattern thought to increase the likelihood a
through perception, memory, affect regulation, person will become dependent on one or more
and motility. This is the view taken by Austrian- substances. Research has not supported this
born U.S. psychoanalyst Heinz Hartmann (1894– view, although it has identified personality traits
1970) in his version of ego psychology. associated with substance abuse, such as
adaptive intelligence the ability to apply impulsivity and neuroticism.
knowledge to novel situations, such as solving Addison’s disease a disorder caused by a mal-
problems and conversing with others, demon- function of the adrenal glands resulting in a defi-
strating an effective ability to interact with, and ciency of adrenal hormones. A major symptom
learn from, the environment. is muscle fatigue with trembling, due in part to
adaptive nonresponding theory a theory an inability to maintain a stable level of blood
that sleep evolved as a means of creating species- sugar for energy. Mental effects include depres-
specific daily periods of inactivity concurrent sion, anxiety, and mood changes. [Thomas Ad-
with periods of greatest threat from predators. dison (1793–1860), British physician]
adaptive process see adjustment process. additive effect the joint effect of two or more
independent variables on a dependent variable
adaptive response see adaptive behavior. equal to the sum of their individual effects: The
adaptive skills activities that require self- value of either independent variable is uncondi-
management, such as controlling impulses, tional upon the value of the other one. Compare
being able to adjust to a new environment, and a interaction effect.
willingness to learn new things. additive scale a scale with all points distributed
adaptive testing a testing technique designed equally so that a meaningful result can be ob-
to adjust to the response characteristics of indi- tained by addition (e.g., a metric ruler).
vidual examinees by presenting items of varying adenosine n. a compound in living cells consist-
difficulty based on the examinee’s responses to ing of an adenine molecule and a ribose sugar
previous items. The process continues until a sta- molecule. Adenosine functions as a neuromodu-
ble estimate of the ability level of the exam- lator: By binding to special adenosine receptors,
inee can be determined. it influences the release of several neurotrans-
ADC abbreviation for aids dementia complex. mitters in the central nervous system. Combined
with three phosphate units, adenosine becomes
ADD abbreviation for attention-deficit disor-
atp (adenosine triphosphate), which functions
der.
as an energy source in metabolic activities.
ADDH abbreviation for attention-deficit disorder ADHD abbreviation for attention-deficit/hy-
with hyperactivity. See attention-deficit/hy-
peractivity disorder.
peractivity disorder.
adherence n. the ability of an individual to con-
addict n. a person who has developed a sub- form to a treatment regimen, especially one in-
stance dependence. volving drug treatment, as outlined by a health
addicted athlete an individual habitually in- care provider. External factors affecting adher-
volved in an athletic activity who will experience may include appropriate education regard-
ence withdrawal symptoms if deprived of ing a drug and its use, the individual’s ability to
12
adjustment reaction
pay for or otherwise obtain the treatment recom- each intervention bringing its own characteristic
mended, and familial or cultural value systems perspectives and methods to bear on the client’s A
influencing the acceptability of the treatment to mental awareness and healing. Adjunctive ther-
the individual. Internal factors include the indi- apy is typically conducted by a different practi-
vidual’s belief in the potency of the treatment, tioner than is the primary intervention, which
the presence or absence of unpleasant side ef- distinguishes it from combination therapy.
fects, and the individual’s capability to under- The term is sometimes used synonymously with
stand or conform to instructions given by the adjuvant therapy. See also collaborative
health care provider. See also nonadherence. care. Compare adjuvant therapy; combina-
Also called compliance. tion therapy.
adience n. a response or behavior that results in adjusted mean in the analysis of covari-
movement toward a stimulus, either by physical ance, the numerical average of a batch of scores
approach or by an action that increases contact on a dependent variable that is obtained after
with the stimulus. Compare abience. —adient the effects of a covariate are removed.
adj. adjustive behavior any response of an organ-
adinazolam n. a benzodiazepine of the ism that effectively incorporates environmental
triazolobenzodiazepine class with antidepres- or situational demands.
sant as well as anxiolytic properties. It currently adjustment n. a change in attitude, behavior, or
is not available in the United States. Italian trade both by an individual on the basis of some recog-
name: Deracyn. nized need or desire to change, particularly to ac-
Adipex n. a trade name for phentermine. count for the current environment or changing,
atypical, or unexpected conditions. It may be as-
adipsia n. an absence of thirst, manifest as a lack sessed via a type of survey called an adjustment
of drinking. Adipsia is associated with lesions of inventory, which compares one’s emotional and
the thirst center in the anterior hypothalamus, social adjustment with a representative sample
but may also be caused by head injury, stroke, or of other individuals. A well-adjusted person is
other conditions. Compare polydipsia. one who satisfies his or her needs in a healthy,
adjective checklist a self-inventory, used in beneficial manner and demonstrates appropri-
personality assessment, consisting of a list of ad- ate social and psychological responses to situa-
jectives (e.g., intelligent, lazy, productive) that tions and demands. —adjust vb.
the respondent checks off as descriptive of or ap- adjustment disorder in DSM–IV–TR, impair-
plicable to him- or herself. ment in social or occupational functioning and
adjudicative competence an umbrella term unexpected severe emotional or behavioral
that encompasses all forms of meaningful partic- symtoms occurring within three months after an
ipation in proceedings of the criminal justice individual experiences a specific identifiable
system, including competency to stand trial, stressful event, such as a divorce, business crisis,
competency to plead guilty, and competency to or family discord. The event is not as stressful as
waive Miranda rights. a traumatic stressor, which can result in post-
adjunct n. 1. a drug that is used concurrently traumatic stress disorder. Symptoms may
with another drug in treating a condition in include anxiety, depression, and conduct distur-
order to provide additional therapeutic effects. It bances and tend to remit following elimination
may have a mechanism of action that differs of the stressors. In chronic adjustment disorder,
from that of the main drug used in treatment. 2. the symptoms last more than six months due to
more generally, a supplementary or nonessential either the persistence or the severity of the
part of something. —adjunctive adj. stressor.
adjunctive therapist 1. in psychotherapy, a adjustment inventory a survey form used to
provider of any secondary adjunctive ther- assess a person’s emotional and social adjust-
apy. 2. in health care, a member of a multidis- ment as compared with a large and representa-
ciplinary treatment team whose functions are tive sample of individuals from the same
ancillary to the main therapeutic program. Such population.
therapists provide direct clinical services to pa- adjustment mechanism a habitual behav-
tients in such areas as improvement of daily liv- ioral pattern that enables the individual to meet
ing skills, behavior management, coordination the demands of life.
of educational activities, and management of lei- adjustment process any means through which
sure time. human beings modify attitudes and behaviors in
adjunctive therapy one or more secondary in- response to environmental demands. Such at-
terventions used concurrently with a primary in- tempts to maintain a balance between needs and
tervention to enhance treatment effectiveness. the circumstances that influence the satisfaction
For example, medication may be used concur- of those needs are influenced by numerous fac-
rently with cognitive behavior therapy, with tors that vary widely across situations and indi-
the latter as the primary form of intervention; viduals and are a frequent subject of research.
group therapy may be used secondarily to in- adjustment reaction a temporary, maladjust-
dividual psychodynamic psychotherapy, with ive psychological response to a situation. Such
13
adjuvant therapy
reactions were subsumed under the category admission procedures the administrative and
A transient situational personality disorder medical procedures of admitting a person as an
in DSM–I, comprising adjustment reactions of inpatient to a health care facility.
infancy, childhood, adolescence, and later life, adolescence n. the period of human develop-
and under transient situational distur- ment that starts with puberty (10–12 years of
bance in DSM–II; the corresponding category for age) and ends with physiological maturity (ap-
these reactions in DSM–III and DSM–IV–TR is ad- proximately 19 years of age), although the exact
justment disorder. age span varies across individuals. During this
adjuvant therapy therapy provided after the period major changes occur at varying rates in
initial (primary) form of treatment to enhance physical characteristics, sexual characteristics,
effectiveness or to increase the chances of a cure. and sexual interest, resulting in significant ef-
Adjuvant therapy typically refers to medical fects on body image, self-concept, and self-
rather than psychotherapeutic treatment, partic- esteem. Major cognitive and social develop-
ularly any drug therapy used in support of ments take place as well: Most young people
nondrug interventions. For example, in the acquire enhanced abilities to think abstractly,
treatment of cancer, chemotherapy and radia- evaluate reality hypothetically, reconsider
tion are often used as adjuvant therapies after prior experiences from altered points of view,
the primary intervention of surgery. The term is assess data from multiple dimensions, reflect
sometimes used in psychotherapy as a synonym inwardly, create complex models of under-
for the preferred adjunctive therapy. standing, and project complicated future sce-
Adler, Alfred (1870–1937) Austrian psychia- narios. Adolescents also increase their peer
trist. Trained at the University of Vienna and refocus and involvement in peer-related activi-
ceiving his MD in 1895, Adler was the first ties, place greater emphasis on social accep-
disciple of Sigmund freud to break away and tance, and seek more independence and
form his own school, known as individual psy- autonomy from parents. —adolescent adj., n.
chology. This was based on the theory that adolescent counseling the provision of pro-
human beings are governed by a conscious drive fessional guidance, advice, and information to
to express and fulfill themselves, as opposed to adolescents through such means as personal in-
Freud’s theory of dominance by early sexual terviews, analysis of case-history data, and the
trauma and blind unconscious instincts. The use of psychological tests.
school revolved around such concepts as the
adolescent crisis the emotional turmoil that
striving for superiority, the inferiority
may occur during adolescence as individuals
complex, compensation and overcompensa-
seek to achieve independence (by casting off old
tion, social interests, and the creative develop-
emotional ties and developing new relation-
ment of an individual style of life that
ships) and adapt to a changed body.
incorporates both personal and social goals. See
also guiding fiction; life goal; life plan; adolescent homosexuality same-sex activity
persuasion therapy; social instinct; social during the pubertal period. It has been estimated
interest; will to power. —Adlerian adj. that at least 20% of boys and 3% of girls have en-
gaged in such activity, resulting in orgasm, be-
Adlerian psychology see individual psy- fore the end of adolescence, and about twice that
chology.
number have had casual or relatively unin-
ADLs abbreviation for activities of daily liv- volved gay or lesbian experiences during adoles-
ing. cence. Many of these experiences, especially for
administration n. 1. the application of a drug boys, actually involve mutual masturbation to
or other agent in the diagnosis or treatment of a heterosexual stimuli and thus do not indicate
disorder. This may be accomplished enterally same-sex eroticism or predict adult gay or les-
(via the digestive tract) or parenterally (via all bian sexual orientation.
other means). The former includes oral and adolescent psychotherapy psychotherapy
sublingual (under the tongue) routes, whereas for adolescents who are experiencing social,
the latter includes subcutaneous, intramuscular, emotional, or behavioral problems.
and intravenous injection; rectal and vaginal adolescent rebellion the rejection by adoles-
suppositories; inhalation; and absorption cents of family values and family control over
through skin or mucous membranes. 2. the giv- their behavior, reflecting their desire for in-
ing of a test for the purpose of obtaining infor- creased independence.
mation.
adoption n. the legal process by which an infant
admission n. the act of registering an individual or child is permanently placed with a family
for treatment or observation in a health care fa- other than his or her birth family. An adoption
cility. See first admission; readmission; vol- may be private, in which a birth parent volun-
untary admission. —admit vb. tarily plans for the placement of the child with
admission certification an aspect of utiliza- adoptive parents through intermediaries, or
tion review in which the medical necessity of a public, in which a child removed from his or her
patient’s admission to a health care facility is de- birth parent(s) because of neglect or abuse is
termined. placed with adoptive parents through public
14
Adult Children of Alcoholics
child welfare agencies. Adoptions may also be pletely inhibits the binding of the neurotrans-
closed, allowing no contact between the birth mitters norepinephrine or epinephrine to ad- A
and adoptive parents, or open, permitting vary- renergic receptors and thus blocks or disrupts
ing degrees of pre- and postplacement contact the action of these neurotransmitters. Such
and making possible a relationship between all blocking agents are classed according to which
three parties. of the two types of receptors they inhibit bind-
adoption study a research design that investi- ing to: alpha blockers, used primarily to widen
gates the relationships among genetic and envi- blood vessels in the treatment of hypertension,
ronmental factors in the development of or beta blockers, used to treat hypertension as
personality, behavior, or disorder by comparing well but by reducing the rate and force of heart
the similarities of biological parent–child pairs contractions, arrhythmia, tremor, and anxiety-
with those of adoptive parent–child pairs. related symptoms. Also called adrenoceptor
blocking agent; adrenoreceptor blocking
ADR abbreviation for adverse drug reaction. agent.
adrenal androgen any of the androgenic hor-
adrenergic drug see sympathomimetic drug.
mones (chiefly dehydroepiandrosterone and
androstenedione) secreted by the adrenal cor- adrenergic receptor a molecule in a cell mem-
tex. See adrenarche; androgen. brane that specifically binds and responds to
adrenal cortex the outer layer of the adre- norepinephrine and, to a lesser extent, epineph-
nal gland. It secretes a number of hormones, rine, which act as neurotransmitters in the sym-
including adrenal androgens, glucocorti- pathetic nervous system. There are two types:
coids, and mineralocorticoids. Adrenal alpha-adrenergic receptors (or alpha recep-
cortical functions are controlled by cortico- tors) and beta-adrenergic receptors (or beta
tropin, secreted by the anterior pituitary receptors). Also called adrenoceptor; adreno-
gland. receptor.
adrenal cortical hyperfunction the exces- adrenoleukodystrophy n. a genetic disease
sive production of one or more of the hormones characterized by destruction of the myelin
of the adrenal cortex. The manifestations vary sheath surrounding the nerves of the brain (i.e.,
with the hormone but potentially include demyelination) and progressive dysfunction of
(among others) hypertension, sudden weight the adrenal gland. Nerve function becomes er-
gain, torso obesity, and low blood levels of po- ratic, resulting in a variety of physiological and
tassium. Causes may include a tumor or congen- behavioral symptoms involving changes in body
ital adrenal hyperplasia, a disorder marked by tone, motor movements, gait, speech, ability to
increased adrenal production of cortisol precur- eat, vision, hearing, memory, attention, and
sors and androgens. cognitive processes. There are several types of
adrenoleukodystrophy, of which the childhood
adrenal gland an endocrine gland adjacent
X-chromosome-linked form is the most com-
to the kidney. Its outer layer, the adrenal cortex,
mon and the most severe.
secretes a number of hormones, including an-
drogens, glucocorticoids, and mineralo- adult n. 1. a person who has reached adult-
corticoids. Its inner core, the adrenal medulla, hood. 2. a person who has reached the legal age
secretes the hormones epinephrine and nor- of maturity. Although it may vary across juris-
epinephrine, both of which are catechol- dictions, an individual 18 years of age is typically
amines and also serve as neurotransmitters. Also considered an adult.
called suprarenal gland.
Adult Attachment Interview (AAI) an hour-
adrenaline n. see epinephrine. long interview used for classifying a person’s
adrenarche n. the stage of prepubertal develop- subjective evaluation of his or her own attach-
ment marked by the start of androgen secretion ment experiences with his or her parents, espe-
by the adrenal cortex. Normally, it occurs be- cially centering on hurtful experiences, separa-
tween 6 to 8 years of age and does not result tions, and discipline. The categories of adult
in androgenization. Premature adrenarche, attachment that emerge are dismissing (inter-
characterized by pubertal levels of adrenal an- viewees idealize their early relationships but can-
drogens, is manifested by the early appearance not provide specific supporting examples);
of pubic hair. It may be associated with psycho- preoccupied (interviewees describe their early
logical disturbances. By parent report on the di- parental relationships as overly involving and
agnostic interview schedule for Children, angry); and secure or autonomous (interview-
44% of the children with premature adrenarche ees provide objective, coherent accounts of rela-
met the diagnostic criteria for psychological tionships). A fourth category, unresolved or dis-
disorders, primarily anxiety disorders. The con- organized, is used for individuals who have
dition is also associated with self-reported de- experienced loss of attachment figures and who
pression and parent-reported behavior problems show lapses in reasoning when discussing such.
and low scores on various intelligence tests. Adult Children of Alcoholics (ACOA) a
adrenergic blocking agent any pharma- twelve-step program for adults who were
cological substance that either partially or com- raised in a family environment where alcohol-
15
adult day care
ism or other family dysfunctions were present. term sometimes is used synonymously with side
A See also self-help group. effect, but an adverse drug reaction more prop-
adult day care a group program for the nonres- erly denotes an unexpected negative occurrence,
idential care and supervision of adults with func- whereas side effects may be positive or negative
tional impairments, designed to meet their and are usually anticipated. Also called adverse
health, social, and functional needs in a setting drug event (ADE); adverse event; adverse
other than their homes. See day care center. reaction.
adult foster care the provision of community- adverse event 1. in health care, an injury or
based living arrangements to adults who require harmful effect resulting from medical interven-
supervision, personal care, or other services in tion or research. 2. in pharmacology, see ad-
daily living on a 24-hour basis. Host families verse drug reaction.
open their own homes to, and act as caregivers advice giving a counseling technique in
for, such adults who are unable safely to live in- which the therapist advises the client on alterna-
dependently, which is what distinguishes adult tives or options for consideration.
foster homes from other residential care facil- advocacy n. speaking or acting on behalf of an
ities. individual or group to uphold their rights or ex-
adult home an assisted-living residence that plain their point of view. For example, health
provides shared rooms, common meals, per- care advocates represent consumers to protect
sonal care services, activities, and protective their rights to effective treatment, while thera-
oversight to adults who are unable to live inde- pists may act as advocates for clients in court
pendently. Intensive medical or nursing services hearings or other situations involving decisions
are generally not available. based on the clients’ mental health or related is-
adulthood n. the period of human development sues.
in which full physical growth and maturity have advocate n. an individual who represents and
been achieved and certain biological, cognitive, defends the interests of another individual or of
social, personality, and other changes associated a group or cause. In health care, advocates repre-
with the aging process occur. Beginning after ad- sent consumers to protect their rights to effec-
olescence, adulthood is sometimes divided into tive treatment. There are two general types of
young adulthood (roughly 20 to 35 years of age); such advocates: A case advocate represents a sin-
middle adulthood (about 36 to 64 years); and gle individual, and a class advocate represents a
later adulthood (age 65 and beyond). The last whole group. See ombudsman. See also child
is sometimes subdivided into young-old (65 to advocacy.
74), old-old (75 to 84), and oldest old (85 and aerobic exercise physical activity, typically
beyond). The oldest old group is the fastest grow- prolonged and of moderate intensity (e.g., jog-
ing segment of the population in many devel- ging or cycling), that involves the use of oxygen
oped countries. in the muscles to provide the needed energy.
adultomorphism n. 1. the attribution of adult Aerobic exercise strengthens the cardiovascular
traits or motives to children. Also called en- and respiratory systems and is associated with a
elicomorphism. Compare pedomorphism. 2. variety of health benefits including increased en-
more specifically, the tendency to reconstruct durance, reduction of body fat, and decreased
developmental phases by extrapolating from depression and anxiety. Compare anaerobic
adult psychopathology. —adultomorphic adj. exercise.
advance directive a legal mechanism for indi- affect n. any feeling or emotion, which may be
viduals to specify their wishes and instructions irreflexive or reflexive. Irreflexive affect is the di-
about prospective health care in the event they rect experience in consciousness of a particular
later become unable to make such decisions. emotional state (as in a person’s feeling of ela-
This can be achieved by means of a durable tion upon receiving good news). Reflexive affect
power of attorney, a legal document designating occurs when a person makes his or her feelings
someone to make health care decisions on that objects of scrutiny (as when a person wonders
person’s behalf, or a living will, a legal document why he or she does not feel particularly elated
clarifying a person’s wishes regarding future upon receiving good news). A distinction may
medical or, increasingly, mental health treat- also be made between negative affect and
ment. positive affect. Along with cognition and co-
advantage by illness see secondary gain. nation, affect is one of the three traditionally
identified components of mind.
adverse drug reaction (ADR) any unin-
tended, harmful, and potentially fatal response affect-block n. a condition marked by an in-
to a drug. Reactions may be genetically deter- ability to adequately express or experience emo-
mined (as in the case of hypersensitivity), in tions, especially strong ones, because of a
which case they are highly individual and can be dissociation of these emotions from ideas or
difficult to predict, or they may arise through thoughts. It is characteristically seen in individu-
interactions with other prescribed or non- als with schizophrenia or obsessive-compulsive
prescribed drugs or with dietary items (as in the disorder.
case of monoamine oxidase inhibitors). This affect display a facial, vocal, or gestural behav-
16
affect regulation
ior that serves as an indicator of affect. See personal interactions, as may occur in group
emotional expression. therapy or in a family. A
affect hunger a craving for affection and lov- affective logic the hypothesis that emotions
ing care. have their own independent set of mental opera-
affect intensity the tendency to experience tions, distinct from those governing other forms
emotional states very strongly, irrespective of of mental life. [proposed by French psychologist
the nature (e.g., positive versus negative) of Théodule A. Ribot (1839–1916)]
those states. affective meaning the attitude or emotion
affect inversion see reversal of affect. elicited by a stimulus, such as a musical piece, a
drawing, or—especially—a word or phrase.
affection n. fondness, tenderness, and liking, es-
pecially when nonsexual. Feelings of emotional affective neuroscience a discipline that ad-
attachment between individuals, particularly dresses the brain mechanisms underlying emo-
human infants and their caregivers, are called tions. In seeking to understand the particular
affectional bonds. They are particularly impor- roles of major subcortical and cortical structures
tant to attachment theory, and their presence in the elicitation, experience, and regulation of
is evidenced by proximity-seeking behaviors and emotion, affective neuroscience provides an im-
distress if loss or involuntary separation occurs. portant framework for understanding the neural
—affectionate adj. processes that underlie psychopathology, partic-
ularly the mood and substance-related disorders.
affective adj. demonstrating, capable of produc-
ing, or otherwise pertaining to emotion or feel- affective psychosis originally, a mood alter-
ings. —affectivity n. ation so profound as to impair one’s capacity to
interact with the environment appropriately
affective amnesia see functional amnesia. and effectively. In essence, it was a synonym for
affective assessment evaluation of an individ- affective disorder, which itself is now a synonym
ual’s emotional or psychological state and de- for mood disorder. In contemporary usage the
gree of emotional intensity. term refers to a mood disorder accompanied by
affective–cognitive structure the combina- delusions or hallucinations (i.e., psychotic fea-
tion of an emotional experience with a thought tures). The mood disruption precedes the psy-
or image, such as the linking of the emotions of chotic symptoms, and the psychotic symptoms
relief and fear reduction to the idea of a parent as only occur during a major depressive episode
a haven of safety. or a manic episode.
affective development see emotional de- affective rigidity a condition in which emo-
velopment. tions or feelings remain unchanged through
varying situations in which such changes would
affective discharge the expression of strong normally occur. Affective rigidity is common in
emotions (e.g., sorrow or anger) by clients un- obsessive-compulsive disorder and schizophre-
dergoing therapy in which the therapist uses nia.
techniques aimed at facilitating deeper explora-
tion of past experiences. Affective discharge is affective state any type of emotional state. The
believed to be a release of psychic energy. Also term is often used in situations where emotions
called cathectic discharge. dominate the person’s awareness.
affective disorder see mood disorder. affective theory a framework underlying cer-
tain approaches to psychotherapy that empha-
affective education any program in which sizes the importance of feelings and emotions in
learning is focused on or derived from emotion therapeutic change.
rather than reason, for example, a curriculum
designed to enhance students’ emotional and so- affective tone the mood or feeling associated
cial growth and encourage positive behavior with a particular experience or stimulus. In psy-
change. The concept is gaining popularity as a chotherapy, when a client fails to recognize his
means of reducing conflict and aggression in or her affective tone, the therapist may draw the
schools. client’s attention to it as a primary element of
the therapeutic interaction. Also called feeling
affective experience any emotionally charged tone.
experience.
affectivity n. the degree of a person’s response
affective forecasting predicting one’s own or susceptibility to pleasure, pain, and other emo-
future emotional states, especially in connection tional stimuli. Evaluation of affectivity is an im-
with some event or outcome that one faces. Peo- portant component of a psychological examina-
ple often “forecast” more extreme and lasting tion; the therapist or clinician may look for
emotional reactions to events than they actually evidence of such reactions as blunted affect,
experience. inappropriate affect, loss of affect, ambiv-
affective hallucination a hallucination that alence, depersonalization, elation, depres-
occurs in the context of affective psychosis sion, or anxiety.
and has a manic or depressive content. affect regulation the attempt to alter or pro-
affective interaction highly emotional inter- long one’s mood or emotional state. Trying to
17
affect scale
get out of a bad mood is the most common ex- vided for convalescent patients, such as those
A ample. Because people cannot usually change who are recovering from surgery. 2. a form of
their emotions simply by deciding to feel differ- day care, as in programs designed to care for chil-
ently, they use many indirect strategies for affect dren after school. See child care.
regulation. afterplay n. affectionate and sensual activity
affect scale any of several psychometric mea- (e.g., hugging, caressing, kissing) that continues
sures for quantifying the intensity of the subjec- after orgasm is achieved in sexual activity.
tive aspects of emotion. An example is the beck age-appropriate maturity the ability to deal
depression inventory. effectively and resiliently with experience and to
affiliation n. a social relationship with one or perform satisfactorily in developmental tasks
more other individuals, usually based on liking (biological, social, cognitive) characteristic of
or a personal attachment rather than on per- one’s age level.
ceived material benefits. Affiliation appears to be age-associated memory impairment
a basic source of emotional security, given the (AAMI) the minor memory deficits often associ-
anxiety, frustration, and loneliness stemming ated with normal aging, for example, forgetting
from the absence of such relationships. Some the name of a recently read book. These changes
propose that the seeking of cooperative, friendly are not associated with dementias, such as Alz-
association with others who resemble or like one heimer’s disease, and affect the ability to acquire
or whom one likes is a fundamental human de- and recall new information rather than the recall
sire, referring to it variously as the affiliative of established memories (e.g., the name of one’s
drive or affiliative need. —affiliative adj. hometown). Also called benign senescence;
affiliative behavior any action that is carried benign senescent forgetfulness.
out with the aim of maintaining or enhancing age-equivalent scale a system of expressing
one’s personal relationship with one or more test scores in terms of age norms or averages.
other individuals or that is associated more gen-
agency n. the state of being active, usually in the
erally with the urge to form, maintain, or en-
service of a goal, or of having the power and ca-
hance personal attachments. See affiliation.
pability to produce an effect or exert influence.
affinity n. 1. an inherent attraction to or liking
agenesis n. the failure of a body part to develop
for a particular person, place, or thing, often
fully or to develop at all. An example is callosal
based on some commonality. 2. relationship by
agenesis (or corpus callosum agenesis), in which
marriage or adoption rather than blood. 3. in
the nerve tract joining the two cerebral hemi-
pharmacology, the tendency of a particular neu-
spheres (see corpus callosum) fails to develop.
rotransmitter or drug to bind to a particular re-
—agenetic adj.
ceptor.
age norm the standard score or range of scores
affirmative defense a defense in which the
that represent the average achievement level of
defendant admits committing the act with
people of a particular chronological age.
which he or she is charged but provides evidence
that undermines the prosecution’s or plaintiff’s agent n. 1. a person or entity that acts or has the
claim of criminal intent. The insanity defense, capacity to act. 2. a person who acts on behalf
diminished responsibility, contributory negli- of another or of a group. 3. in psychotherapy,
gence (the defendant’s claim that the plaintiff a therapist who helps a client gain self-under-
acted carelessly or with disregard and was par- standing. 4. in group therapy, the therapist or
tially at fault), and self-defense are examples of any individual client who helps another client.
affirmative defenses. 5. a means by which something is done or
caused. For example, an infectious agent is a bac-
affirmative therapy a socioculturally in-
terium or other microorganism that causes a par-
formed intervention that empowers clients and
ticular disease. —agentive adj.
their communities, particularly in situations
in which ethnic, gender, or sexual orientation agentic orientation an emphasis on achiev-
diversity has been resisted or in which normal ing, doing, succeeding, and making one’s own
conditions (e.g., gay identity) have been pa- mark in the world, which may be expressed
thologized. Emphasizing self- and cultural aware- through such traits as competitiveness and self-
ness, this therapy may be practiced as a distinct focus.
intervention or within the context of other age of consent the age at which an individual is
psychotherapies. considered legally competent to assent to some-
African trypanosomiasis see sleeping sick- thing, especially sexual intercourse or marriage.
ness. age of onset the chronological age at which
aftercare n. 1. a program of outpatient treat- symptoms of a disease or disorder first appear in
ment and support services provided for individ- an individual. One of the hallmarks of some ge-
uals discharged from an institution, such as a netic syndromes is that the age of onset is earlier
hospital or mental health facility, to help main- in individuals with hereditary susceptibility
tain improvement, prevent relapse, and aid ad- than in sporadic cases.
justment of the individual to the community. age regression a hypnotic technique in which
Aftercare may also refer to inpatient services pro- the therapist helps the client recall a crucial ex-
18
agnus castus
perience by inducing amnesia for the present, aggressive erotic containing both violent and
then suggesting that he or she return, year by sexual elements. It may describe a type of por- A
year, to the earlier date when a particular experi- nography or behavior (e.g., rape).
ence took place. This technique is also used in fo- aggressive instinct in psychoanalytic theory,
rensic contexts to help eyewitnesses and victims a derivative of the death instinct that directs
recall their experiences. The use of age regression destructive impulses away from the self and to-
in either context is controversial, given the po- ward the outside world.
tential for false memories and the debatable le-
gitimacy of recovered memories. aggressiveness n. a tendency toward social
dominance, threatening behavior, and hostility.
aggravating factor a fact relating to a crime or It may cause a transient change in behavior
to the defendant that makes the offense more se- within an individual or be a characteristic trait of
rious or supports the argument for a harsher sen- an individual. —aggressive adj.
tence. An example of an aggravating factor is the
use of a deadly weapon in the commission of a aggressive script a script based on anger, hos-
crime. Also called aggravating circumstance. tility, and overcompetitiveness that becomes
Compare mitigating factor. stored in the memory of some individuals and
guides their judgments and behavior. It is
aggregate score a combination of two or more thought that such scripts are acquired from early
scores on variables that are related to one an- family experiences, association with aggressive
other conceptually or empirically. peers, and exposure to media violence.
aggregation problems the difficulty of sepa- aging n. the biological and psychological
rating individual effects from situational effects changes associated with chronological age. A
when established groups or institutions are used distinction is often made between changes that
as the unit of analysis in an evaluation. For ex- are due to normal biological processes (see pri-
ample, investigators are likely to attribute char- mary aging) and changes that are caused by
acteristics of the institution to the individual. age-related pathologies (see secondary aging).
aggression n. behavior that harms others physi- aging disorder any disruption of the gradual
cally or psychologically or destroys property. It structural and immune changes that occur with
can be distinguished from anger in that anger is the passage of time, leading to increased proba-
oriented at overcoming the target but not neces- bility of early death. An example is progeria (or
sarily through harm or destruction. When such Hutchinson–Gilford syndrome), a very rare in-
behavior is purposively performed with the pri- herited disorder in which children age extremely
mary goal of intentional injury or destruction it rapidly and typically die of a heart attack or
is termed hostile aggression. Other types of ag- stroke between the ages of 10 and 15 years. A
gression are less deliberately damaging and more common example is Alzheimer’s disease.
may be instrumentally motivated (proactive) or
agitated depression a major depressive epi-
affectively motivated (reactive). Instrumental ag-
sode in which psychomotor agitation (excessive
gression involves an action carried out princi-
but purposeless activity), restlessness, and irrita-
pally to achieve another goal, such as acquiring a
bility predominate.
desired resource. Affective aggression involves
an emotional response to an aversive state of agitation n. a state of increased but typically
affairs, which tends to be targeted toward the purposeless and repetitious activity, as in
perceived source of the distress but may be dis- psychomotor agitation.
placed onto other people or objects if the dis- agitophasia n. very rapid and cluttered speech
turbing agent cannot be attacked (see displaced in which sounds, words, or parts of words are
aggression). In the classical psychoanalytic the- omitted or distorted. Also called agitolalia.
ory of Sigmund freud, the aggressive impulse is agnosia n. loss or impairment of the ability to
innate and derived from the death instinct, recognize or appreciate the nature of sensory
but most nonpsychoanalytically oriented psy- stimuli due to brain damage or disorder. Recog-
chologists view it as socially learned or as a reac- nition impairment is profound and specific to a
tion to frustration (see frustration–aggression particular sensory modality. auditory agnosia,
hypothesis). —aggressive adj. tactile agnosia, and visual agnosia are the
aggressive character a personality character- most common types, and each has a variety of
ized by a hostile or competitive attitude to others subtypes.
and the pursuit of power, prestige, and material agnus castus an herbal preparation derived
possessions. German-born U.S. psychoanalyst from the flowers of the chasteberry tree and ap-
Karen D. Horney (1885–1952) defined the devel- proved by Commission E of the German Federal
opment of such a character as one of three basic Institute for Drugs and Medical Devices for use
neurotic trends used as a defense against in the management of symptoms associated
basic anxiety. Compare compliant charac- with the late luteal phase of the menstrual cycle
ter; detached character. (see premenstrual dysphoric disorder) and
aggressive cue a signal or stimulus in a person’s in the alleviation of menstrual cycle abnormali-
environment that is interpreted as aggressive or ties or irregularities. Also called vitex agnus
that is typically associated with aggression. castus.
19
agonist
agonist n. a drug or other chemical agent that handwriting. Agraphia generally is seen in apha-
A binds to a particular receptor and produces a sia, although there is considerable variability of
physiological effect, typically one similar to that writing ability within a given aphasia type. Also
of the body’s own neurotransmitter at that recalled dysgraphia. —agraphic adj.
ceptor. There are partial agonists, which stim- agreeableness n. the tendency to act in a coop-
ulate the receptor only somewhat to produce the erative, unselfish manner, construed as one end
same physiological effect as the natural neuro- of a dimension of individual differences (agree-
transmitter but to a lesser degree, and inverse ableness versus disagreeableness) in the big five
agonists, which act at the receptor to produce a personality model. It is also a dimension in
physiological effect opposite to that produced by the five-factor personality model. —agree-
another agonist at that same receptor. Compare able adj.
antagonist. —agonism n. —agonistic adj. agrypnia n. see insomnia.
agonist–antagonist a substance that simulta- aha experience the emotional reaction that
neously binds to multiple receptors, mimicking typically occurs at a moment of sudden insight
the action of the body’s natural neurotransmit- into a problem or other puzzling issue. For exam-
ter at one type of receptor and inhibiting that ac- ple, in psychotherapy it is a client’s sudden in-
tion at another, different type of receptor. sight into his or her motives for cognitions,
agoraphobia n. an excessive, irrational fear of affects, or behaviors. Also called aha reaction.
being in open or unfamiliar places, resulting in ahedonia n. see anhedonia.
the avoidance of public situations from which ahistoric therapy a therapeutic approach that
escape may be difficult, such as standing in line focuses on here-and-now situations and behav-
or being in a crowd. Agoraphobia may accom- iors. This approach is distinguished from ap-
pany panic disorder (panic disorder with ago- proaches that place a strong emphasis on earlier
raphobia), in which an individual experiences events and circumstances.
unexpected panic attacks, or it may occur in the
AHP abbreviation for allied health profes-
absence of panic disorder (agoraphobia without
sional.
history of panic disorder), when an individual
fears paniclike symptoms or limited symptom ahypnia n. see insomnia.
attacks but has not experienced full-blown panic ahypnosia n. see insomnia.
attacks. See also anxiety disorder. —agora- AI abbreviation for artificial insemination.
phobic adj.
aided recall the process of remembering some-
agrammatism n. a manifestation of aphasia thing under circumstances where a prompt is
characterized by loss or impairment of the abil- given to assist recall. Aided recall is used, for ex-
ity to use speech that conforms to grammatical ample, to assist an eyewitness or victim of a
rules, such as those governing word order, verb crime to retrieve memories relevant to the event.
tense, and subject–verb agreement. It is distinct AIDS acquired immune deficiency syndrome: a
from syntactic aphasia, which is a more specific clinical condition in which the immune system
manifestation involving loss or impairment only is so severely damaged from infection with
of the ability to adhere to rules governing syn- human immunodeficiency virus (see hiv) as to
tax, that is, to correctly combine or sequence result in certain serious opportunistic infections
words in sentences. Also called dysgram- and diseases.
matism.
AIDS counseling counseling in which guid-
agranulocytosis n. a decline in the number of ance, advice, and information are provided to
certain white blood cells (neutrophils), typically individuals on issues related to HIV infection
as a result of an immune reaction to a drug or and AIDS. Such counseling typically covers ways
other chemical or the toxic effect of this sub- to avoid exposure to HIV infection, provision of
stance on the bone marrow, causing production HIV antibody testing, and the importance of ad-
of white blood cells to fall. Agranulocytosis is di- hering to medication, as well as dealing with the
agnosed when the neutrophil count is below myriad psychological and social issues associ-
3
200/mm or when the total white-blood-cell ated with AIDS, including stigma, the anxiety in
3
count is below 500/mm . The condition results dealing with a life-threatening illness, and the
in suppression of the immune response, render- nature of friendships and other support systems.
ing individuals vulnerable to opportunistic in- Also called HIV/AIDS counseling.
fections. Psychotropic drugs, such as clozapine AIDS dementia complex (ADC) neuropsy-
and phenothiazine antipsychotics, can induce chological dysfunction directly attributable to
agranulocytosis. hiv infection, found most commonly in those
agraphia n. loss or impairment of the ability to who have developed AIDS. It is marked by im-
write as a result of neurological damage or disor- pairment in four areas: (a) cognition (e.g., mem-
der. The specific forms of writing difficulties vary ory loss, inability to concentrate); (b) behavior
considerably, but may include problems with (e.g., inability to perform normal activities of
such things as spelling irregular or ambiguous daily living); (c) motor coordination (e.g., un-
words, writing numbers or particular letters, or steady gait, loss of balance, incontinence); and
performing the motor movements needed for (d) mood (e.g., severe depression, psychosis).
20
alcohol derivatives
Brain scans of affected individuals reveal cortical alcoholics anonymous and includes Alateen
atrophy. Also called HIV dementia. for younger individuals. Al-Anon members share A
aim n. 1. the symbolic or internal representation their experiences with and offer support to one
of a goal that may motivate and direct behavior another in order to promote personal recovery
toward achieving that goal: an intention or pur- and growth.
pose. 2. a goal toward which an organism volun- alarm reaction see general adaptation syn-
tarily directs behavior, effort, or activity: an drome.
objective. 3. in psychoanalytic theory, see aim alcohol n. 1. ethanol (ethyl alcohol). 2. any
of the instinct; object of instinct. other member of the class of chemical com-
aim-inhibited adj. in psychoanalytic theory, pounds to which ethanol belongs.
describing a behavior—particularly an interper- Alcohol, Drug Abuse and Mental Health
sonal behavior—in which the underlying drives Administration (ADAMHA) an agency in
are deflected from their original object and re- the U.S. Department of Health and Human Ser-
main unconscious. According to the theory, aim vices that was replaced in 1992 by the sub-
inhibition characterizes those situations in stance abuse and mental health services
which an instinct fails to achieve direct satis- administration (SAMHSA). In this reorganiza-
faction of its aim but obtains reduced gratification, the three ADAMHA research institutes, the
tion through activities or relationships similar to National Institute on Alcohol Abuse and Alco-
the original aim. Sigmund freud used this idea holism (NIAAA), the National Institute on Drug
to explain affectional relationships within fami- Abuse (NIDA), and the national institute of
lies and platonic friendships as deriving from an mental health (NIMH), were moved to the Na-
aim-inhibited sexual instinct. tional Institutes of Health. The substance abuse
aim of the instinct in psychoanalytic theory, and mental health services programs provided
the activity through which an instinct is grati- by ADAMHA remain the responsibility of
fied, resulting in the release of internal tension. SAMHSA.
For example, kissing may satisfy the oral in- alcohol abuse a pattern of alcohol consump-
stinct. Also called instinctual aim. See also re- tion that persists despite recurrent significant
versal of affect. adverse consequences resulting directly from
akathisia (acathisia) n. extreme restlessness alcohol use, including neglect of important per-
characterized by an inability to sit or stand still sonal, financial, social, occupational, or recrea-
for at least several minutes and by fidgety move- tional activities; absenteeism from work or school;
ments or jitteriness, as well as a subjective re- repeated encounters with the police; and the use
port of inner restlessness. It occurs as an of alcohol in situations in which drinking is haz-
extrapyramidal symptom resulting from ex- ardous (e.g., driving while intoxicated). It is dis-
posure to a neuroleptic (antipsychotic) medica- tinct from alcohol dependence in that it does
tion (neuroleptic-induced acute akathisia) or in not involve tolerance or withdrawal.
response to ssri antidepressant medications alcohol addiction see addiction; alcohol
(medication-induced movement disorder not dependence.
otherwise specified). Akathisia is also a feature alcohol-amnestic disorder the DSM–III des-
of some neurological and general medical con- ignation for the condition classified in DSM–IV–
ditions (e.g., Parkinson’s disease and iron- TR as alcohol-induced persisting amnestic
deficiency anemia). disorder.
akinesia algera a condition in which pain is alcohol dependence a pattern of repeated or
experienced with any body movement, a disor- compulsive use of alcohol despite significant be-
der often associated with psychogenic factors. havioral, physiological, and psychosocial prob-
akinetic adj. characterized by loss of voluntary lems, including indications of physical and
movement not due to paralysis. psychological dependence—tolerance and char-
akinetic mutism an absence or gross reduction acteristic withdrawal symptoms if use is sus-
of voluntary movements and speech, although pended—resulting in impaired control. It is
the individual does follow eye movements. The further differentiated from alcohol abuse by the
condition is associated with damage to the ante- preoccupation with obtaining alcohol or recov-
rior cingulate gyrus and supplementary motor ering from its effects, and the overwhelming de-
area in the mesial part of the frontal lobes. sire for experiencing alcohol’s intoxicating
result (i.e., craving). Alcohol dependence is
Akineton n. a trade name for biperiden. known popularly as alcoholism.
alalia n. partial or total inability to speak. Al- alcohol derivatives drugs that use the sedative
though mostly historical now, the term is occa- and hypnotic effects of alcohols for therapeutic
sionally used as a synonym for mutism. purposes. In the 1890s, it was found that com-
Al-Anon n. an international self-help organiza- pounds derived from methyl alcohol had cns
tion for people who have been affected by the depressant effects. In the 1950s, a new genera-
compulsive use of alcohol by a family member or tion of alcohol-based compounds with greater
friend. Founded in the United States in 1951, it hypnotic activity was introduced. They included
uses the twelve-step program adapted from ethchlorvynol and ethinamate; the latter is a
21
alcohol hallucinosis
more potent sleep inducer than ethchlorvynol, behavioral change associated with consumption
A but its abuse potential is similar to that of barbi- of an amount of alcohol usually insufficient to
turates. Due to their toxicity, alcohol derivatives intoxicate most people. The idiosyncratic behav-
are rarely used in modern clinical practice. ior is atypical of the individual when he or she is
alcohol hallucinosis see alcohol-induced not drinking: for example, a quiet, shy person
psychotic disorder. may become belligerent and assaultive. Al-
though this diagnosis was removed from DSM–
alcoholic n. a person who meets the DSM–IV–TR
IV because of its rarity, controversy over the de-
criteria for alcohol dependence.
cision to remove it remains.
alcoholic blackout see blackout.
alcohol-induced persisting amnestic dis-
alcoholic brain syndrome any of several order a disturbance in memory caused by the
syndromes associated with the acute or chronic persisting effects of alcohol. The ability to learn
effects of alcohol on brain function, including new information or to recall previously learned
alcohol intoxication delirium, alcohol information is impaired severely enough to in-
withdrawal delirium, alcohol-induced terfere markedly with social or occupational
persisting dementia, alcohol-induced per- functioning and to represent a significant de-
sisting amnestic disorder, and alcohol- cline from a previous level of functioning.
induced psychotic disorder. See also korsakoff’s syndrome; wernicke–
alcoholic cerebellar degeneration degen- korsakoff syndrome.
eration of the cerebellum caused by long-term alcohol-induced persisting dementia a
alcohol abuse, commonly producing gait distur- deterioration of mental function resulting from
bances. the persisting effects of alcohol abuse. It is char-
alcoholic dementia see alcohol-induced acterized by multiple cognitive deficits, espe-
persisting dementia. cially of memory but also including impairment
alcoholic hallucinosis see alcohol- of speech (see aphasia), movement (see apraxia),
induced psychotic disorder. and sensory capabilities (see agnosia), and ex-
alcoholic Korsakoff’s syndrome a form of ecutive dysfunction. Also called alcoholic
korsakoff’s syndrome caused by long-term al- dementia. See also substance-induced per-
cohol abuse. See alcohol-induced persisting sisting dementia.
amnestic disorder. alcohol-induced psychotic disorder hallu-
alcoholic myopathy see acute alcoholic cinations or delusions due to the direct physio-
myopathy. logical effects of alcohol. Also called alcoholic
(or alcohol) hallucinosis. See also sub-
alcoholic neuropathy any of various neuro-
stance-induced psychotic disorder.
logical disturbances, including weakness and ab-
normal skin sensations, such as numbness, alcohol intoxication a reversible condition
tingling, and burning, that are secondary to that develops after the ingestion of alcohol. It
chronic heavy consumption of alcohol. Specific comprises behavioral or psychological changes,
causative factors are not well understood, but ap- such as inappropriate or aggressive behavior, im-
pear to include vitamin deficiencies and a di- paired judgment, or impaired social functioning;
rectly toxic effect of alcohol on nerves. and physiological changes, such as slurred
alcoholic psychosis in DSM–II, a category of speech, unsteady gait, and disruption of atten-
mental disorders associated with the detrimental tion or memory. The effects typically become
neurological effects of alcohol abuse. The equiv- more marked with increased alcohol intake. See
alent DSM–IV–TR disorders include the follow- also substance intoxication.
ing: alcohol intoxication delirium, alcohol alcohol intoxication delirium a reversible
withdrawal delirium, alcohol-induced syndrome that develops over a short period of
psychotic disorder, alcohol-induced per- time (usually hours to days) following heavy al-
sisting dementia, and alcohol-induced per- cohol consumption. Disturbance of conscious-
sisting amnestic disorder. ness (e.g., reduced ability to focus, sustain, or
Alcoholics Anonymous (AA) a worldwide shift attention) is accompanied by changes in
voluntary organization of men and women who, cognition (e.g., memory deficit, disorientation,
through a twelve-step program, seek to help or language disturbance) in excess of those usu-
each other stay sober and learn to live healthy, ally associated with alcohol intoxication.
fulfilling lives. The only requirement for mem- See also substance intoxication delirium.
bership is a desire to stop drinking. Two critical alcoholism n. see alcohol dependence.
components of the AA program are its focus on alcoholism treatment interventions designed
alcoholics helping alcoholics and its desire to to enable the alcohol-dependent person either
put principles above personalities in conducting to achieve and maintain abstinence, which is the
its business. Founded in the United States in generally accepted goal of treatment for alcohol
1935, AA is the oldest, largest, and best-known dependence, or to reach and maintain a stable
self-help organization. pattern of nonproblem drinking, which is a con-
alcohol idiosyncratic intoxication in troversial, less common goal of treatment. Also
DSM–III, a condition characterized by marked called alcohol rehabilitation.
22
allele
alcohol withdrawal a group of physical cal origin, which sometimes accompanies men-
symptoms that arise after cessation of repeated tal difficulties (e.g., anxiety, schizophrenia, de- A
and prolonged heavy alcohol consumption. pression). See also psychic pain.
Withdrawal symptoms include autonomic hy- alien abduction a claim by individuals that
peractivity (sweating, pounding heart, dry they have been kidnapped by extraterrestrial be-
mouth, etc.), hand tremor, insomnia, nausea or ings. Although this phenomenon is commonly
vomiting, psychomotor agitation, anxiety, associated with delusional thinking, post-
and in some cases hallucinations or illusions, sei- traumatic stress disorder, and acute stress
zures, and delirium tremens. reactions, many of these individuals have no
alcohol withdrawal delirium a reversible other clear symptoms of mental disorder. His-
syndrome that develops over a short period of torically, there is no conclusive physical evi-
time (usually hours to days) following cessation dence to support the validity of their claims.
of prolonged, heavy alcohol consumption. The Also called extraterrestrial kidnapping.
features are disturbed consciousness (e.g., re- alienation n. 1. estrangement from others, re-
duced ability to focus, sustain, or shift attention) sulting in the absence of close or friendly rela-
and changes in cognition (e.g., memory deficit, tionships with people in one’s social group (e.g.,
disorientation, or language disturbance) in ex- family, workplace, community). 2. estrangement
cess of those usually associated with alcohol from oneself. An individual experiences life as a
withdrawal. See also delirium tremens. search for his or her true personal identity,
Aldomet n. a trade name for methyldopa. which is believed to have been hidden through
alertness n. the state of being awake, aware, at- socialization and nurturing, and as a continuous
tentive, and prepared to act or react. Neuro- failure to reach an ideal but unattainable level of
logically, alertness corresponds with high- personal fulfillment. This creates a deep-seated
frequency, low-amplitude brain waves resulting sense of dissatisfaction with one’s personal exis-
from stimulation of the reticular formation. tence and lack of trust in one’s social or physical
See also arousal. environment or in oneself. 3. the experience of
being separated from reality or isolated from
alexia n. loss or impairment of the ability to com-
one’s thoughts or feelings, as in derealization
prehend written or printed words as a result of
and depersonalization. —alienated adj.
lesions, stroke, or other forms of neurological
damage or disorder. It is generally seen in apha- alienation test an evaluation of an individual’s
sia but may occur in isolation, in which case it is feelings of estrangement or separation from his
called pure alexia (or alexia without agraphia) or her milieu, work, or self.
and characterized by reading impairment with alien limb syndrome a motor disorder char-
preserved language production and auditory acterized by involuntary hand, arm, or leg move-
comprehension. Individuals with pure alexia ments in place of or in addition to intended
can also write but are frequently unable to read movements (e.g., grabbing objects or throwing
what they have written. See also dyslexia. things) and the person’s feeling that he or she
alexithymia n. an inability to express, describe, has no control over the limb or that it is “for-
or distinguish between one’s emotions. It may eign,” sometimes to the extent that the person
occur in a variety of disorders (e.g., depression), does not recognize the limb as his or her own in
especially psychosomatic and some substance the absence of visual clues. The syndrome may
use disorders, or following repeated exposure to be associated with lesions to the supplemen-
a traumatic stressor. tary motor area or the motor regions of the
Alfenta n. a trade name for alfentanil. See corpus callosum. Alien hand syndrome is a
fentanyl. specific kind of the disorder.
alfentanil n. see fentanyl. aliphatic phenothiazines phenothiazine
antipsychotic agents containing an aliphatic
algedonic adj. relating to pain associated with (fatty acid) side chain in their molecular struc-
pleasure, or the pleasantness–unpleasantness di- ture. Including chlorpromazine, promazine, and
mension of experience. Algedonics is the study triflupromazine, they are the least potent of the
of the mixture of pleasure and pain. phenothiazines and are now rarely used.
algesia n. the ability to experience the sensation alkalosis n. an abnormally high level of alkalin-
of pain. Compare analgesia. —algesic adj.
ity (bicarbonate ion concentration) in the blood
algolagnia n. a sexual disorder in which sexual and tissues, which upsets the body’s acid–base
excitement is achieved by experiencing or in- balance. The condition is often marked by slow,
flicting pain. See active algolagnia; passive shallow breathing. It has a variety of causes and
algolagnia; sexual masochism; sexual sa- additional symptoms vary with each, potentially
dism. including neurological abnormalities such as
algophilia n. liking for the experience or inflic- muscle twitching, confusion, tremors or spasms,
tion of pain. See also algolagnia; masochism; and numbness. Compare acidosis. —alka-
sadism. lotic adj.
algopsychalia n. physical pain recognized by allele n. an alternate form of a gene that occupies
the patient as being of mental rather than physi- a given position on each of a pair of homolo-
23
allied health professional
gous chromosomes. Each person typically has to altering the self. Also called alloplastic
A two alleles of each gene: One is inherited from adaptation. 2. surgical repair of diseased or
the mother and the other from the father. Alleles damaged tissue through implantation using
may be alike (homozygous) or different (hetero- synthetic or organic material from outside the
zygous), and are responsible for variation in inpatient’s body. Compare autoplasty. —allo-
herited characteristics, such as hair color or plastic adj.
blood type. See also dominant allele; reces- allopsychic delusion see autopsychic delu-
sive allele. —allelic adj. sion.
allied health professional (AHP) a licensed allostasis n. stability through change. Allostasis
health care professional with specialized educa- refers particularly to the idea that parameters of
tion and training who assists other professional most physiological regulatory systems change to
staff in the prevention, treatment, and rehabili- accommodate environmental demands. Al-
tation process. though allostatic processes are critical for adap-
allocation decision 1. a choice in which an in- tive functioning, chronic or repeated activation
dividual must decide how to distribute a limited of physiological systems in response to life’s
resource across entities (e.g., hypothetical facto- challenges are hypothesized to exact a toll on
ries or hospitals). 2. in group problem solving, such systems.
the group’s allocation of particular roles or jobs allosteric modulation the binding of a sub-
to individual members. stance (called an allosteric modulator) to a cer-
allocentric 1. adj. denoting externality to the tain site on a receptor in a way that alters the
self, particularly an orientation toward or focus conformation of other sites on the receptor,
on groups and connections to others. 2. adj. in thereby increasing or decreasing the affinity of
anthropology, respecting the values and customs the receptor for other molecules. Allosteric mod-
of other cultures (i.e., not ethnocentric). 3. n. an ulation recently has been recognized as an al-
individual who is dispositionally predisposed to ternative pharmacological approach to gain se-
put the goals and needs of the group above his or lectivity in drug action.
her own. Just as societies based on collectiv- allotriophagy n. a desire to eat inappropriate
ism stress connections among members and the foods or nonnutritive substances. Also called
welfare of the group, allocentrics emphasize their allotriophagia. See also pica.
connections to others and are group-centered.
all-payer system a health care system in which
They are more likely to join groups and to base
prices for health care services and payment
their identities on their memberships. Also
methods are the same regardless of who is pay-
called interdependent. Compare idiocentric.
ing (e.g., the patient or an insurance company).
See also sociocentrism. —allocentrism n.
Also called multipayer system.
allochthonous adj. stemming from sources or Allport, Gordon Willard (1897–1967) U.S.
forces external to a particular system: not indige- psychologist. Allport received his PhD from Har-
nous or innate. Compare autochthonous. vard University in 1922. He is widely recognized
allocortex n. those regions of the cerebral cortex as the originator of a theory of personality based
that are phylogenetically older and have fewer on three categories of traits (see allport’s per-
than six main layers of cells. The allocortex is in- sonality trait theory) and as coauthor of two
volved primarily in olfactory functions and personality inventories, the allport–vernon–
limbic functions related to memory and emo- lindzey study of values and the Allport AS
tion, and comprises the three-layered archicortex Reaction Study. Allport was also a major contrib-
(or archipallium), found mostly in the hippo- utor to the field of social psychology, emphasiz-
campus, and the four- or five-layered paleocortex ing the role of attitudes in motivation and
(or paleopallium), found mostly in the pyriform making major theoretical contributions to the
area and parahippocampal gyrus. Compare neo- study of prejudice. See also directedness;
cortex. functional autonomy; group relations
alloeroticism n. the extension of erotic feelings theory; humanistic perspective; personal-
toward and the derivation of sexual satisfaction istic psychology; personality structure;
from others, as opposed to autoeroticism. Also propriate striving; proprium; self-extension;
called alloerotism. —alloerotic adj. self-objectification.
allopathy n. a system of medicine in which a Allport’s personality trait theory the the-
disease or disorder is treated with agents that ory that an individual’s personality traits are
produce effects different from or incompatible the key to the uniqueness and consistency of his
with those caused by the disease or disorder. or her behavior. Traits are regarded as dynamic
Allopathy is often equated with conventional or forces that interact with each other and the envi-
pharmacological medical practice. Compare ho- ronment to determine the characteristic actions
meopathy. —allopathic adj. or reactions that define the self (see proprium).
They develop largely from experience, learning,
allophasis n. disorganized, incoherent speech. and imitation and fall into three main catego-
alloplasty n. 1. a process of adaptive response ries: (a) cardinal traits or master qualities (e.g.,
that aims to alter the environment, as opposed overweening ambition); (b) central traits, or
24
alteration hypothesis
clusters of distinctive attitudes and characteris- humans or other animals to block alpha waves
tics; and (c) secondary traits, which are more by reinforcement or biofeedback. See alpha A
limited and not essential to personality descrip- blocking.
tion. [Gordon W. allport] alpha blocker see adrenergic blocking
Allport–Vernon–Lindzey Study of Values agent.
(SOV) a two-part personality test designed to alpha blocking the suppression of alpha
show the relative importance of six basic values waves that occurs upon deviation from a wake-
in the participant’s life: theoretical, economic, ful but relaxed state, as, for example, when fo-
aesthetic, social, political, and religious. The cat- cusing the eyes on an unexpected stimulus or
egories are presented in the form of 45 items to performing an active mental task. It is some-
which participants respond. Part one consists of times taken as an indicator of orienting or atten-
30 statements, each describing a situation with tion. Typically, blocked alpha waves are replaced
two alternative choices; participants must by faster, low-amplitude, irregular waveforms on
choose which option they prefer and indicate the electroencephalogram, a phenomenon called
the strength of that preference by distributing desynchronization.
three points between the two alternatives. Part alpha coefficient see cronbach’s alpha.
two consists of 15 questions, each with four al-
ternative answers; participants must rank the an- alpha error see type i error.
swers in order of preference. The SOV was alpha level see significance level.
originally published in 1931 as the Allport– alpha wave in electroencephalography, a type
Vernon Study of Values but in 1951 was revised of low-amplitude brain wave (frequency 8–12
and renamed. The most recent version of the test Hz) that typically occurs when the eyes are
was published in 1960. Also called Study of unfocused and no active mental processes are
Values. [Gordon W. allport; Philip E. Vernon taking place, indicating a wakeful but relaxed
(1905–1987), British psychologist; Gardner state. The occurrence of alpha waves may be in-
Lindzey (1920–2008), U.S. psychologist] creased, for example, through meditation or al-
allusive thinking a type of thinking marked pha-wave training, a type of biofeedback
by inference and suggestion rather than tradi- training that involves providing a feedback
tional logic and direct communication of ideas. stimulus (typically an auditory tone) when alpha
The concepts employed may seem diffuse and waves appear on the electroencephalogram
indistinct. See also analogical thinking. (EEG). Also called alpha rhythm; Berger
rhythm.
alogia n. inability to speak because of dysfunc-
tion in the central nervous system. In a less se- Alport’s syndrome a familial condition char-
vere form, it is sometimes referred to as dyslogia. acterized by hematuria (bloody urine), nephrop-
athy (disease of the kidney), and deafness.
alpha (symbol: α) n. the probability of a type i Hematuria may first appear in infancy, while
error. deafness is likely to develop around the age of
alpha-adrenergic receptor a receptor that puberty. The condition also may be accompa-
binds norepinephrine and causes stimulation nied by cataracts and mental retardation. It is
of smooth muscle in responses of the sympa- caused by mutation of the genes COL4A3,
thetic nervous system, such as pupil dilation COL4A4, COL4A5, or COL4A6, which specify
and increased vascular resistance (vaso- chains of basement membrane (Type IV) colla-
constriction). There are two types, α1-adreno- gen. [described in 1927 by Arthur Cecil Alport
receptors and α2-adrenoreceptors, each of which (1879–1959), British physician]
is divided into subtypes designated by subscript alprazolam n. a benzodiazepine used for the
capital letters (α1A-adrenoreceptor, α2A-adreno- treatment of generalized anxiety disorder and
receptor, etc.). Also called alpha adrenocep- panic disorder. It is rapidly absorbed and has a
tor; alpha adrenoreceptor; alpha receptor. relatively brief duration of action. Common side
Compare beta-adrenergic receptor. effects include drowsiness, light-headedness,
L-alpha-acetyl-methadol n. see laam. headache, and confusion. U.S. trade name:
alpha-adrenoreceptor blocking agent see Xanax.
adrenergic blocking agent. ALS abbreviation for amyotrophic lateral
alpha alcoholism one of five types of alcohol- sclerosis.
ism defined by U.S. physician Elvin M. Jellinek Alström–Hallgren syndrome a familial dis-
(1890–1963), the others being beta alcohol- order that is characterized by obesity, deafness,
ism, gamma alcoholism, delta alcoholism, visual disorders, and diabetes and is occasionally
and epsilon alcoholism. It is characterized by associated with mental disorders. [Carl-Henry
undisciplined drinking that disturbs interper- Alström (1907–1993), Swedish physician; Bertil
sonal and family relationships and work life and Hallgren, 20th-century Swedish geneticist]
a reliance on the effects of alcohol for the relief alter n. 1. any of the secondary personalities
of physical or emotional pain, but it does not in- in a person with dissociative identity disor-
volve losing control or inability to abstain. der. 2. the other person in a social interaction.
alpha-block conditioning the training of alteration hypothesis a theoretical explana-
25
altered state of consciousness
tion of the misinformation effect stating that alternative dispute resolution the resolv-
A misleading information introduced after a wit- ing of disputes between parties using neutral
nessed event replaces, transforms, or impairs the third parties, who act as arbitrators or mediators,
original memory of the event, leading to errone- rather than by engaging in a lawsuit.
ous reporting of that event. Also called substi- alternative hypothesis (symbol: H1) a state-
tution hypothesis. Compare coexistence ment of the position opposite to that of the null
hypothesis. hypothesis. It usually outlines the predicted re-
altered state of consciousness (ASC) a state lationship between variables that a researcher is
of psychological functioning that is significantly seeking to demonstrate empirically as true. In
different from ordinary states of conscious- hypothesis testing, the alternative hypothesis
ness, being characterized by altered levels of self- may be considered plausible only when the null
awareness, affect, reality testing, orientation to hypothesis is rejected at a predetermined signif-
time and place, wakefulness, responsiveness to icance level.
external stimuli, or memorability or by a sense of alternative medicine see complementary
ecstasy, boundlessness, or unity with the uni- and alternative medicine.
verse.
alternative psychotherapy any treatment
alter ego 1. a second identity or aspect of a per- approach not considered to be within the main-
son that exists metaphorically as his or her sub- stream of psychotherapy. primal therapy and
stitute or representative, with different reichian analysis are considered alternative
characteristics. 2. an intimate, supportive friend approaches by most therapists.
with whom an individual can share all types of
altruism n. an apparently unselfish concern for
problems and experiences, as if he or she were
others or behavior that provides benefit to oth-
“another self.” 3. in psychodrama, a group
ers at some cost to the individual. In humans, it
member, other than the therapist, who assumes
covers a wide range of behaviors, including
the role of a significant figure in the protago-
volunteerism and martyrdom, but the degree to
nist’s life (see auxiliary ego) but who also
which such behaviors are legitimately without
speaks as part of the protagonist in order to give
egotistic motivation is subject to much debate.
voice to and portray actions felt but not ex-
—altruistic adj. —altruist n.
pressed by the protagonist.
altruistic behavior behavior performed for
alter-egoism n. an altruistic concern or a feeling the benefit of others. Altruistic behavior covers a
of empathy for another person in the same situa-
wide range of actions, including expressions of
tion as oneself.
interest, support, and sympathy; special favors
alternate-forms reliability an estimate of performed for others; active defense of the rights
the extent to which a test yields consistent re- of the oppressed or deprived; volunteerism;
producible results that is obtained from the cor- and martyrdom (see altruistic suicide). The
relation of scores on different versions of that degree to which altruistic behavior is true—that
test. These alternate forms of the test may be of is, without egoistic motivation—is subject to
three types: comparable forms have items of much debate. See also egoistic helping; empa-
similar content and difficulty; equivalent forms thy–altruism helping; helping; prosocial
have items of similar content and difficulty but behavior.
demonstrate differences in certain statistical altruistic suicide suicide committed, or sui-
characteristics (e.g., standard deviations); and cidal actions undertaken, in the belief that this
parallel forms have items of similar content and will benefit the group or serve a greater good, as
difficulty and are similar in all statistical char- exemplified by terrorist suicide bombings, the
acteristics (e.g., means, standard deviations, cor- Japanese kamikaze attacks of World War II, or
relations with other measures). Comparable suicides by older adults who believe they are a
forms have the least degree of similarity to one burden to their families. Altruistic suicide is gen-
another, while parallel forms have the greatest erally committed by members of highly inte-
degree of similarity and are essentially inter- grated groups. See also mass suicide. [defined
changeable. by French sociologist Emile Durkheim (1858–
alternating personality a personality with 1917)]
components that appear alternately. See Alzheimer’s disease a progressive neuro-
dissociative identity disorder. degenerative disease characterized by cortical
alternative behavior completion a tech- atrophy, neuronal death, synapse loss, and accu-
nique in behavior therapy for extinguishing mulation of senile plaques and neurofib-
unwanted habits by substituting an incompati- rillary tangles, causing dementia and a
ble behavior for the nondesired behavior (e.g., significant decline in functioning. Early features
substituting nail care for nail biting). This tech- include deficits in memory (e.g., rapid forgetting
nique can be practiced in vivo (see in vivo de- of new information, impaired recall and recogni-
sensitization) or imaginally in the therapy tion), executive dysfunction, and subtle person-
session or assigned as homework. It is often used ality changes such as decreased energy, social
as an alternative to mild aversion therapy. See withdrawal, indifference, and impulsivity. As
also competing response training. the disease progresses, there is global deteriora-
26
ambulatory schizophrenia
tion of cognitive capacities with intellectual de- sory modality that can be interpreted in more
cline, aphasia, agnosia, and apraxia as well as than one way. A
behavioral features including apathy, emotional ambisexual adj. 1. denoting individuals or
blunting, mood-dependent delusions, decreased characteristics that manifest no sex or gender
sleep and appetite, and increased motor activity dominance. Compare asexual. 2. an older term
(e.g., restlessness and wandering). Onset of Alz- for bisexual (see bisexuality), now rarely used.
heimer’s disease is insidious and typically after —ambisexuality n.
age 65, although early-onset cases do occur.
ambitendency n. 1. the tendency to act in op-
Major risk factors for Alzheimer’s disease include
posite ways, based on conflicting behavioral mo-
advanced age, a family history of the disease,
tivations. 2. a pattern of incomplete motor
and genetic factors, particularly the presence of
responses in anticipation of a voluntary action.
the ApoE4 allele on chromosome 19. [first de-
It occurs in catatonic states as a type of
scribed in 1907 by Alois Alzheimer (1864–1915),
psychomotor retardation in which the indi-
German neurologist]
vidual appears motorically stuck and exhibits
Alzheimer’s Disease and Related Disor- hesitant, indecisive motions in the absence of
ders Association, Inc. an organization that voluntary movement. 3. in Jungian psychology,
provides support groups, assistance, and infor- the psychic ambivalence that is caused by the ex-
mation for caregivers of patients with Alzhei- istence of opposing tendencies.
mer’s disease.
ambivalence n. 1. the simultaneous existence
amae n. an indigenous Japanese concept that de- of contradictory feelings and attitudes, such as
scribes a behavioral pattern roughly translated as pleasantness and unpleasantness or friendliness
indulgent dependency in which people ask oth- and hostility, toward the same person, object,
ers to perform actions for them that they could event, or situation. Conflicting feelings are often
actually perform for themselves. Typically found strong toward parents, since they are agents of
in mother–child relationships, amae is distin- both discipline and affection. Swiss psychiatrist
guished from true dependency by the inappro- Eugen Bleuler (1857–1939), who first defined
priateness of the requests and their presumed ambivalence in a psychological sense and re-
acceptance. [first described by Japanese psychol- ferred to it as affective ambivalence, regarded ex-
ogist Takeo Doi (1920–2009)] treme ambivalence, such as an individual
amantadine n. an antiviral drug that is also a expressing great love for his or her mother while
dopamine-receptor agonist and is occasion- also asking how to kill her, as a major symptom
ally used to ameliorate the extrapyramidal of schizophrenia. 2. uncertainty or indecisive-
symptoms of antipsychotic drugs active at dopa- ness about a course of action. —ambivalent
mine receptors. U.S. trade name: Symmetrel. adj.
amative intercourse sexual intercourse that ambivalent attachment in the strange sit-
occurs as part of a loving, caring relationship. uation, a form of insecure attachment in
This is distinguished from sexual activity be- which infants show a combination of positive
tween people who neither know each other nor and negative responses toward a parent. After
have an emotional relationship (e.g., a prostitute separation, for example, infants may simulta-
and a client). neously seek and resist close contact with the
returning parent. Also called resistant attach-
ambenomium n. an anticholinesterase (see
ment.
cholinergic drug) that can be taken orally to
relieve the symptoms of myasthenia gravis. ambiversion n. the tendency to display charac-
U.S. trade name: Mytelase. teristics of introversion and extraversion in ap-
proximately equal degrees. Such a person would
Ambien n. a trade name for zolpidem. be referred to as an ambivert.
ambiguity n. 1. the property of a behavior, be- ambulation n. the act of walking from place to
havior pattern, or situation that might lead to in- place. Ambulation training often is necessary in
terpretation in more than one way. 2. the the rehabilitation of individuals who have had a
property of a word, phrase, or sentence that has spinal injury, stroke, or other trauma affecting
more than one possible meaning. In psychoana- the neuromuscular system and in the physical
lytic theory, ambiguous words or phrases are therapy of individuals with certain genetic or
usually interpreted as a symptom of the congenital disorders.
speaker’s hidden feelings or unconscious wishes
about the subject. —ambiguous adj. ambulatory care medical or psychological ser-
vices provided to individuals on an outpatient,
ambiguity scale any questionnaire used in nonemergency basis. Such services may include
evaluating tolerance or intolerance for vague- observation, diagnosis, treatment (referred to as
ness, ambiguity, and indefiniteness. ambulatory treatment), and rehabilitation and
ambiguity tolerance the degree to which one are often provided at such places as a doctor’s of-
is able to accept, and to function without distress fice, health center, or hospital outpatient depart-
or disorientation in, situations having conflict- ment.
ing or multiple interpretations or outcomes. ambulatory schizophrenia a condition in
ambiguous stimulus a stimulus in any sen- which a person who was previously hospitalized
27
ambulatory services
from extreme symptoms and then diagnosed as certification of sex educators, counselors, and
A having schizophrenia no longer requires hospi- therapists and to promote understanding of
talization but nonetheless behaves eccentrically human sexuality and healthy sexual behavior.
and cannot function in a manner consistent American Association on Intellectual
with social expectations. and Developmental Disabilities (AAIDD)
ambulatory services mental health, counsel- a professional organization, founded in 1876,
ing, or medical services provided on an outpa- whose mission is to promote progressive poli-
tient basis, that is, without the client needing to cies, sound research, and effective practices in
be in or remain in a hospital, clinic, or other pro- the field of mental retardation, together with
vider facility. See also walk-in clinic. universal human rights for people with intellec-
amenorrhea n. the absence of menstruation. tual and developmental disabilities. It is the old-
When menstruation fails to begin after puberty, est and largest interdisciplinary organization in
the condition is called primary amenorrhea. If this field. Formerly called American Associa-
menstrual periods stop, in the absence of preg- tion of Mental Retardation (AAMR).
nancy or menopause, after starting, the condi- American Board of Professional Psy-
tion is known as secondary amenorrhea. chology (ABPP) the umbrella organization for
Changes in physical or mental health can be a 13 psychological specialty boards in the United
causal factor. States. Established in 1947, its purpose is to es-
American Academy of Clinical Sexolo- tablish, implement, and maintain standards and
gists (AACS) an institution founded in 1986 as set examinations for specialty areas in the prac-
the educational arm of the American Board of tice of psychology. A “specialty” is defined as a
Sexology. Since 1995 it has provided profes- focused area in which special competency has
sional training for sex therapists at Maimonides been acquired through an organized sequence of
University, Miami Beach, Florida. education, training, and practical experience.
American Association of Applied and American Law Institute Model Penal
Preventive Psychology (AAAPP) a profes- Code Insanity Test a legal standard for estab-
sional organization whose purpose is to promote lishing criminal responsibility, adopted in
the interests of clinical and preventive psychol- 1962, that combines elements of the mc-
ogy. It encourages a research orientation toward naughten rule and the irresistible impulse
clinical and preventive work, emphasizing the rule. According to this standard, individuals are
consumer and public interest above guild or per- not responsible for criminal conduct if at the
sonal interests. Its main publication is the jour- time of such conduct, as a result of mental illness
nal Applied and Preventive Psychology: Current or defect, they lacked substantial capacity either
Scientific Perspectives. to appreciate the criminality of their conduct or
American Association of Applied Psy- to conform their conduct to the requirements of
chology (AAAP) a professional organization the law. Also called American Law Institute
founded in 1937 by a group of consulting, clini- Guidelines (ALI Guidelines); Brawner de-
cal, educational, and industrial psychologists cision; Brawner rule.
who broke from the american psychological American Orthopsychiatric Association
association in order to represent the applied (AOA) an interdisciplinary professional organi-
interests of U.S. psychologists more effectively. zation engaged in preventive, treatment, and ad-
Their main publication was the Journal of Con- vocacy approaches to mental health. The prefix
sulting Psychology. In 1944 the group rejoined the ortho- (from the Greek orthos, “straight”) empha-
American Psychological Association. sizes the need for preventive approaches. The
American Association of Clinical Psy- American Journal of Orthopsychiatry is its major
chologists (AACP) a professional organiza- publication. [founded in 1924 by U.S. physician
tion founded in 1917 when clinical psycholo- Karl Menninger (1893–1990)]
gists broke from the american psychological American Parkinson Disease Associa-
association in order to promote training and tion, Inc. an organization that provides sup-
certification standards for the practice of clinical port groups, information, and referrals for
psychology. The AACP returned to the American individuals with Parkinson’s disease and their
Psychological Association in 1919 as its first spe- families.
cial-interest group, the Section of Clinical Psy-
American Psychiatric Association (APA)
chology.
a national medical and professional organiza-
American Association of Mental Retar- tion whose physician members specialize in the
dation (AAMR) see american association diagnosis, treatment, and prevention of mental
on intellectual and developmental dis- disorders. It was founded in 1844 as the Associa-
abilities. tion of Medical Superintendents of American In-
American Association of Sex Educators, stitutes for the Insane and renamed the
Counselors and Therapists (AASECT) a American Medico-Psychological Association in
nonprofit, interdisciplinary, professional accred- 1892. The current name was adopted in 1922. Its
iting organization founded in 1967 whose mis- objectives include the improvement of care for
sion is to provide professional education and people with mental illnesses, the promotion of
28
amnesia
research and professional education in psychia- must be obtained from foods. Other amino
try, and the dissemination of psychological acids (e.g., glutamic acid, glycine) are A
knowledge through nationwide public informa- neurotransmitters or precursors to neurotrans-
tion, education, and awareness programs and mitters.
materials. Its extensive publications include the
amino acid imbalance a disorder, genetic or
Diagnostic and Statistical Manual of Mental Disor-
acquired, characterized by a deficiency in the
ders (see dsm–iv–tr), the most widely used psy-
body’s ability to transport or utilize certain
chiatric reference in the world.
amino acids. The cause is usually an absence or
American Psychoanalytic Association lack of an enzyme needed to carry an amino acid
(APsaA) a professional organization for psycho- or its components through a step of a metabolic
analysts that focuses on education, research, and cycle. More than 80 kinds of amino acid imbal-
membership development. Founded in 1911, it ance have been identified, and many (e.g.,
is the oldest national psychoanalytic organiza- phenylketonuria, homocystinuria) affect
tion, with 29 accredited training institutes and the central nervous system.
42 affiliate psychoanalytic societies. It is the U.S.
chapter of the International Psychoanalytic As- aminoketone n. the chemical classification of
sociation. Its major publication is the Journal of the antidepressant agent bupropion, whose
the American Psychoanalytic Association. structure and mechanism of action differ from
other marketed antidepressants. Although the
American Psychological Association specific method of action is unknown it is pre-
(APA) a scientific and professional organization sumed to involve noradrenergic or dopamin-
founded in 1892 that represents psychology in ergic mechanisms.
the United States and is the largest association of
psychologists worldwide. Its mission is to ad- aminopterin n. a drug similar to methotrexate
vance psychology as a science, as a profession, (also called amethopterin and used in treating
and as a means of promoting health and human leukemia) that is sometimes used in nonclinical
welfare. Among its specific goals are the promo- settings to induce abortions. Surviving infants
tion of psychological research and improvement show teratogenic effects (see teratogen), such
of research methods and conditions; the estab- as hydrocephalus, craniosynostosis (prema-
lishment and maintenance of high standards of ture skull ossification) with skull defects, and
professional ethics and conduct of its members; mild to moderate mental retardation. Amin-
and the increase and diffusion of psychological opterin is in current use as a rodenticide and is
knowledge through a variety of means, includ- under investigation as a treatment for certain
ing over 50 scholarly journals, the APA Publica- forms of leukemia.
tion Manual, 75 books and videotapes per year, amitriptyline n. a tricyclic antidepressant
and 7 electronic databases. introduced into clinical use in 1961; with
American Psychological Association imipramine, it was the first widely used antide-
code see code of ethics. pressant agent. Its tertiary amine structure
makes it a more potent inhibitor of serotonin
American Psychological Society (APS) a
reuptake than secondary amines (thereby in-
professional organization founded in 1988 to ad-
creasing the availability of serotonin for
vance the needs and interests of scientific, ap-
neurotransmission), but also contributes to its
plied, and academic psychologists as opposed to
significant antihistamine, anticholinergic, and
those engaged in clinical practice. Its mission is
adrenoreceptor-blocking activity (producing ad-
to promote, protect, and advance the interests of
verse side effects). It is an effective antidepres-
scientifically oriented psychology in research,
sant, but its side effects and toxicity in overdose
application, and the improvement of human
have led to a decline in its use in favor of the
welfare. The APS publishes three journals: Psy-
ssris and other agents. Although still used as an
chological Science, Current Directions in Psychologi-
antidepressant, amitriptyline is no longer con-
cal Science, and Psychological Science in the Public
sidered first-line medication and is more
Interest.
likely to be employed in low doses for chronic
American Psychosomatic Society (APS) pain management or the prevention of mi-
an interdisciplinary professional organization graine. It is also sold in combination with a
founded in 1942 whose mission is to promote a benzodiazepine anxiolytic (as Limbitrol in the
scientific understanding of the interrelation- United States) or an antipsychotic (as Etrafon or
ships among biological, psychological, social, Triavil in the United States). U.S. trade name:
and behavioral factors in human health and dis- Elavil.
ease. Its main publication is Psychosomatic Medi-
cine. amnesia n. partial or complete loss of memory.
Either temporary or permanent, it may be due to
amethystic n. see anti-intoxicant. physiological factors such as injury, disease, or
amino acid an organic compound that contains substance use, or to psychological factors such as
an amino group (–NH2) and a carboxyl group a traumatic experience. A disturbance in mem-
(–COOH), 20 of which are constituents of pro- ory marked by inability to learn new informa-
teins; 9 of these are essential amino acids, that tion is called anterograde amnesia and one
is, they cannot be synthesized by the body and marked by inability to recall previously learned
29
amnestic apraxia
information or past events is called retrograde individual experiences a period of social

A amnesia. When severe enough to interfere mark- withdrawal and apathy, followed by a violent,
edly with social or occupational functioning unprovoked attack on nearby individuals. If not
or to represent a significant decline from a previ- overpowered or killed, the affected male eventu-
ous level of functioning, the memory loss is ally collapses from exhaustion and afterward has
known as amnestic disorder. —amnesiac adj., no memory of the event. See also mal de pelea.
n. —amnesic or amnestic adj. amotivational syndrome a behavior pattern
amnestic apraxia an inability to remember associated with chronic use of cannabis, charac-
and therefore carry out a command, although terized by loss of drive and initiative. The con-
there is no loss of ability to perform the task. cept is mainly conjectural and anecdotal, based
Also called amnesic apraxia. on observations of the lifestyles of chronic can-
nabis users in various cultures around the world.
amnestic disorder in DSM–IV–TR, a distur-
See cannabis abuse; cannabis dependence.
bance in memory marked by inability to learn
new information (anterograde amnesia) or to re- amoxapine n. an antidepressant, one of the sec-
call previously learned information or past events ondary amine tricyclic antidepressants
(retrograde amnesia) that is severe enough to in- (TCAs), that inhibits the reuptake of norepi-
terfere markedly with social or occupational func- nephrine and serotonin. It may also have
tioning or represents a significant decline from a antipsychotic activity due to the strong dopa-
previous level of functioning. A distinction is mine-receptor-blocking activity of one of its
made between amnestic disorder due to a gen- metabolites. Amoxapine may cause extra-
eral medical condition, substance-induced pyramidal symptoms and tardive dyskinesia
persisting amnestic disorder, and amnestic but is less associated with anticholinergic side ef-
disorder not otherwise specified. The first of fects than other TCAs. U.S. trade name: Asendin.
these can be caused by a variety of conditions, AMPA receptor a type of glutamate recep-
including head injury, anoxia, and posterior ce- tor that binds the agonist AMPA (alpha-amino-
rebral artery stroke, resulting in lesions in spe- 3-hydroxy-5-methyl-4-isoxazole-propionic acid)
cific brain regions, including the medial as well as glutamate. AMPA receptors are coupled
temporal lobe and the diencephalon, and to ligand-gated ion channels and are responsi-
their connections with various cortical areas. It ble for most of the activity at synapses where glu-
may be transient, lasting from several hours to tamate is the neurotransmitter. Compare nmda
no more than a month (see also transient receptor.
global amnesia), or chronic (lasting more than amphetamine n. a cns stimulant, closely re-
1 month). In DSM–III, amnestic disorder was lated in structure and activity to ephedrine (see
called amnesic (or amnestic) syndrome. ephedra), that is the prototype of the group of
amniocentesis n. a method of examining fetal drugs known as the amphetamines. U.S. trade
chromosomes for any abnormality or for deter- name: Benzedrine.
mination of sex. A hollow needle is inserted amphetamine abuse in DSM–IV–TR, a pattern
through the mother’s abdominal wall into the of use of amphetamines or amphetamine-like
uterus, enabling the collection of amniotic fluid, substances manifested by recurrent significant
which contains fetal cells. Compare chorionic adverse consequences related to the repeated in-
villus sampling. gestion of these substances. This diagnosis is pre-
amobarbital n. an intermediate-acting, rapidly empted by the diagnosis of amphetamine
excreted barbiturate that was formerly used as dependence: If the criteria for amphetamine
a sedative and hypnotic. Like other barbiturates, abuse and amphetamine dependence are both
its toxicity has led to its clinical eclipse by safer met, only the latter diagnosis is given. See also
agents, such as the benzodiazepines. Amo- substance abuse; substance dependence.
barbital abuse can result in addiction, stupor, amphetamine dependence in DSM–IV–TR, a
and death. Amobarbital was occasionally used to cluster of cognitive, behavioral, and physiologi-
conduct interviews (Amytal interviews) designed cal symptoms indicating continued use of an
to elicit subconscious material from patients, as amphetamine or amphetamine-like substance
well as information that was consciously with- despite significant substance-related problems.
held. Such interviews were also used in attempt- There is a pattern of repeated substance inges-
ing to distinguish between patients who were tion resulting in tolerance, characteristic symp-
malingering and those who had a bona fide con- toms if use is suspended (see amphetamine
version disorder. Due to numerous legal and eth- withdrawal), and an uncontrollable drive to
ical issues surrounding amobarbital interviews, continue use. See also amphetamine abuse.
in addition to the medical risks associated with amphetamine-induced psychotic disor-
administration of barbiturates, such techniques der a condition marked by paranoid delusions
are no longer acceptable in modern clinical prac- due to the direct physiological effects of an am-
tice. U.S. trade name: Amytal. phetamine or amphetamine-like substance. The
amok (amuck) n. a culture-bound syndrome delusions can continue as long as the use of
observed among males in Malaysia, the Phil- these substances continues and might persist for
ippines, and other parts of southeast Asia. The weeks or months after withdrawal from the sub-
30
Amytal
stances has been completed. Also called am- crash) often follow an episode of intense, high-
phetamine psychosis. dose use. See also substance withdrawal. A
amphetamine intoxication a reversible syn- amputation fetish see acrotomophilia.
drome caused by the recent ingestion of amphet- Amsterdam dwarf disease a congenital dis-
amines or amphetamine-like substances. It is order characterized by delayed growth, small
characterized by behavioral or psychological stature, microcephaly, and such features as
changes (e.g., inappropriate aggressive behavior, cleft lip and palate, upturned nose, and
impaired judgment, suspiciousness, and para- hirsutism. Other manifestations can include
noia), as well as one or more signs of physiologi- malformed or missing limbs, fingers, or hands,
cal involvement (e.g., unsteady gait, impairment seizure disorders, bowel abnormalities, and car-
in attention or memory). See also substance in- diac defects. Developmental delays are common,
toxication. as is some degree of mental retardation (usually
amphetamine intoxication delirium a re- moderate to severe). Also called Amsterdam
versible syndrome that develops over a short pe- type of retardation; Brachmann–de Lange
riod of time (usually hours to days) following the syndrome. See also de lange’s syndrome.
heavy ingestion of amphetamines or amphet- amuck n. see amok.
amine-like substances. The features include dis-
amurakh n. a culture-bound syndrome ob-
turbed consciousness (e.g., reduced ability to
served among Siberian women and character-
focus, sustain, or shift attention) and changes
ized by compulsive mimicking of other people’s
in cognition (e.g., memory deficit, disorienta-
words or behaviors. See also latah.
tion, or language disturbance) in excess of those
usually associated with amphetamine intoxi- amygdala n. an almond-shaped structure in the
cation. See also substance intoxication de- temporal lobe that is a component of the
lirium. limbic system and considered part of the basal
ganglia. It comprises two main groups of nu-
amphetamine psychosis see amphetamine-
clei—the corticomedial group and the
induced psychotic disorder.
basolateral group—and through widespread
amphetamines pl. n. a group of drugs (substi- connections with other brain areas has numer-
tuted phenylethylamines) that stimulate the ous viscerosensory and autonomic functions as
reticular formation in the brain and cause a well as an important role in memory, emotion,
release of stored norepinephrine. The effect is a perception of threat, and fear learning. Also
prolonged state of arousal and relief from feel- called amygdaloid body; amygdaloid com-
ings of fatigue (see cns stimulant). Amphet- plex; amygdaloid nuclei. —amygdaloid
amines were introduced in 1932 for a variety of adj.
clinical uses. amphetamine abuse can result in amyl nitrite an organic nitrite, administered by
dependence and a well-defined state of psycho- nasal inhalation, that dilates (widens) arteries by
sis (see amphetamine dependence; amphet- relaxing smooth muscles in arterial walls. The
amine-induced psychotic disorder). Although main effects are to dilate the coronary arteries
widely used in the past for weight loss, relief of supplying the heart and to reduce blood pres-
depression, and other indications, modern use sure. Amyl nitrite has been used therapeutically
of amphetamines is more circumscribed because in the treatment of angina pectoris and as an an-
of their adverse effects. They are now used tidote in the treatment of cyanide poisoning. It
mainly in short- and long-acting preparations is now best known as a recreational drug that is
to manage symptoms of attention deficit/hyper- reputed to enhance orgasm and other aspects of
activity disorder and to treat certain cases of se- the sexual experience; adverse effects can in-
vere depression or narcolepsy. Amphetamines clude anxiety, nausea, dizziness, faintness asso-
include amphetamine itself (the prototype), ciated with a drop in blood pressure, and
dextroamphetamine, and methamphetamine. impaired oxygen-carrying capacity of the blood.
Related drugs, with a similar mode of action but
different molecular structure, include methyl- amyloid plaque see senile plaque.
phenidate. In addition, some forms and deriva- amyotrophic lateral sclerosis (ALS) a rap-
tives (including dom, mda, and mdma) have idly progressive adult-onset disease involving
been manufactured as recreational hallucino- degeneration of both lower motor neurons, re-
genic drugs. sponsible for muscle contraction, and upper
amphetamine withdrawal a characteristic motor neurons, responsible for muscle spindle
withdrawal syndrome that develops after cessa- sensitivity, and leading to death within 5 years
tion of (or reduction in) prolonged, heavy con- of diagnosis. Symptoms include muscular atro-
sumption of an amphetamine or amphetamine- phy and weakness, partial and complete paralysis,
like substance. The essential characteristic is de- speech impairment, and difficulties swallowing
pressed mood, sometimes severe, and there may or breathing. Amyotrophic lateral sclerosis is
also be fatigue, disturbed sleep, increased appe- often used interchangeably with motor neuron
tite, vivid and unpleasant dreams, or psycho- disease, especially in the United States. Also
motor retardation or agitation, or all of called Lou Gehrig’s disease.
these features. Marked withdrawal symptoms (see Amytal n. a trade name for amobarbital.
31
Amytal interview
Amytal interview see amobarbital. ing energy in the absence of adequate oxygen.
A Compare aerobic exercise.
anabolic-androgenic steroids steroids that
are used to increase muscle bulk and also affect anaesthesia n. see anesthesia.
the secondary sex characteristics. Anafranil n. a trade name for clomipramine.
anaclisis n. 1. an extreme dependence on an- anagogic interpretation the interpretation
other person for emotional and in some cases of dreams and other unconscious material as ex-
physical support, just as an infant is dependent pressions of ideals or spiritual forces, in contrast
on the parents for the satisfaction of his or her to the instinct-based interpretations of psycho-
basic needs. See anaclitic object choice. 2. in analysis. [introduced by Carl jung and devel-
the classical psychoanalytic theory of Sigmund oped by Austrian psychoanalyst Herbert Silberer
freud, the attachment of the sex drive to the (1882–1923)]
satisfaction of another instinct, such as hunger
anagram problem solving in studies of
or defecation. —anaclitic adj.
problem solving, a common task in which par-
anaclitic depression dependent depression: ticipants are asked to determine the word that
intense sadness and dysphoria stemming from corresponds to a series of scrambled letters (e.g.,
early disruptions in caring relationships, such as rlmoebp–problem).
deprivation, inconsistency, or overindulgence,
anal-aggressive personality in psychoana-
that lead to an indefinite fear of loss of love,
lytic theory, a personality type characterized by
abandonment, and impoverishment. The indi-
obstinacy, obstructionism, defiance, and passive
vidual expresses a child-like dependency; has lit-
resistance. Such traits are held to stem from the
tle capacity for frustration; and desires to be
anal stage, in which the child asserted himself
soothed directly and immediately. Compare
or herself by withholding feces. Also called
introjective depression.
anal-aggressive character. See also anal
anaclitic identification in psychoanalytic personality; anal sadism; anal-sadistic
theory, the first phase of the identification phase.
process, which is rooted in the child’s initial anal character see anal personality.
total dependence on the mother (as well as oth-
ers) for basic biological and emotional needs. analeptics pl. n. stimulants other than amphet-
The child acquires the mother’s characteristics amines that produce subjective effects similar to
in the service of becoming his or her own source those caused by amphetamine use. These effects
of reinforcement and comfort. The child incor- may include alertness, elevated mood, increased
porates the mother into his or her superego (see feeling of energy, decreased appetite, irritability,
ego-ideal). A weaker version of this is seen with and insomnia. The group includes diethylpro-
other significant figures in the child’s life (e.g., pion, methylphenidate, and pemoline. See also
teachers). appetite suppressant.
anaclitic object choice in psychoanalytic anal eroticism in psychoanalytic theory, plea-
theory, the selection of a mate or other love ob- surable sensations associated with expulsion, re-
ject who will provide the same type of assis- tention, or observation of the feces or through
tance, comfort, and support that the individual stimulation of the anus. These sensations first
received from the parents during infancy and arise in the anal stage of psychosexual de-
early childhood: A woman chooses a man resem- velopment, between the ages of 1 and 3. Also
bling or modeled on her father and a man called anal erotism. See also anal personal-
chooses a woman like his mother. Sigmund ity; coprophilia.
freud contrasted this with narcissistic object anal-expulsive phase in psychoanalytic the-
choice, which involves selecting a mate who is ory, a phase of the anal stage in which pleasure
similar to oneself. According to Freud, these are is obtained by expelling feces and the sadistic
the only two possible types of object choice. Also instinct is linked to destruction of the ob-
called anaclitic love. See also anaclisis. ject. According to the theory, fixation at this
anaclitic personality according to some psy- phase results in an adult anal personality.
choanalytic theories, a line of personality devel- See also anal-sadistic phase. Compare anal-
opment that is focused on feelings of loneliness retentive phase.
or fear of abandonment with regard to interper- analgesia n. absence of or reduction in the sen-
sonal relationships and—if the personality fails sation of pain. Compare algesia. —analgesic
to develop properly—may result in psychopa- adj.
thological dependency. Compare introjective analgesics pl. n. drugs or other agents that alle-
personality. viate pain. Analgesic drugs usually are classed as
anaerobic exercise strength-based physical opioid (narcotic) or nonopioid (nonnarcotic),
activity, such as weight training and sprinting, depending on their chemical composition and
that occurs in short, intense bursts with limited potential for physical dependence. opioid anal-
oxygen intake. The anaerobic threshold is the gesics are generally the most effective in re-
point at which energy use by the body is so lieving pain. The most widely used of the less
great as to require the muscles to begin produc- potent nonopioid analgesics are the nsaids
32
analysis of variance
(nonsteroidal anti-inflammatory drugs)—most stage of psychosexual development, involving

notably aspirin—and acetaminophen. both the destruction of the object and its pos- A
anal intercourse a form of sexual activity in session and control. It is manifested in the adult
which pleasure is achieved through the insertion in the form of an anal-aggressive personal-
of the penis into the anus. Also called coitus ity.
analis; coitus in ano. See also sodomy. anal-sadistic phase in psychoanalytic theory,
anal masturbation a form of anal eroticism in a phase of the anal stage in which the child
which sexual excitement is achieved through manifests aggressive, destructive, and negative
manual or mechanical self-stimulation of the tendencies. One expression of these tendencies
anus. is withholding the feces in defiance of parental
urging. See anal-aggressive personality. See
analogical thinking thinking characterized also anal-expulsive phase; anal-retentive
by extrapolations from the familiar to the unfa- phase.
miliar, rather than the use of formal logic or con-
anal stage in psychoanalytic theory, the second
secutive reasoning. It is particularly important in
stage of psychosexual development, typically
problem solving and learning, in which known
occurring during the 2nd year of life, in which
similarities between aspects of certain entities
the child’s interest and sexual pleasure are fo-
are used to make assumptions about other as-
cused on the expulsion and retention of feces
pects or entities. Also called analogical rea-
and the sadistic instinct is linked to the desire to
soning.
both possess and destroy the object. Fixation
analogue experiment an experiment in during this stage results in an anal personal-
which a phenomenon is produced in the labora- ity. Also called anal phase. See also anal-
tory in order to obtain greater control over the expulsive phase; anal-retentive phase; anal-
phenomenon. Examples include the use of hyp- sadistic phase.
nosis, drugs, and sensory deprivation to produce analysand n. in psychoanalysis, a patient who is
brief periods of abnormal behavior that simulate undergoing analysis.
those of psychopathological conditions.
analysis n. 1. the division of any entity into its
analogue study a research design in which the component parts, typically for the purpose of
procedures or participants used are similar but investigation or study. 2. see psychoanalysis.
not identical to the situation of interest. For ex- —analytic or analytical adj.
ample, if researchers are interested in the effects
of therapist gender on client perceptions of ther- analysis of covariance (ANCOVA) an exten-
apist trustworthiness, they may use undergradu- sion of the analysis of variance that adjusts
ate students who are not clients and provide the dependent variable for the influence of a cor-
simulated counseling dialogues that are typed related variable (covariate) that is not being in-
and identified as offered by a male or female vestigated but may influence the study results.
therapist. The results of such studies are assumed An analysis of covariance is appropriate in two
to offer a high degree of experimental control types of cases: (a) when experimental groups are
and to generalize to actual clinical practice. Also suspected to differ on a background-correlated
called analogue model. variable in addition to the differences attributed
to the experimental treatment and (b) where ad-
anal personality in psychoanalytic theory, a justment on a covariate can increase the preci-
pattern of personality traits believed to stem sion of the experiment.
from the anal stage of psychosexual devel-
analysis of the resistance a basic procedure
opment, when defecation is a primary source of
in psychoanalysis, in which the patient’s ten-
pleasure. Special satisfaction from retention of
dency to maintain the repression of uncon-
the feces will result in an adult anal-retentive
scious impulses and experiences is subjected to
personality, marked by frugality, obstinacy, and
analytic scrutiny. The process of explaining
orderliness, whereas fixation on expelling feces
resistances is believed to be a major contribu-
will produce an aggressive and disorderly anal-
tion to self-understanding and positive change.
expulsive personality. Also called anal charac-
ter. See also anal-aggressive personality; analysis of the transference in psychoanal-
hoarding orientation. ysis, the interpretation of a patient’s early rela-
tionships and experiences as they are reflected
anal phase see anal stage. and expressed in his or her present relationship
anal-retentive phase in psychoanalytic the- to the analyst. Also called transference analy-
ory, a phase of the anal stage marked by plea- sis. See transference; transference resis-
sure in retaining feces and thereby defying the tance.
parent, in which the sadistic instinct is linked to analysis of variance (ANOVA) any of several
possession and control of the object. Fixation at statistical procedures that isolate the joint and
this phase results in an adult anal personality. separate effects of independent variables upon a
See also anal-sadistic phase. Compare anal- dependent variable and test them for statistical
expulsive phase. significance (i.e., to determine whether they are
anal sadism in psychoanalytic theory, the ex- greater than they would be if obtained by chance
pression of aggressive impulses in the anal alone). See also general linear model.
33
analyst
analyst n. generally, one who practices psycho- ages gratifications that might drain off energy
A analysis. This is usually a psychoanalyst in the that could be utilized in the therapeutic process;
tradition of Sigmund freud; however, the term and the rule against acting out feelings and
is also applied to therapists adhering to the events instead of talking them out.
methods of Carl jung (see analytic psychol- anamnesis n. a patient’s account of his or her
ogy) or Alfred adler (see individual psychol- developmental, family, and medical history
ogy). prior to the onset of a mental or physical disor-
analytical intelligence in the triarchic der. Compare catamnesis. [first suggested by
theory of intelligence, the skills measured by Swiss-born U.S. psychiatrist Adolf Meyer (1866–
conventional tests of intelligence, such as analy- 1950) as an aid to diagnosis and exploration of
sis, comparison, evaluation, critique, and judg- possible causes of a patient’s disorder]
ment. Compare creative intelligence; prac- anamnestic analysis psychoanalysis that em-
tical intelligence. phasizes the patient’s historical account of his or
analytical psychotherapy 1. a short-term her problem with added material from family
method of psychotherapy using psychoanalytic and friends. [introduced by Carl jung]
principles but with less depth of analysis, more anancastic personality (anankastic per-
active intervention on the part of the therapist, sonality) an older name for obsessive-
and less frequent sessions than are required for a compulsive personality disorder.
true psychoanalysis. 2. historically, an alterna-
anandria n. the absence of masculinity in a
tive method to psychoanalysis proposed by Vi-
male.
ennese psychoanalyst Wilhelm Stekel (1868–
1940). anaphrodisiac n. a drug or other agent that
functions as a sexual sedative to reduce or repress
analytic couch see couch.
sexual desire. Among substances claimed to have
analytic group psychotherapy a form of this effect are potassium bromide, heroin, and
group psychotherapy based on the application camphor. Anaphrodisiacs also may be a cause of
of psychoanalytic concepts and techniques to sexual anesthesia. See also chemical castra-
three principal age groups: (a) play-group psy- tion.
chotherapy for preschool children, (b) activ-
anaphylaxis n. hypersensitivity to the intro-
ity-interview group psychotherapy for
duction of a substance (e.g., a food item such as
children before adolescence, and (c) interview
peanuts or a drug such as penicillin) into body
group psychotherapy for adolescents and
tissues, resulting from previous exposure to it.
adults. [developed by 20th-century Russian-born
Symptoms, which may include breathing diffi-
U.S. psychotherapist Samuel Richard Slavson]
culties and wheezing, are sudden and severe,
analytic psychology the system of psycho- progressing rapidly to anaphylactic shock—pul-
analysis proposed by Carl jung, in which the monary edema, heart arrhythmia, shock, loss of
psyche is interpreted primarily in terms of philo- consciousness, and potential respiratory or car-
sophical values, primordial images and symbols, diac arrest—if untreated. See also psychologi-
and a drive for self-fulfillment. Jung’s basic con- cal anaphylaxis. —anaphylactic adj.
cepts are (a) the ego, which maintains a balance anarthria n. inability to speak.
between conscious and unconscious activities
and gradually develops a unique self through in- anatomically detailed doll a doll with ana-
dividuation; (b) the personal unconscious, tomically correct genitalia that is used during an
made up of memories, thoughts, and feelings interview with a child to help a professional de-
based on personal experience; (c) the col- cide whether the child has been sexually abused.
lective unconscious, made up of ancestral Also called anatomically correct doll.
images, or archetypes, that constitute the in- anchor n. a reference point used when making a
herited foundation of an individual’s intellec- series of subjective judgments. For example, in
tual life and personality; and (d) dynamic an experiment in which participants gauge dis-
polarities, or tension systems, which derive their tances between objects, the experimenter intro-
psychic energy from the libido and influence duces an anchor by informing the participants
the development and expression of the ego: con- that the distance between two of the stimulus
scious versus unconscious values, introversion objects is a given value. That value then func-
versus extraversion, sublimation versus repres- tions as a reference for participants in their sub-
sion, rational versus irrational. The object of life, sequent judgments. Also called anchor point.
and of Jungian therapy, is to achieve a creative anchoring n. 1. the assignment of set points
balance among all these forces. Also called ana- (anchors) for judgment scales. According to
lytical psychology. this theory, all judgments are relative to an im-
analytic rules the three rules laid down by plicit scale of comparison; for example, poverty
Sigmund freud for conducting psychoanalytic is evaluated differently when people are given
therapy: the basic rule of free association, specific examples of either extreme or moderate
which gives free reign to the unconscious to poverty. 2. the process in which one or more
bring repressed impulses and experiences to the items in a list being learned serve as anchors
surface; the rule of abstinence, which discour- with which the other items are associated. For
34
Angelman syndrome
instance, the first and last items in a list of words techniques such as acupuncture or hypnotic
may serve as anchors, cuing the words in be- suggestion, or it may occur spontaneously as a A
tween. result of injury or disease. —anesthetic adj.
ANCOVA acronym for analysis of covariance. anethopath n. a person lacking ethical or moral
androgen n. any of a class of steroid hormones inhibitions. See also antisocial personality
that act as the principal male sex hormones, disorder. —anethopathy n.
the major one being testosterone. Androgens aneuploidy n. the condition in which a cell or
are produced mainly by the testes and influence organism has fewer or more than the normal
the development of masculine primary and sec- number of chromosomes, for example (in hu-
ondary sex characteristics. They are also se- mans), 45 or 49, instead of the normal 46.
creted in small quantities by the cortex of the Aneuploidy is often associated with neurological
adrenal gland and can be produced syntheti- or cognitive defects. See autosome. —aneu-
cally. —androgenic adj. ploid adj., n.
androgen antagonist n. see antiandrogen. aneurysm (aneurism) n. an enlargement (wid-
androgenization n. the masculinizing effect of ening) at some point in an artery caused by the
androgens, especially testosterone, on body pressure of blood on weakened tissues, often at
tissues and organs sensitive to them, as in the de- junctions where arteries split off from one an-
velopment of male sex characteristics. other. —aneurysmal adj.
androgynophilia n. 1. sexual attraction to angakok n. an Inuit name for a shaman or spiri-
both males and females. See bisexual behav- tual guide. The angakok is a central figure of
ior. 2. sexual attraction to someone who is an- Inuit spiritual life; present at major ceremonies,
drogynous in appearance. he foretells weather and the movement of game
androgynous personality a personality style animals, cures illness, retrieves lost or stolen
in which an individual displays both stereotypi- souls, and converses with other spiritual beings.
cal masculine and stereotypical feminine psy- angel dust a street name for crystals of pcp
chological characteristics (e.g., both assertiveness (phencyclidine). The crystals are sometimes
and sensitivity). sprinkled onto oregano, parsley, or alfalfa and
androgynous sex role 1. a mixture of sex sold as marijuana.
roles in which there is confusion or uncertainty Angell, James Rowland (1869–1949) U.S.
about gender identity and behavior that may be psychologist. After studying at the University of
labeled both masculine and feminine. A male Michigan under John dewey, Angell moved to
may play a feminine role and prefer a partner of Harvard University to study under William
his own sex, or a female may play a masculine james and Josiah Royce (1855–1916), before
role and prefer a partner of her own sex. 2. a sex studying at various German universities, includ-
role that does not conform to either stereotypi- ing the University of Halle. From 1894 through
cal male or female sex roles, but rather combines 1919 Angell taught at the University of Chicago,
positive elements of both. where he became professor of psychology, dean,
androgyny n. 1. the presence of male and fe- and finally acting president of the university
male characteristics in one individual. 2. the (1918–1919). He then became chair of the Na-
state of being neither distinguishably masculine tional Research Council, president of the Carne-
or feminine in appearance, as in dress. See also gie Corporation, and finally (in 1921) president
hermaphroditism. —androgyne n. —an- of Yale University until his retirement in 1937.
drogynous adj. In all these positions, Angell used his consider-
anecdotal evidence evidence based on infor- able influence to promote the development of
mal, uncontrolled personal observations. psychology as a science. He was a leading expo-
nent of the school of functionalism, as out-
Anectine n. a trade name for succinylcholine. lined in his 1906 American Psychological
anencephaly n. congenital absence of the cra- Association presidential address. He argued that,
nial vault (the bones forming the rear of the rather than study the discrete elements of con-
skull), with cerebral hemispheres completely sciousness (e.g., memories, images, sensations)
missing or reduced to small masses. Infants born as Edward B. titchener advocated, psycholo-
with anencephaly are usually blind, deaf, uncon- gists ought to study the evolutionary utility or
scious, and unable to feel pain. Anencephaly is functions of consciousness. Providing the foun-
an example of a neural tube defect. —anen- dation of the school of behaviorism, function-
cephalic adj. alism as Angell and others defined it has exerted
anergia n. 1. absence of energy. 2. a state of pas- widespread influence on psychology in the
sivity. Also called anergy. —anergic adj. United States. Angell received many honors, in-
anesthesia (anaesthesia) n. the loss of sensitiv- cluding election to the National Academy of Sci-
ity to stimuli, either in a particular area (local) or ences in 1920 and the American Academy of Arts
throughout the body and accompanied by loss and Sciences in 1932.
of consciousness (general). It may be produced Angelman syndrome a congenital disorder,
intentionally, for example via the administra- caused by a genetic abnormality on chromo-
tion of drugs (called anesthetics) or the use of some 15, characterized by abnormalities or im-
35
anger
pairments in neurological, motor, and cognitive depressed mood), but is also seen in other disor-
A functioning, including severe learning disabili- ders, including schizophrenia. [first defined in
ties, absence of speech, and a stiff, jerky gait and 1897 by French psychologist Théodule Ribot
movements (see ataxia). Individuals with (1839–1916)] —anhedonic adj.
Angelman syndrome have happy dispositions anhypnia n. see insomnia.
and a propensity for paroxysms of inappropriate
laughter. Craniofacial abnormalities, including a aniconia n. an absence of mental imagery.
small or unusually flattened head, a large anilides pl. n. a group of aniline derivatives de-
mouth, and a protruding jaw, are also common. veloped as analgesics and antipyretics of which
The condition was formerly called happy- acetaminophen is the only member in current
puppet syndrome. [Harry Angelman (1915– use. The parent compound, acetanilide, was
1996), British pediatrician] originally introduced in 1886 as an antipyretic,
anger n. an emotion characterized by tension but its toxicity led to its disuse and the develop-
and hostility arising from frustration, real or ment of a number of derivatives, including
imagined injury by another, or perceived injus- phenacetin (acetophenetidin; no longer in clini-
tice. It can manifest itself in behaviors designed cal use) and acetaminophen.
to remove the object of the anger (e.g., deter- anilingus n. the practice of applying the mouth
mined action) or behaviors designed merely to to the anus as a form of sexual activity. Also
express the emotion (e.g., swearing). Anger is called aniliction; anililagnia.
distinct from, but a significant activator of, ag- anima n. 1. in the earlier writings of Carl jung, a
gression, which is behavior intended to harm person’s innermost being, which is in closest
someone or something. Despite their mutually contact with the unconscious and is con-
influential relationship, anger is neither neces- trasted with the persona, or the externally di-
sary nor sufficient for aggression to occur. rected part of a person. 2. in Jung’s later writings,
anger control therapy a treatment that (a) an archetype that represents universal femi-
makes use of therapist-guided progressive expo- nine characteristics or (b) the unconscious femi-
sure to anger-provoking cues in conjunction nine aspect of the male psyche. Compare
with therapist modeling, client rehearsal, asser- animus.
tiveness training, and other forms of coping animal-assisted therapy the therapeutic use
skills training. Practiced in both individual and of pets to enhance individuals’ physical, social,
group settings, the intervention is used with cli- emotional, or cognitive functioning. Animal-
ents who have general difficulty with anger (e.g., assisted therapy may be used, for example, to
intensity, frequency, or mode of expression) or help people receive and give affection, especially
with clients who have specific disorders. See also in developing communication and social skills.
anger management. It may be most effective for people who have suf-
anger-in n. hostility turned inward, particularly fered losses or separation from loved ones. Also
as a source of depression. See also self- called pet-assisted therapy; pet therapy.
accusation. animal magnetism a hypothetical physical
anger management techniques used by indi- force that allegedly can have a curative effect
viduals—sometimes in counseling or therapy— when focused on ailing parts of the body, often
to control their inappropriate reactions to anger- through the use of a magnetized wand, magne-
provoking stimuli and to express their feelings of tized rods, or a magnetized bath. See mesmer-
anger in appropriate ways that are respectful of ism. [proposed by Austrian physician Franz
others. Such techniques include using relaxation Anton Mesmer (1734–1815), who claimed some
methods (breathing deeply, repeating a word or success using this method]
phrase, visualizing a relaxing experience) to re- animal phobia a persistent and irrational fear
duce physiological responses to anger, replacing of a particular type of animal, such as snakes,
exaggerated or overly dramatic thoughts with cats, dogs, mice, or birds. The focus of fear is
more rational ones (see cognitive restructur- often anticipated harm or danger. The emotion
ing), communicating more calmly and thought- of disgust may also play a role in the mainte-
fully about one’s anger, and removing oneself nance of certain animal phobias (e.g., mice). Sit-
from situations or circumstances that provoke uations in which the phobic animal may be
anger or avoiding them altogether. encountered are often avoided or else endured
angst n. 1. fear or anxiety (German). 2. in exis- with intense anxiety or distress. Animal phobias
tentialism, a state of anguish or despair in typically start in childhood. The DSM–IV–TR
which a person recognizes the fundamental un- designation is specific phobia, animal type.
certainty of existence and understands the sig- animatism n. the belief that within all entities,
nificance of conscious choice and personal living and nonliving, there exist supernatural
responsibility. forces or powers.
anhedonia n. the inability to enjoy experiences animism n. the belief that natural phenomena
or activities that normally would be pleasurable. or inanimate objects are alive or possess lifelike
It is one of two defining symptoms of a major characteristics, such as intentions, desires, and
depressive episode (the other being a persistent feelings. —animistic adj.
36
anosognosia
animus n. in analytic psychology, (a) an ar- anomalous experience any of a variety of

chetype that represents universal masculine conscious states, often categorized as altered A
characteristics or (b) the unconscious masculine states of consciousness, that are uncommon
component of the female psyche. Compare or that are believed to deviate from the usually
anima. [sense originated by Carl jung] accepted explanations of reality. Examples in-
aniridia-oligophrenia-cerebellar ataxia clude out-of-body experiences, mystical expe-
syndrome a rare form of mental retardation in riences, lucid dreaming, and synesthesia.
which the patient also suffers from lack of nor- anomaly n. anything that is irregular or deviates
mal muscle control and has speech difficulty. from the norm, often referring to a congenital or
Lenses and corneas may be normal, but the eyes developmental defect. —anomalous adj.
lack irises and visual acuity is in a range between anomia n. 1. loss or impairment of the ability to
20/100 and 20/200. Also called Gillespie syn- name objects. All individuals with aphasia ex-
drome. hibit anomia, and the extent of naming diffi-
Anna O. the pseudonym of Austrian social culty is a good general measure of aphasia
worker and feminist Bertha Pappenheim (1859– severity. 2. an obsolete term for a defective
1936), who was a patient of Austrian physician moral sense. [defined by U.S. physician
Josef Breuer (1842–1925), a colleague of Sigmund Benjamin Rush (1745–1813)] —anomic adj.
freud. Breuer’s treatment of her hysteria was anomic suicide a former name for a suicide in
written up in an early case study that was an im- response to an unfavorable change in the per-
portant precursor to psychoanalysis. See also son’s financial or social situation. [first defined
talking cure. by French sociologist Émile Durkheim (1858–
annihilation n. complete destruction. In psy- 1917)]
choanalytic theory, annihilation is destruction anomie n. a sense of alienation and hopelessness
of the self. In object relations theory, fear of in a society or group that is often a response to
annihilation (annihilation anxiety) is viewed as social upheaval. It may also be accompanied by
the earliest form of anxiety. Melanie klein at- changes in personal and social values. —an-
tributed it to the experience of the death in- omic adj.
stinct; British psychoanalyst Donald Winnicott
(1896–1971) saw it as the anxiety that accom- anorectant n. see appetite suppressant. Also
panies impingements from the environment. called anorexiant.
—annihilate vb. anorexia n. absence or loss of appetite for food
anniversary event the annual occurrence of a or, less commonly, for other desires (e.g., sex),
date marking a significant event or experience especially when chronic. It may be primarily a
that may be positive or negative. psychological disorder, as in anorexia nervosa,
or it may have physiological causes, such as
anniversary reaction a strong emotional re- hypopituitarism. —anorectic or anorexic
sponse on the anniversary of a significant event. adj., n.
It most commonly involves depressive symp-
toms around the same time of the year that the anorexia mirabilis a culture-bound syn-
death of a loved one or a severe disappointment drome found in medieval Europe, characterized
or adverse event occurred. by severe restriction of food intake associated
with religious devotion and piety. Also called
annulment n. in psychoanalytic theory, a pro- holy anorexia.
cess in which disagreeable ideas or events are
neutralized or made ineffective by converting anorexia nervosa an eating disorder, occur-
them into daydreams and fantasies. Compare ring most frequently in adolescent girls, that in-
repression. volves persistent refusal of food, excessive fear of
weight gain, refusal to maintain minimally nor-
anodyne n. any agent or procedure that relieves mal body weight, disturbed perception of body
pain, including analgesics (e.g., aspirin), anes- image, and amenorrhea (absence of at least three
thetics, or acupuncture. menstrual periods). See also reverse anorexia.
anoetic adj. 1. not involving or subject to intel- anorgasmia n. the inability to achieve orgasm.
lectual or cognitive processes. Emotions are Also called anorgasmy. See also female or-
sometimes considered anoetic. 2. describing a gasmic disorder; male orgasmic disorder.
level of knowledge or memory in which there is —anorgasmic adj.
no consciousness of knowing or remembering.
Anoetic consciousness is a corresponding state of anosmia n. absence or loss of the ability to smell,
“unknowing knowing” in which one is aware of which may be general or limited to certain
external stimuli but not of interpreting them. odors. General or total anosmia implies inability
[defined by Estonian-born Canadian psycholo- to smell all odorants on both sides of the nose,
gist Endel Tulving (1927– )] 3. lacking the ca- whereas partial anosmia implies an inability to
pacity for understanding or concentrated smell certain odorants. —anosmic adj.
thought. This meaning, originally applied to de- anosognosia n. a neurologically based failure to
note mental retardation, is no longer common. recognize the existence of a deficit or disorder,
Compare autonoetic; noetic. —anoesis n. such as hearing loss, poor vision, or paralysis.
37
ANOVA
anton’s syndrome is an example of ano- blocks the physiological effects of androgens,

A sognosia for blindness. the male sex hormones, on tissues normally re-
ANOVA acronym for analysis of variance. sponsive to these hormones. Examples include
bicalutamide (U.S. trade name: Casodex), fina-
anovulatory menstrual cycle a menstrual
steride (U.S. trade name: Propecia), flutamide
cycle that occurs without ovulation. It results
(U.S. trade name: Eulexin), and nilutamide (U.S.
from an imbalance between hormone produc-
trade name: Nilandron).
tion of the pituitary gland and the ovaries and is
marked by irregular menstruation. An anovu- antiandrogen therapy medical treatment
latory menstrual cycle is most likely to be associ- using antiandrogens to correct the effects of
ated with menarche or menopause. excessive levels of male sex hormones. It may be
anoxemia n. the absence of oxygen in the blood, used to control hair loss and cancer of the pros-
a condition that frequently results in loss of con- tate in males and to reverse masculine traits (e.g.,
sciousness and brain damage. See also hypox- excessive facial hair) in females. More controver-
emia. —anoxemic adj. sially, antiandrogens have been used in the treat-
ment of repeat sex offenders (see chemical
anoxia n. total lack of oxygen in the body tissues, castration).
including the brain. Consequences depend on
the severity of the anoxia and the specific areas antianxiety medication see anxiolytic.
of the brain that are affected, but can include antibiotics pl. n. drugs that are used to destroy
generalized cognitive deficits or more focal defi- pathogenic or otherwise harmful microorgan-
cits in memory, perception, or executive func- isms, especially bacteria. Antibiotics can be pro-
tion. Anoxia sometimes is used as a synonym of duced by or obtained from living cells (e.g.,
hypoxia. —anoxic adj. molds, yeasts, or bacteria) or manufactured as
ANS abbreviation for autonomic nervous sys- synthetic chemicals with effects similar to natu-
tem. ral antibiotics. Some work by interfering with
bacterial reproduction, while others may disrupt
Antabuse n. a trade name for disulfiram.
the normal life functions of the pathogen. Anti-
antagonist n. a drug or other chemical agent biotics are ineffective against viruses. Overuse
that inhibits the action of another substance. For and inappropriate use of antibiotics are contrib-
example, an antagonist may combine with the uting to the development of bacterial resistance
substance to alter and thus inactivate it (chemi- to many commonly used antibiotics.
cal antagonism); an antagonist may reduce the
effects of the substance by binding to the same anticathexis n. in psychoanalytic theory, a pro-
receptor without stimulating it, which decreases cess in which the ego withdraws psychic en-
the number of available receptors (pharmacolog- ergy from certain unconscious wishes and ideas
ical antagonism); or an antagonist may bind to a and uses it to strengthen other ideas and wishes
different receptor and produce a physiological capable of blocking their entrance into con-
effect opposite to that of the substance (physio- sciousness. The anticathected idea may be simi-
logical antagonism). Compare agonist. —an- lar to the original idea or opposite but related
tagonism n. —antagonistic adj. to it: for example, philanthropy may neutral-
ize an unconscious wish to hoard. Also called
antecedent variable a variable (a) that pre- countercathexis. See also cathexis.
cedes another variable (b) but that may or may
not be causally related to variable b. anticholinergic drug any pharmacological
agent that blocks or otherwise interferes with the
anterograde amnesia see amnesia. release of the neurotransmitter acetylcholine
anterograde memory the ability to retain and thus disrupts the transmission of impulses
events, experiences, and other information fol- along parasympathetic routes. Because they act
lowing a particular point in time. When this at muscarinic receptors (a category of acetyl-
ability is impaired (i.e., by injury or disease), it choline receptors), these agents are also known
becomes very difficult or even impossible to re- as antimuscarinic drugs. In large doses, they may
call what happened from that moment forward, also interfere with actions of histamine, seroto-
a condition known as anterograde amnesia. For nin, and norepinephrine. Natural anticholin-
example, an individual with deficits of ergic drugs include atropine and scopolamine.
anterograde memory resulting from a stroke A variety of synthetic anticholinergic drugs are
might not remember the name of a new person used to treat neurological disorders, many as
introduced to him or her but would remember antiparkinsonian drugs. They include benz-
the name of a close childhood friend. Compare tropine, biperiden, procyclidine, and tri-
retrograde memory. hexyphenidyl, which are administered primarily
antiaging remedy any intervention that is hy- to relieve the symptoms of muscular rigidity.
pothesized to slow down or reverse the effects of Anticholinergic drugs are often used in combi-
aging. Typically these interventions are pharma- nations to control specific symptoms. tricyclic
cological (e.g., antioxidants, vitamin C, growth antidepressants and some conventional
hormones), but they also can be lifestyle changes antipsychotics also have anticholinergic ac-
(e.g., exercise). tivity. Also called parasympatholytic drugs.
antiandrogen n. a substance that reduces or anticholinergic effects side effects that are
38
antiestrogen
characteristic of anticholinergic drugs and anticipatory guidance counseling and edu-

are also associated with other agents (e.g., cational services provided to individuals or fami- A
tricyclic antidepressants, monoamine lies before they reach a turning point or
oxidase inhibitors) that exert antagonist ef- significant developmental change in their lives.
fects at muscarinic receptors. They include Examples include parental guidance before a
dry mouth, blurred vision, urinary hesitancy or child enters school and counseling of employees
retention, and constipation. Also called anti- soon to reach retirement age.
muscarinic effects. See also anticholiner- anticipatory nausea nausea that occurs prior
gic syndrome. to chemotherapy (typically during the day be-
anticholinergic ileus obstruction of the small fore administration). Nausea and vomiting can
bowel (ileum) due to paralysis of its muscle, re- also occur after an individual has received a few
sulting from administration of agents that block treatments, usually in response to triggers in the
muscarinic receptors in the bowel. Though environment (e.g., odors and sights of the hospi-
rare, it may be caused by strongly antichol- tal room) that have been associated with the
inergic drugs, such as tricyclic antidepressants physical side effects of chemotherapy.
and some older antipsychotics. Ileus may be fatal anticipatory regret a sense of the potential
and requires medical intervention. negative consequences of a decision that influ-
anticholinergic syndrome a disorder pro- ences the choice made: For example, an individ-
duced by anticholinergic drugs and due to their ual may decide not to make an investment
antagonistic effects at acetylcholine recep- because of the feelings associated with an imag-
tors, marked by symptoms involving both the ined loss. See prospect theory.
peripheral and central nervous systems. The for- anticonvulsant n. any drug used to reduce the
mer include dry mucous membranes, dry mouth, frequency or severity of epileptic seizures or to
and flushed skin and face, while the latter in- terminate a seizure already underway. Until the
clude ataxia (unsteady gait), drowsiness, slurred advent of the hydantoins in the 1930s,
speech, confusion and disorientation, hallucina- anticonvulsants consisted mainly of bromides
tions, and memory deficits, particularly of short- and barbiturates: phenobarbital was first
term memory. Tricyclic antidepressants, aliphatic used in the treatment of epilepsy in 1912 and re-
phenothiazines, antiparkinsonian agents, and mained the mainstay of treatment until the in-
scopolamine are examples of drugs that can troduction of the hydantoin phenytoin. Drugs
cause anticholinergic syndrome. This syndrome now used to treat partial or tonic–clonic seizures
is often observed in patients receiving combina- include phenytoin, carbamazepine, valproic
tions of such drugs. See central anticholin- acid, phenobarbital, and newer anticonvuls-
ergic syndrome. ants, such as lamotrigine, gabapentin,
anticholinesterase n. see cholinesterase. tiagabine, topiramate, vigabatrin, and zonis-
anticipation n. 1. looking forward to a future amide. Ethosuximide and other succinimides
event or state, sometimes with an affective com- may be used in managing absence seizures. The
ponent (e.g., pleasure, anxiety). 2. the onset of a benzodiazepines are also effective antiseizure
hereditary disease at earlier and earlier ages in medications. Also called antiepileptic.
successive generations. antidepressant n. any drug administered in the
anticipatory anxiety worry or apprehension treatment of depression. Most antidepressants
about an upcoming event or situation because of work by increasing the availability of mono-
the possibility of a negative outcome, such as amine neurotransmitters such as norepineph-
danger, misfortune, or adverse judgment by oth- rine, serotonin, or dopamine, although they do
ers. The worry or apprehension is often accom- so by different routes. The monoamine oxidase
panied by somatic symptoms of tension. inhibitors (MAOIs) work by inhibiting mono-
Anticipatory anxiety is a common feature of amine oxidase, one of the principal enzymes
panic disorder, in which the concern is over that metabolize these neurotransmitters. Most
the possibility of experiencing future panic at- of the other antidepressants, including the
tacks. tricyclic antidepressants (TCAs) and the se-
lective serotonin reuptake inhibitors (see ssri),
anticipatory grief sorrow and anxiety experi- inhibit the reuptake of serotonin or nor-
enced by someone who expects a loved one to epinephrine (and to a much lesser degree dopa-
die within a short period. The period of anticipa- mine) into the presynaptic neuron. Either
tory grief can be regarded as having both stress- process leaves more of the neurotransmitter free
ful and constructive possibilities: It might to bind with postsynaptic receptors, initiating a
cushion the emotional impact when the death series of events in the postsynaptic neuron that
actually occurs, but it could have the unfortu- is thought to produce the actual therapeutic ef-
nate consequence of leading a person to with- fect.
draw from the relationship, treating the other
person as though he or she were already dead. antiepileptic n. see anticonvulsant.
See also complicated grief; traumatic grief. antiestrogen n. a substance that reduces or
[introduced as a concept in 1944 by U.S. psy- blocks the physiological effects of estrogens, the
chologist Erich Lindemann (1900–1974)] female sex hormones, on tissues normally re-
39
antiharassment policies
sponsive to these hormones. Examples include antimuscarinic drug see anticholinergic

A tamoxifen (U.S. trade name: Nolvadex), to- drug.
remifene (U.S. trade name: Fareston), fulves- antinociceptive adj. describing or relating to
trant (U.S. trade name: Faslodex), and selective any factor that increases tolerance for, or reduces
estrogen receptor modulators (SERMs), such as sensitivity to, harmful stimuli, usually stimuli
raloxifene (U.S. trade name: Evista), which have that cause pain. See also pain perception.
both inhibitory and facilitative effects upon dif-
ferent pathways mediated by estrogen receptors. antinodal behavior see nodal behavior.
Antiestrogens are variously used in the treat- antiparkinsonian drug any pharmacologi-
ment or prevention of breast cancer and some cal agent that reduces the severity of symp-
estrogenically mediated effects of menopause toms of Parkinson’s disease or drug-induced
and also in the treatment of some types of fe- parkinsonism (common with the use of conven-
male infertility. Also called estrogen antago- tional antipsychotics), including tremors,
nist. movement and gait abnormalities, and muscle
antiharassment policies policies and proce- rigidity. Antiparkinsonian agents include hista-
dures adopted by an organization or institution mine antagonists (e.g., diphenhydramine),
to prevent and counter harassment due to gen- anticholinergic drugs (e.g., benztropine, tri-
der, race, or sexual orientation. They typically hexyphenidyl), dopamine-receptor agonists
include conducting awareness training designed (e.g., carbidopa, levodopa), and specific enzyme
to educate people about harassment, imple- inhibitors.
menting disciplinary measures when necessary, antipsychiatry n. an international movement
and having formal grievance procedures. that emerged in the 1960s under the leadership
antihistamine n. any drug or agent that inhib- of British psychiatrist Ronnie D. Laing (1927–
its the effects of histamine at central or periph- 1989), South African psychiatrist David Cooper
eral histamine receptors. They may have (1931–1986), Italian psychiatrist Franco Basaglia
sedative effects and are a common component of (1924–1980), and U.S. psychoanalyst Thomas
over-the-counter sleeping aids. Others (e.g., Szasz (1920– ). Antipsychiatrists contested the
diphenhydramine, U.S. trade name: Benadryl; scientific and practical validity of psychiatry and
and dimenhydrinate, U.S. trade name: Drama- radically opposed what they understood as a
mine) are used in the treatment of allergic reac- hospital-centered medical specialty legally em-
tions or motion sickness. The so-called powered to treat and institutionalize individuals
nonsedating antihistamines have less ability to with mental disorders. Indeed, many anti-
cross the blood–brain barrier and are used psychiatrists argued against the very existence of
solely in the management of allergic responses. mental disorders themselves, advancing the no-
Also called histamine antagonist. tion that mental illnesses are not illnesses at all
but rather alternative ways of behaving that
anti-intoxicant n. a theoretical drug that
alarm people. They viewed psychiatry as a form
would have the effect of countering the in-
of social repression and a means to control devi-
toxicating effects of alcohol. Also called
ance, and treatment as a disguised form of pun-
amethystic.
ishment. —antipsychiatrist n.
antilibidinal ego in the object relations
antipsychotic n. any pharmacological agent
theory of British psychoanalyst W. Ronald D.
used to control the symptoms of schizophrenia
Fairbairn (1889–1964), the portion of the ego
and other disorders characterized by impaired
structure that is similar to Sigmund freud’s
reality testing, as evidenced by severely disorga-
superego. The antilibidinal ego constitutes a
nized thought, speech, and behavior. Formerly
nonpleasure-gratifying, self-deprecatory, or even
called major tranquilizers and later neuroleptics,
hostile self-image; it is posited to develop out of
antipsychotics are commonly divided into two
the unitary ego present at birth when the infan-
major classes: conventional (first-generation)
tile libidinal ego (similar to the id) experiences
antipsychotics, including the phenothiazines
deprivation at the hands of the parent and the
and butyrophenones, and the newer atypical
infant suppresses his or her frustrated needs.
(novel or second-generation) antipsychotics, of
Also called internal saboteur. See fairbairn-
which clozapine is the prototype. The latter
ian theory.
class has fewer adverse side effects than the for-
Antilirium n. a trade name for physostigmine. mer, particularly the neurologically based
antimanic drugs see mood stabilizer. extrapyramidal symptoms but also the less se-
antimetabolite n. a substance that has a mo- rious yet unpleasant autonomic effects, such as
lecular structure so similar to that of another dry mouth and blurred vision.
substance required for a normal physiological antipyretics pl. n. drugs that help control fever
function that it may be accepted as the required or other forms of hyperthermia (raised body
molecule, thereby disrupting a normal meta- temperature) by acting on the thermoregulatory
bolic process. For example, the anticoagulant center in the hypothalamus. They may also help
bishydroxycoumarin functions as an anti- the body to dissipate heat faster by dilating pe-
metabolite by interfering with vitamin K in pro- ripheral arteries. Aspirin and other nonopioid
ducing the blood-clotting agent prothrombin. analgesics function as antipyretics.
40
anxiety disturbance
antisocial adj. denoting or exhibiting behavior cipital lobe of the brain. [first described in 1899
that sharply deviates from social norms and also by Gabriel Anton (1858–1933), Austrian physi- A
violates other people’s rights. Arson and vandal- cian]
ism are examples of antisocial behavior. Com- antonym test an examination in which the re-
pare prosocial. spondent is presented with a word and asked to
antisocial behavior aggressive, impulsive, supply a word with the opposite meaning to it
and sometimes violent actions that violate the (e.g., being given “true” and replying “false”).
established rules, conventions, and codes of a so- Also called opposites test.
ciety, such as the laws upholding personal and
anxiety n. an emotion characterized by appre-
property rights. Compare prosocial behavior.
hension and somatic symptoms of tension in
antisocial personality disorder the pres- which an individual anticipates impending dan-
ence of a chronic and pervasive disposition to ger, catastrophe, or misfortune. The body often
disregard and violate the rights of others. Mani- mobilizes itself to meet the perceived threat:
festations include repeated violations of the Muscles become tense, breathing is faster, and
law, exploitation of others, deceitfulness, im- the heart beats more rapidly. Anxiety may be dis-
pulsivity, aggressiveness, reckless disregard for tinguished from fear both conceptually and
the safety of self and others, and irresponsibility, physiologically, although the two terms are
accompanied by lack of guilt, remorse, and em- often used interchangeably. The former is con-
pathy. The disorder has been known by various sidered a disproportionate response to a vague,
names, including dyssocial personality, psycho- unidentifiable threat whereas the latter is an ap-
pathic personality, and sociopathic personality. propriate response to a clearly identifiable and
It is among the most heavily researched of the specific threat. —anxious adj.
personality disorders and the most difficult to
anxiety attack see panic attack.
treat.
antispasmodic drug any pharmacological anxiety discharge any anxiety-reducing ac-
agent used in the management of spasms of tion or repetitive activity (e.g., exercise, knitting,
smooth muscle. They are commonly used to weeding a garden) associated with normal daily
treat gastrointestinal conditions such as irrita- living, viewed as an alternative to suppression of
ble bowel syndrome. anxiety.
antitussives pl. n. drugs that suppress coughing anxiety disorder any of a group of disorders
by affecting the cough-control center in the me- that have as their central organizing theme the
dulla oblongata of the brain. Because the cough emotional state of fear, worry, or anxious appre-
center is sensitive to opioids, these drugs are ef- hension. This category includes obsessive-
fective in suppressing cough. Opioids used as compulsive disorder, panic disorder, vari-
antitussives include codeine and dextro- ous phobias, posttraumatic stress disorder,
methorphan. Also called cough suppres- and generalized anxiety disorder. Anxiety
sants. disorders have a chronic course, albeit waxing
and waning in intensity, and are among the
antiviral drugs substances that interfere with most common mental health problems in the
the normal functioning of viruses. They may act
United States.
by blocking host-cell enzyme systems required
for viral reproduction, by blocking signals car- anxiety disorder due to a general medi-
ried in messenger RNA, or by uncoating the nu- cal condition significant anxiety (e.g., gener-
cleic acid molecule of the virus. Antiviral drugs alized anxiety, panic attacks, obsessions, and
are difficult to manage in clinical practice be- compulsions) deemed to be caused directly by
cause chemicals that block viral processes may the physiological effects of a general medical
also interfere with the patient’s normal cell func- condition. Anxiety may be caused by a number
tions. Antivirals occasionally interact with sub- of such conditions, including endocrine disor-
stances in human tissues to yield unexpected ders (e.g., hyperthyroidism), respiratory disor-
benefits, as with amantadine, which can be ders (e.g., chronic obstructive pulmonary
used as an antiparkinsonian agent. disease), cardiovascular disorders (e.g., arrhyth-
mia), metabolic disorders (e.g., vitamin B12 defi-
antivitamin n. a substance that interferes with
ciency), and neurological disorders (e.g.,
the functions of vitamins. Most antivitamins are
vestibular dysfunction).
chemicals that are similar in structure to the vi-
tamins they render ineffective. They are used anxiety disorder not otherwise specified
mainly in studies and tests of vitamin deficien- clinically significant anxiety or phobic avoid-
cies. ance that does not meet the criteria for a specific
Anton’s syndrome a rare disorder marked by anxiety disorder in DSM–IV–TR.
the lack of awareness of blindness. The person anxiety disturbance a condition character-
genuinely believes he or she can see despite clini- ized by a marked, persistent, and excessive anxi-
cal evidence of loss of vision, such as difficulties ety that causes a significant degree of emotional
in getting around, handling objects, and so distress, impairment in functioning (e.g., social,
forth. The condition is a type of visual academic, occupational), or both. See anxiety
anosognosia resulting from injury to the oc- disorder.
41
anxiety equivalent
anxiety equivalent in psychoanalysis, a con- also be based on clinician ratings or actual per-
A scious, observable symptom of anxiety, such as formance.
trembling or nausea. anxiety sensitivity fear of sensations associ-
anxiety fixation in psychoanalysis, the main- ated with anxiety because of the belief that they
tenance or continuation of an anxiety reaction will have harmful consequences. For example,
from an earlier developmental stage into a later an individual with high anxiety sensitivity is
one. likely to regard feeling lightheaded as a sign of
impending illness or fainting, whereas an indi-
anxiety hierarchy a series of graduated anxi- vidual with low anxiety sensitivity would tend
ety-arousing stimuli centering on a specific
to regard this sensation as simply unpleasant.
source of anxiety in a specific individual. It is
Research indicates that high anxiety sensitivity
used in the treatment of phobias by systematic
is a personality risk factor for the development of
desensitization: Patients proceed along the hi-
panic attacks and panic disorder.
erarchy from the least threatening situation to-
ward the most threatening situation. anxiety state 1. see anxiety neurosis. 2. for-
merly, a traumatic neurosis precipitated by a
anxiety hysteria in psychoanalysis, a neurosis wartime experience in which the ego-ideals of
in which the anxiety generated by unconscious war conflict with customary ideals. [defined by
sexual conflicts is expressed in phobic symp- Sigmund freud]
toms, such as an irrational fear of dirt or open
spaces, and in physical disturbances that are anxiolytic n. any of a class of drugs used in the
conversion symptoms. The term is now seldom control of anxiety, mild behavioral agitation,
used because it combines disorders that are now and insomnia. Formerly called minor tranquiliz-
classified separately. See anxiety disorder; ers, they can also be used as adjunctive agents in
conversion disorder. [defined by Sigmund the treatment of depression and panic disorder.
freud] The most widely used anxiolytics are the
benzodiazepines. See also azapirone; seda-
anxiety management cognitive-behavioral, tive, hypnotic, and anxiolytic drugs.
behavioral, or other techniques that aid in the
reduction of anxiety, such as biofeedback anxious–ambivalent attachment style an
training, relaxation techniques, or medica- interpersonal style characterized by worry that a
tion. partner will break off a relationship or by hesi-
tancy in forming deeply committed relation-
anxiety neurosis in psychoanalysis, a distur- ships despite a desire to do so. See also
bance or neurosis in which the most prominent attachment theory.
symptoms are persistent anxiety, feelings of im-
pending disaster, and free-floating fear ac- anxious–avoidant attachment in the
companied by such symptoms as difficulty in strange situation, a form of insecure at-
making decisions, insomnia, loss of appetite, tachment in which an infant explores only
and heart palpitations. This term is now seldom minimally and tends to avoid or be indifferent to
used: The current classification of chronic anxi- the parent.
ety of this nature is generalized anxiety dis- anxious–avoidant attachment style see
order. Also called anxiety state. See also avoidant attachment style.
anxiety disorder. anxious depression a major depressive epi-
anxiety nightmare a frightening dream that sode accompanied by high levels of anxiety.
is sometimes taken to represent the fears of the anxious–resistant attachment in the
dreamer. strange situation, a form of insecure at-
anxiety object in psychoanalysis, an object tachment in which an infant appears anxious
upon which anxiety originally caused by an- in the parent’s presence, distressed in the par-
other source is displaced. For example, a nonhu- ent’s absence, and angry upon the parent’s re-
man object may be feared because it represents turn, often resisting contact with him or her.
the father who caused the original anxiety. See aortic arch syndrome a disorder caused by
little hans. progressive obliteration of the main branches of
anxiety reaction an emotional response char- the aortic arch because of arteriosclerosis, aneu-
acterized by marked apprehension and accom- rysm, or a related problem. Usually only one or
panied by somatic symptoms of tension. two of the branches are involved, affecting blood
flow to a local area. If the carotid or vertebral ar-
anxiety-relief response in behavior ther- teries are involved, the brain will be affected. The
apy, the repetition of reassuring or tranquilizing patient may experience fainting spells, epilepsy-
words (e.g., “calm”) in anxiety-provoking situa- like seizures, temporary blindness, paralysis on
tions. one side of the body, aphasia, memory distur-
anxiety scale any of numerous assessment in- bances, or a combination of symptoms. A typical
struments designed to measure the severity of effect is the carotid-sinus syndrome, in which
anxiety symptoms. An important example is the the patient faints after turning the head. Collat-
taylor manifest anxiety scale. Such scales eral circulation may develop to compensate for
usually take the form of self-report tests but can some degree of interrupted blood flow, but pro-
42
appetite suppressant
gressive loss of vision may occur in the mean- trol of speech, whereas nonfluent aphasias are
time. associated with anterior lesions that compro- A
APA 1. abbreviation for american psychiatric mise motor and premotor cortical regions in-
association. 2. abbreviation for american psy- volved in speech production. Numerous types of
chological association. aphasia exist, for example broca’s aphasia and
wernicke’s aphasia. Also (but much less prefer-
APAP n. see acetaminophen. ably) called dysphasia. —aphasic adj.
apareunia n. 1. the inability to perform sexual aphemia n. as originally defined by French phy-
intercourse. 2. abstinence from coitus. sician Pierre Paul Broca (1824–1880), a motor
apastia n. fasting or abstinence from food. Com- aphasia with nonfluency (i.e., lack of speech)
pare aphagia. but intact language functions, as evidenced by
apathy n. indifference and lack of response to intact writing. This condition was later renamed
one’s surroundings. Apathy is commonly asso- broca’s aphasia.
ciated with severe depression or schizophrenia. aphonia n. loss of the voice resulting from dis-
—apathetic adj. ease of or damage to the larynx or vocal tract.
apathy syndrome the pattern of emotional in- aphrodisiac n. any agent that is thought to fa-
sulation (indifference, detachment) adopted by cilitate sexual desire. Substances with such a rep-
many prisoners-of-war and other victims of ca- utation include perfumes and other odors, foods
tastrophes in an effort to maintain their stabil- such as raw oysters, and various drugs, particu-
ity. larly alkaloids such as yohimbine.
Apert’s syndrome an inherited condition in apnea (apnoea) n. temporary suspension of res-
which an abnormally shaped head due to pre- piration. If the apneic period is a long one, the
mature closure of some of the cranial sutures is heart may be slowed and EEG (electroencephalo-
accompanied by mental retardation and gram) changes may occur. Apnea can occur dur-
syndactyly (partial or complete fusion of the dig- ing sleep (see sleep apnea) and is also found in
its). The syndactyly usually involves both hands many disorders, such as major epilepsy and con-
and feet and typically results in fusion of the cussion. —apneic adj.
skin and bones, marked by “mitten hands” and apodia n. the condition of being born with only
“sock feet.” Apert’s syndrome may be compli- one foot or with no feet. See also acheiria.
cated by crouzon’s syndrome (and called apomorphine n. a morphine derivative used as
Apert–Crouzon syndrome), in which case fusion an expectorant and to induce vomiting.
of the digits is partial. Both syndromes are domi-
a posteriori denoting conclusions derived from
nant traits (see acrocephalosyndactyly).
observations or other manifest occurrences: rea-
[Eugène Apert (1868–1940), French pediatrician]
soning causes from facts. When applied to hy-
aphagia n. inability to swallow or eat. Compare pothesis testing, this concept means an a
hyperphagia. —aphagic adj. posteriori test, which is a statistical test planned
aphanisis n. an obsolete term indicating total after research data have been examined because
extinction of sexual desire. [from Greek aphanes, certain patterns in the data warrant further
“invisible”: defined by British physician Ernest study. Compare a priori. [Latin, “from the lat-
Jones (1879–1958)] ter”]
aphasia n. an acquired language impairment apotemnophilia n. see acrotomophilia.
that results from neurological damage to the lan- apparition n. a visual illusion that results from
guage areas of the brain, which are typically lo- distortion of a perceived object. Often inter-
cated in the left hemisphere. Common causes of preted as threatening, apparitions may be associ-
damage include stroke, cerebral hemorrhage, ated with a neurological or toxic disorder, such
brain tumors, and cortical degenerative disor- as alcohol-induced psychotic disorder.
ders (e.g., Alzheimer’s disease). Traditionally, a Appelt–Gerken–Lenz syndrome see rob-
distinction has been made between expressive erts syndrome.
and receptive forms of aphasia, whereby individ-
apperception n. 1. the mental process by
uals with the former primarily have difficulty
which a perception or an idea is assimilated into
producing spoken and written language and
an individual’s existing knowledge, thoughts,
those with the latter primarily have difficulty
and emotions See also tendentious apper-
comprehending spoken and written language. A
ception. 2. the act or process of perceiving
more contemporary distinction, however, is
something consciously. —apperceive vb. —ap-
commonly made between fluent aphasias, char-
perceptive adj.
acterized by plentiful verbal output consisting of
well articulated, easily produced utterances of appersonation n. a delusion in which the indi-
relatively normal length and prosody (rhythm vidual believes him- or herself to be another per-
and intonation), and nonfluent aphasias, char- son and assumes the characteristics of that other
acterized by sparse, effortful utterances of short person. Also called appersonification.
phrase length and disrupted prosody. Fluent appetite suppressant any agent that reduces
aphasias are associated with posterior lesions desire for food and thus controls body weight,
that spare cortical regions critical for motor con- including the amphetamines and other stimu-
43
appetition system
lants (e.g., phentermine, diethylpropion), pare consistency motive; self-enhancement

A sibutramine, and serotonin agonists (fenflura- motive.
mine, dexfenfluramine). Use of the latter com- apprehension n. 1. uneasiness or dread about
pounds, particularly in combination with an upcoming event or the future generally. Also
phentermine (so-called “phen-fen”), resulted in called apprehensiveness. 2. the act or capabil-
heart-valve defects, and this combination was re- ity of grasping something mentally. Compare
moved from the market. Although appetite sup- comprehension. —apprehend vb. —appre-
pressants may result in short-term weight loss, hensible adj. —apprehensive adj.
there is no evidence that they achieve long-term
weight reduction unless used in conjunction
approach n. a particular method or strategy
used to achieve a goal or purpose, for example, a
with a behavioral management program. Also
psychodynamic approach in psychological re-
called anorectant; anorexiant.
search and practice.
appetition system extraversion as repre-
approach–approach conflict a situation in-
sented by an individual’s relative sensitivity to
volving a choice between two equally desirable
appetitive (positive, rewarding) cues and stimuli
but incompatible alternatives. Also called dou-
and his or her processes for approaching them.
ble-approach conflict. See also approach–
Compare aversion system. [proposed by Hans
avoidance conflict; avoidance–avoidance
eysenck]
conflict.
applied behavior analysis (ABA) the exten-
approach–avoidance conflict a situation
sion of skinner’s behavioral principles (i.e.,
involving a single goal or option that has both
operant conditioning) to practical settings. Vari-
desirable and undesirable aspects or conse-
ations of applied behavior analysis may be used
quences. The closer an individual comes to the
clinically (in the form of behavior modifica-
goal, the greater the anxiety, but withdrawal
tion or behavior therapy) as treatment for ab-
from the goal then increases the desire. See also
normal or problematic behaviors.
approach–approach conflict; avoidance–
applied psychology the application of the avoidance conflict; double approach–
theories, principles, and techniques of psychol- avoidance conflict.
ogy to practical concerns, such as problems of
approach gradient the variation in the
living or coping, education, vocational guid-
strength of a drive as a function of the organ-
ance, industry, ergonomics, consumer affairs,
ism’s proximity to its goal. For example, a rat’s
advertising, political campaigns, and environ-
goal-directed behavior increases in intensity as it
mental issues. It may be contrasted with theoret-
nears its goal of food. The approach gradient ap-
ical psychology or academic psychology, in
pears less steep than the avoidance gradient.
which the emphasis is on understanding for its
See also approach–approach conflict; ap-
own sake rather than the utility of the knowl-
proach–avoidance conflict.
edge.
approach motivation expectation of reward
applied relaxation a technique in which cli-
(e.g., a positive emotional experience), which is
ents are taught, in a step-wise fashion, to relax
a condition for goal-directed behavior.
more and more rapidly over a series of sessions in
order to master panic, anxiety, phobias, pain, approach response any behavior that brings
and other symptoms. The goal is for clients to be an organism closer to a stimulus. See adience.
able to relax in 20–30 seconds in situations in appropriate affect an expression of mood or
which their symptoms typically occur. See also feeling that is in harmony with, or naturally in-
progressive relaxation. dicative of, the accompanying thought, action,
applied tension a technique in behavior reaction, or verbal expression.
therapy that focuses on changing physiological appropriate death the death a person would
responses (e.g., low blood pressure leading to choose if given the opportunity. The concept
fainting) by having the client practice muscle draws attention to the differing needs and values
tensing and releasing during exposure to in- of individuals in the terminal phase of life. It
creasingly anxiety-evoking stimuli associated challenges the tendency to treat the disease
with a feared situation. The technique was devel- rather than the patient and the assumption that
oped and is still primarily used for blood, injury, a “good death” has the same meaning for all peo-
and injection phobias. ple. palliative care, especially as given in hos-
appraisal n. the cognitive evaluation of the na- pices, attempts to protect individuality and
ture and significance of a phenomenon or event. offers a communication process and caring envi-
In appraisal theories of emotion, such evalu- ronment providing the maximum possible op-
ations are seen as determinants of emotional portunity for the dying person to make
experience. See cognitive appraisal theory. personally meaningful decisions.
—appraise vb. approximation conditioning see shaping.
appraisal motive the desire to gain accurate apraxia n. loss or impairment of the ability to
information about the self. It leads people to perform purposeful, skilled movements despite
seek highly diagnostic feedback (see diagnos- intact motor function and comprehension. The
ticity) and to reject flattery or other bias. Com- condition may be developmental or induced by
44
Armed Forces Qualification Test
neurological dysfunction and is believed to rep- arachnophobia n. see spider phobia.

resent an impairment of the ability to plan, se- A
arbitrary inference a cognitive distortion
lect, and sequence the motor execution of in which a person draws a conclusion that is un-
movements. There are several major types of related to or contradicted by the evidence.
apraxia, including buccofacial (or orofacial)
apraxia, involving difficulty performing skilled
archaic inheritance presumed phylogenetic
influences in the development of the individ-
facial movements; ideational apraxia, involving
ual’s mental processes, such as the racial mem-
difficulty carrying out in the proper order a series
ory and archetypes of Carl Jung’s analytic
of acts that comprise a complex task; ideomotor
psychology. See phylogeny.
apraxia, involving difficulty imitating actions or
gesturing to command; limb kinetic (or melo- archetype n. 1. a perfect or typical example of
kinetic) apraxia, involving difficulty making something or the original model from which
precise, coordinated but individual finger move- something is held to derive. See also prototype.
ments; and speech (or verbal) apraxia, involving 2. in analytic psychology, a structural com-
difficulty coordinating the movements neces- ponent of the mind that derives from the accu-
sary for speaking. —apraxic adj. mulated experience of humankind. These
inherited components are stored in the collec-
A prime (symbol: A′) a measure of the sensitivity
tive unconscious and serve as a frame of refer-
for correctly detecting or remembering a stimu-
ence with which individuals view the world and
lus in a task or test. This measure is based on the
as one of the major foundations on which the
nonparametric theory of signal detection, which
structure of the personality is built. Examples are
does not make stringent assumptions about the
anima, animus, persona, shadow, supreme
distribution of responses. See signal detection
being, magna mater, and hero. Also called ar-
theory.
chetypal image; primordial image. —ar-
a priori denoting conclusions derived from pre- chetypal adj.
mises or principles: deducing effects from prior
arctic hysteria see piblokto.
assumptions. When applied to hypothesis
testing, this concept means an a priori test, area postrema a highly vascularized region of
which is a statistical test explicitly planned be- the brain located in the basal wall of the lateral
fore research data have been examined and ventricle. Brain capillaries in this area form a
trends observed. Compare a posteriori. [Latin, relatively permeable region of the blood–brain
“prior to”] barrier, enabling the passage of toxic sub-
stances to the underlying chemoreceptor
aprosody n. absence of the normal variations in trigger zone, which elicits a vomiting re-
the rhythm, stress, and pitch of speech, resulting sponse.
in monotone speech. Unusual or abnormal vari-
ations are known as dysprosody (or dyspro- arecoline n. a drug, related to muscarine, that
sodia). Also called aprosodia. stimulates smooth muscles and glands that re-
spond to postganglionic cholinergic agents. It is
APS 1. abbreviation for american psychologi- used in veterinary medicine to eliminate inter-
cal society. 2. abbreviation for american psy- nal parasites and was formerly used in the man-
chosomatic society. agement of schizophrenia.
APsaA abbreviation for american psychoana- argumentativeness n. a persistent tendency
lytic association. to dispute and argue. —argumentative adj.
aptitude–treatment interaction (ATI) a Aricept n. a trade name for donepezil.
phenomenon in which people with certain at-
aripiprazole n. an atypical antipsychotic
tributes (e.g., personality traits, cognitive styles)
agent that is thought to exert its effects by bind-
respond better to one treatment, whereas peo-
ing to the presynaptic D2 dopamine auto-
ple different attributes respond better to another
receptor, thereby inhibiting the release of
treatment. The influence of personal characteris-
dopamine from the presynaptic terminal. It is
tics upon treatment outcome is of particular in-
used in the treatment of schizophrenia. U.S.
terest in educational and psychotherapeutic
trade name: Abilify.
contexts, given the goal of finding the optimal
instructional method or intervention for differ- arithmetic mean see mean.
ent types of people. Armed Forces Qualification Test (AFQT) a
Aquachloral n. a trade name for chloral hy- screening test developed in 1950 by the Depart-
drate. ment of Defense to determine a person’s eligibil-
ity for acceptance into U.S. military service by
arachidonic acid a long-chain, polyunsatu- assessing his or her mental ability qualification.
rated fatty acid that is a component of cell mem- Originally consisting of 100 multiple-choice
branes. When liberated from the membrane by items measuring vocabulary, arithmetic, spatial
the enzyme phospholipase A2, it is transformed relations, and mechanical ability, the AFQT was
into a series of compounds known as eicosa- used as a stand-alone test until 1976, when the
noids, which serve as precursors for prosta- armed services vocational aptitude bat-
glandins, thromboxanes, and leukotrienes. tery (ASVAB) became the official screening in-
arachneophobia n. see spider phobia. strument of all U.S. military branches.
45
Armed Services Vocational Aptitude Battery
Armed Services Vocational Aptitude thought to produce a pleasurable response.

A Battery (ASVAB) a test battery developed in Common experiences that can produce an
1966 by the Department of Defense for use by arousal jag include a roller-coaster ride or watch-
the U.S. military as a standardized instrument ing a scary movie. [introduced in 1970 by Brit-
for personnel selection and classification (spe- ish-born Canadian psychologist Daniel E.
cific job assignment); in 1976 it became the offi- Berlyne (1924–1976)]
cial testing instrument of all U.S. military arousal level the extent to which an organism
branches. It currently consists of nine timed is alert to stimuli.
multiple-choice tests in the areas of word knowl-
arousal–performance relationship the
edge, paragraph comprehension, arithmetic rea-
pattern of association between cognitive or
soning, mathematics knowledge, general science,
physiological arousal (or both) and achieve-
auto and shop information, mechanical compre-
ment at physical or cognitive tasks. Also called
hension, electronics information, and assem-
anxiety–performance relationship. See ca-
bling objects. The first four tests are used to
tastrophe cusp theory; inverted-u hypoth-
determine eligibility for service (see armed
esis; reversal theory.
forces qualification test); the remainder are
used to determine interests and aptitudes. Al- arousal phase see sexual-response cycle.
though sometimes administered to high school arousal regulation the controlling of cogni-
students to assist in career planning, the ASVAB tive and physiological activation using cogni-
is a required part of the application process for tive-behavioral methods. See autogenic
all potential military recruits. training; progressive relaxation.
armoring n. a defense mechanism used to dis- arousal training a technique in behavior
tance oneself by withholding the expression of therapy that teaches clients to detect levels of
emotion through blocking of one’s experience physiological arousal and then to enhance or re-
and expression of life-affirming emotions (sad- duce these levels depending on therapeutic
ness, joy, anger, grief, and fear). goals. This technique is often used in anger
control therapy and behavioral sex ther-
Arnold–Chiari malformation a congenital
apy.
deformity in which the medulla oblongata
and cerebellum protrude through the fora- arousal transfer an increase in the intensity of
men magnum, so that the cerebellum overlaps one emotion that follows the experience of an-
the top of the spinal cord. hydrocephalus and other emotion. For instance, the intensity of
meningomyelocele are commonly associated love may increase following an intense experi-
with the different types of the deformity. [Julius ence of fear or anger.
Arnold (1835–1915), German pathologist; Hans arranged marriage a marriage planned and
Chiari (1851–1916), Austrian pathologist] contracted by the parents or other relatives of
aromatherapy n. a type of therapy purported the partners or by significant figures (e.g., elders)
to improve psychological and physical health in the partners’ culture or social group. In cul-
through the use of selected essential oils ex- tures in which arranged marriages are the norm
tracted from seeds, herbs, flowers, fruits, and and in contrast to the concept of the “love
trees. The fragrances of these oils are inhaled or match,” marriage is typically seen as the union
the oils themselves are applied topically, using of two kinship groups and not merely of two in-
compresses, baths, or massages, in an effort to dividuals.
induce relaxation, reduce stress and emotional array n. any ordered arrangement of data, partic-
distress, and enhance well-being. So-called evi- ularly a two-dimensional grouping of data into
dence supporting the effectiveness of aroma- rows and columns (i.e., a matrix). The concept
therapy is almost entirely anecdotal. See also may be extended to more than two dimensions.
complementary and alternative medicine. arrhythmia n. any variation from the normal
arousal n. 1. a state of physiological activation rhythm of the heartbeat. Kinds of arrhythmia in-
or cortical responsiveness, associated with sen- clude tachycardia, any rate above 100 beats per
sory stimulation and activation of fibers from minute; bradycardia, a rate of less than 60 beats
the reticular activating system. 2. a state of per minute; premature beats; atrial flutter, in
excitement or energy expenditure linked to an which one of the upper chambers contracts at a
emotion. Usually, arousal is closely related to a rate of as much as 400 times per minute; and
person’s appraisal of the significance of an event heart block, marked by failure of the heart to
or to the physical intensity of a stimulus. Arousal contract because of the interruption or delay of
can either facilitate or debilitate performance. an electrical stimulus needed to trigger the con-
See also catastrophe cusp theory. —arouse traction. —arrhythmic adj.
vb. Artane n. a trade name for trihexyphenidyl.
arousal jag an increase of activation followed arteriopathia hypertonica a form of arterial
by a more or less sudden decrease, often accom- degeneration associated with hypertension. The
panied by laughter as a release of tension. The muscle and elastic tissue of the walls of the arte-
abrupt fall from elevated levels of arousal to a rial system increases and forms layers that are
lower, more appropriate level of arousal is eventually replaced by connective-tissue fibers.
46
as-if personality
The condition can be both a cause and an effect opportunity to express oneself imaginatively,
of hypertension, leading to cerebrovascular acci- authentically, and spontaneously; over time, A
dents if not controlled by medication. this process can lead to personal fulfillment,
arteriosclerosis n. a group of diseases charac- emotional reparation, and transformation. The
terized by hardening and loss of elasticity of the products made in art therapy are seen as a means
walls of the arteries. A common type is athero- of symbolic communication and a vehicle for
sclerosis. —arteriosclerotic adj. developing new insights and understandings, re-
solving conflicts, solving problems, and formu-
arteritis n. inflammation of an artery or more
lating new perceptions to achieve positive
than one artery. A common form is temporal (or
changes, growth, and rehabilitation.
giant cell) arteritis, a chronic disease of older
people that largely involves the carotid arterial arugamama n. see morita therapy.
system, especially the arteries of the temple and ASA abbreviation for acetylsalicylic acid. See aspi-
scalp. It is marked by the appearance of giant, rin.
multinucleate cells and granulomas in the af- asana n. a yoga posture or position. Each asana is
fected arteries; symptoms include severe tempo- said to have both physical and psychological ef-
ral-area headaches on both sides and visual fects that may be therapeutic or cathartic.
disturbances, which may result in loss of sight in
one eye. See also panarteritis. ASC abbreviation for altered state of con-
sciousness.
arthritis n. inflammation of a joint, causing
pain, swelling, and stiffness. The most severe Asch, Solomon E. (1907–1996) Polish-born
and disabling form is rheumatoid arthritis, asso- U.S. psychologist. Asch emigrated with his fam-
ciated with the body attacking its own cells as ily to the United States in 1920 and earned his
foreign (see autoimmunity). The psychosocial doctorate from Columbia University in 1932; his
effects of arthritis, which can be chronic, pain- dominant influences were the Gestalt psycholo-
ful, recurrent, and debilitating, can include life- gists, especially Max wertheimer. Asch taught
style changes, stress on personal relationships, at various universities, including Swarthmore
and depression. —arthritic adj. College, where for some 19 years he was part of a
group of Gestalt psychologists that also included
arthrogryposis multiplex congenita a
Wolfgang köhler, and the University of Penn-
congenital disorder, with evidence of hereditary
sylvania, where he remained from 1972 until his
factors in 30% of cases, marked by distorted
retirement. Asch is best known for his contribu-
joints in different body areas, clubfoot, and a
tions to social psychology, especially for his clas-
greater than average incidence of mental retar-
sic 1952 text on that field. He was particularly
dation. In some cases arms are rotated inward,
successful in designing laboratory experiments
the hips are dislocated, and the muscles are
that reflected the complexity of human social
small, weak, and hypotonic. The term itself
life. His experiments were among the first to
means “crooked-joint disorder.” Four separate
show how social context could influence even
types of the disease are known. Also called
such fundamental processes as perception. For
arthrogryposis.
example, in his famous studies of conformity,
articulation disorder any disorder of speech he showed that people’s perception of a line’s
involving the substitution, omission, distortion, length could be influenced by the false reports of
or addition of speech sounds. See also dys- others around them. His work was widely influ-
arthria; phonological disorder; speech ential; the famous conformity experiments of
and language disorder. Stanley Milgram (1933–1984) grew directly out
artifact n. an experimental finding that is not a of Asch’s work. Asch held many honors, includ-
reflection of the true state of nature but rather ing the Nicholas Murray Butler Medal from Co-
the consequent of flawed design or analytic lumbia University and a Distinguished Scientific
error. Contribution Award from the American Psycho-
artificial insemination (AI) the use of medi- logical Association. He was elected to the Ameri-
cal or surgical techniques to achieve conception can Academy of Arts and Sciences in 1965.
by introducing sperm into the female reproduc- ASD 1. abbreviation for acute stress disorder.
tive system. In humans, this is done by introduc- 2. abbreviation for autistic spectrum disor-
ing sperm from the donor (who masturbates to der.
provide the semen) into the vagina or through Asendin n. a trade name for amoxapine.
the cervical opening, directly into the uterus. As
with intercourse, artificial insemination may asexual adj. lacking sexual characteristics or
need to be done more than once for pregnancy drive. —asexuality n.
to occur, but it is usually scheduled to coincide as-if hypothesis an unproven hypothesis that
with the days of ovulation, to maximize success. is treated “as if” it were correct, usually because
Success rates of 75% are usual. of its value as an explanatory model or its utility
art therapy the use of artistic activities, such as as a basis for experiment and research. Many of
painting and clay modeling, in psychotherapy the hypothetical entities postulated by psychol-
and rehabilitation. The process of making art is ogy and psychoanalysis are of this nature.
seen as healing, an experience that provides the as-if personality a type of personality style in
47
asitia
which the individual behaves as if well adjusted, carisoprodol, orphenadrine), or other drugs.
A but in fact is doing only what is expected and is Because many of these preparations can be ob-
unable to behave in a genuine or spontaneous tained without a doctor’s prescription, individu-
manner. This condition has reportedly been ob- als with the habit of regular self-medication are
served in individuals with schizophrenia before at risk of developing gastrointestinal symptoms
they exhibit psychotic symptoms, such as hallu- (e.g., peptic ulcer) and other toxic reactions (see
cinations or delusions. [first described in 1942 by salicylism; caffeine intoxication).
U.S. psychologist Helene Deutsch (1884–1982)] aspirin poisoning see salicylism.
asitia n. repulsion at the thought or sight of food. assault n. 1. a violent attack on an individual.
See also anorexia. 2. illegal conduct occurring when an individual
asocial adj. 1. declining to engage, or incapable either attempts to injure another person or
of engaging, in social interaction. See also schiz- threatens to do so, and has the capacity to carry
oid personality disorder. 2. lacking sensitiv- out the threat. —assaultive adj.
ity or regard for social values or norms. See also assertiveness n. a style of communication in
antisocial personality disorder. —asoci- which individuals express their feelings and
ality n. needs directly, while maintaining respect for
Asperger’s disorder a pervasive developmen- others.
tal disorder associated with varying degrees of assertiveness training a method of teaching
deficits in social and conversational skills, diffi- individuals to change verbal and nonverbal sig-
culties with transitions from one task to another nals and behavioral patterns and to enhance in-
or with changes in situations or environments, terpersonal communication generally through
and preference for sameness and predictability techniques designed to help them express emo-
of events. Obsessive routines and preoccupation tions, opinions, and preferences—positive and
with particular subjects of interest may be pres- negative—clearly, directly, and in an appropri-
ent, as may difficulty reading body language and ate manner. role play or behavior rehearsal
maintaining proper social distance. Some people is often used to prepare clients to be appropri-
with Asperger’s disorder have reported over- ately assertive in real-life situations.
sensitivity to sounds, tastes, smells, and sights,
but the nature of such sensitivities is not well reassessment n. 1. in general, a judgment of the
searched. In contrast to autistic disorder, lan- quality, worth, importance, or value of some-
guage skills develop, and there is no clinically thing or someone. 2. see psychological as-
significant delay in cognitive or adaptive func- sessment.
tioning other than in social interactions. By defi- assignment therapy a technique used in
nition, people with Asperger’s disorder have an group therapy to enhance cohesiveness and
IQ in the normal to superior range, and some communication among the participants so as to
may exhibit exceptional specific skills or talents. obtain maximum therapeutic benefit. A
See also autistic spectrum disorder. Also sociometric test is administered to determine the
called Asperger’s syndrome. [described in patterns of intermember relations within the
1944 by Hans Asperger (1906–1980), Austrian group as a whole, and these patterns are then
psychiatrist] used to assign individuals to smaller, more fo-
asphyxophilia n. arousal and enjoyment ob- cused groups. [articulated by Romanian-born
tained from being unable to breathe during sex- psychiatrist and philosopher Jacob L. Moreno
ual activity. As a paraphilia, this may involve (1889–1974)]
being choked or strangled by a partner. assisted death an action taken by one person to
aspirin n. acetylsalicylic acid: the most com- end the life of another, at the request of the lat-
monly used nonopioid analgesic, which also ter. This action can take the form of either as-
has antipyretic and anti-inflammatory proper- sisted suicide or active euthanasia. Assisted
ties and the ability to prevent formation of blood death differs from mercy killing in that it is
clots. Aspirin alleviates pain mainly by periph- generally performed by a physician and is not in
eral mechanisms (see nsaids); in controlling response to an acute situation. It is sometimes
fever, it acts on the body’s thermoregulatory called physician-assisted suicide, which assumes
center in the hypothalamus. Adverse effects a firm determination of the cause of death.
include gastric irritation or ulceration with assisted living a form of congregate housing
bleeding and occasional allergic reactions. Over- for older adults requiring long-term care services
dosage affects the central nervous system and that include meals, personal care, and scheduled
other body systems (see salicylism). nursing care. Typically comprising private rooms
aspirin combinations drug mixtures that in- or apartments, it encourages a degree of auton-
clude aspirin as one of the components, the omy and independence in residents that is not
others commonly being other analgesics (e.g., provided for in nursing homes.
acetaminophen, codeine, propoxyphene), assisted suicide suicide in which the person
stimulants (usually caffeine), or both. Aspirin ending his or her own life is provided the means
combinations may also include a barbiturate to do so (e.g., a prescription) by another. See as-
(e.g., butalbital), a skeletal muscle relaxant (e.g., sisted death.
48
asymptomatic
assistive technology (AT) 1. the field con- tion of bonds between elements. In different
cerned with development and service provision types of associationistic learning theories, these A
of tools that improve the functioning of individ- associated elements may be stimulus and re-
uals with limitations or disabilities. See also bio- sponse, mental representations of events, or ele-
engineering. 2. any equipment or system ments in neural networks. Historically, the
designed to maintain or improve the functional associationistic theories of Clark L. hull and
capabilities of individuals with disabilities. Kenneth W. spence (1907–1967) are contrasted
Assistive devices (or assistive technology de- with the nonassociative and cognitive theory of
vices) range from simple low-technology items Edward C. tolman.
such as canes, walkers, and reachers to high- associative linkage see associative anam-
technology items such as voice-controlled com- nesis.
puters and computerized speech-output devices.
These devices are also occasionally referred to as
associative memory retrieval of a memory
(e.g., of a stimulus, behavior, place, or past
daily-living aids or independent-living aids.
event) that occurs upon recall or presentation of
association n. 1. a connection or relationship something associated with it.
between items, particularly ideas, events, or feel-
ings. Associations are established by experi-
associative strength the strength of the link
(association) between two or more items (e.g.,
ence and are fundamental to learning theory
between stimulus and response or between items
and behaviorism. 2. the degree of statistical
in memory), as measured by the capacity of the
dependence between two or more phenomena.
first item to elicit the second.
3. a group of individuals who gather occasion-
ally for some common purpose. —associative associative thinking a largely uncontrolled
adj. —associational adj. cognitive activity in which the mind “wanders”
association cortex any of various areas of the without specific direction among elements
cerebral cortex that are not involved princi- based on their connections (associations) with
pally in sensory or motor representations but one another, as occurs during reverie, daydream-
may be involved in integrative functions. Also ing, and free association.
called association area. assumption n. 1. the premise or supposition
association disturbance see disturbance of that something is fact; that is, the act of taking
association. something for granted. 2. one or more condi-
tions that need to be met in order for a statistical
Association for the Advancement of Psy- procedure to be fully justified from a theoretical
chology (AAP) an organization founded in perspective. For example, analysis of variance
1974 for the purpose of promoting human wel- assumes homogeneity of variance and inde-
fare through the advancement of the profession pendence of observations, among other criteria.
and science of psychology. The AAP promotes If the assumptions were to be violated to an ex-
the interests of psychologists through (a) repre- treme extent, the results would be invalid.
sentation before public and governmental bod-
ies, (b) cooperation with other organizations and assurance n. see reassurance.
agencies in furtherance of the profession and sci- astasia n. severe impairment or complete loss of
ence of psychology, and (c) the operation of a the ability to stand due to problems in motor co-
political committee known as Psychologists for ordination. —astatic adj.
Legislative Action Now (AAP/PLAN). astasia–abasia the ability to walk only with a
association-reaction time the elapsed time wobbly, staggering gait, although control is nor-
between stimulus and response in a word-associ- mal while lying down. This is believed to be psy-
ation test. chogenic in origin and may be manifested as a
associative anamnesis a psychiatric interview symptom of conversion disorder. Also called
technique in which the client gives an autobio- Blocq’s disease.
graphical account of his or her history and diffi- asthenia n. severe weakness or loss of strength,
culties, while the therapist listens for key words often associated with general fatigue or certain
and expressions that are then used to establish disorders. Asthenia was formerly thought to be a
an associative linkage that will bring the client common symptom of a major depressive epi-
closer to the unconscious roots of his or her dis- sode but is no longer defined as such. —as-
turbance. See also sector therapy. [developed thenic adj.
by Felix Deutsch (1884–1964)] asthma n. a chronic disorder in which intermit-
associative fluency the ability to make a wide tent inflammation and narrowing of the bron-
range of connections when presented with an chial passages produces wheezing, gasping,
object, event, word, or concept. High associative coughing, and chest tightness. Though the pre-
fluency has been identified as an aspect of cre- cipitating cause is usually an allergen, such as
ativity that in many individuals is not posi- dust or pollen, environmental irritants, respira-
tively correlated with high intelligence. See also tory infection, anxiety, stress, and other agents
creative thinking; divergent thinking. may produce or aggravate symptoms. —asth-
associative learning the process of acquiring matic adj.
new and enduring information via the forma- asymptomatic adj. not showing any symp-
49
AT
toms. For example, hypertension is considered athymia n. 1. absence of feeling or emotion. 2.

A asymptomatic because usually it does not have congenital absence of the thymus.
any outright physical or behavioral symptoms Ativan n. a trade name for lorazepam.
and can be detected only by measuring the
blood pressure. atmosphere effect the tendency for particular
behaviors to be stimulated by a particular envi-
AT abbreviation for assistive technology. ronment or situation, even when inappropriate,
ataque de nervios a culture-bound syn- such as gesturing when using the telephone or
drome found among Latinos, characterized by applauding a poor speech.
shaking, uncontrollable shouting or crying, a ATP adenosine triphosphate: a nucleotide in liv-
sense of rising heat, loss of control, and verbal or ing cells that is the source of chemical energy for
physical aggression, followed by fainting or biological processes. A bond between two of its
seizurelike episodes. Symptoms often occur fol- three component phosphate groups is easily
lowing a stressful event related to the family, and split by a particular enzyme, ATPase (adenosine
most individuals quickly return to their previous triphosphatase), yielding energy when a cell re-
level of functioning. quires it.
ataractics pl. n. agents that have a calming or at risk vulnerable to a disorder or disease. Risk
quieting effect, producing a state of ataraxy. status for an individual is defined by genetic,
The name was introduced as an alternative to physical, and behavioral factors or conditions.
tranquilizer. Also called ataraxics. For example, children of people with schizo-
Atarax n. a trade name for hydroxyzine. phrenia may be considered at risk for schizo-
phrenia, and heavy cigarette smokers are at risk
ataraxy n. a state of mind that is characterized for emphysema and lung cancer.
by perfect peace or detached serenity without
loss of mental abilities or clouding of conscious- at-risk mental states psychological symp-
ness. Also called ataraxia. —ataraxic or toms or mental processes that render individuals
ataractic adj. vulnerable to mental illnesses or to adverse be-
haviors, such as violence.
ataxia n. inability to perform coordinated volun-
tary movements. Ataxia may be seen as a symp- atrophy n. a wasting away of the body or a body
tom of various disorders, such as multiple part, as from lack of nourishment, inactivity, de-
sclerosis or cerebral palsy, or it can occur in isola- generative disease, or normal aging. —atrophic
tion. It can be heritable, as in friedreich’s adj.
ataxia, or acquired from injury or infection af- atropine n. an anticholinergic drug derived
fecting the nervous system. When due to dam- from certain plants, particularly belladonna (see
age to the cerebellum it is called cerebellar belladonna alkaloids), and also produced
ataxia and when due to loss of sensory feedback synthetically. Its effects include increases in
from the muscles and joints it is called sensory heart rate and rate of breathing, relaxation of
ataxia. —ataxic adj. smooth muscles, and reduction of secretions
ataxic feeling a sense that the ability to coordi- (e.g., saliva). It may be used to treat organo-
nate muscular movement has been lost. The feel- phosphate poisoning and bradycardia (slowing
ing may be psychogenic or caused by such of the heart rate), or as an adjunct to anesthesia,
psychotropic drugs as antipsychotics, benzo- but is most commonly employed in eye exami-
diazepines, and lithium. nations to dilate the pupil. Atropine is closely re-
lated, chemically and pharmacologically, to
ataxiophemia n. incoordination of the muscles scopolamine.
used in speaking. It is essentially equivalent to
atropine-coma therapy (ACT) a now-
dysarthria.
abandoned method of treating tense, agitated,
ateliosis n. 1. incomplete development of the and anxious people with psychoses by adminis-
body or of any of its parts, as in infantilism or tering atropine sulfate to induce coma.
dwarfism. 2. formerly, the persistence of infan-
attachment n. the close emotional bond be-
tile or childlike cognitive or emotional develop-
tween a human infant or a young nonhuman
mental stages. Also called atelia.
animal and its parent figure or caregiver, devel-
atherosclerosis n. a common form of arterio- oped as a step in establishing a feeling of security
sclerosis resulting from accumulations of and demonstrated by calmness while in their
lipids such as cholesterol on the inner walls of ar- presence. Attachment also denotes the tendency
teries and their hardening into atherosclerotic to form such strong bonds with certain other in-
(or atheromatous) plaques. —atherosclerotic dividuals in infancy as well as the tendency in
adj. adulthood to seek emotionally supportive rela-
athletic triad the combination of amenor- tionships.
rhea, disordered eating, and osteoporosis ob- attachment behavior 1. behavior associated
served in some female athletes, particularly with the formation of and investment in signifi-
those in subjectively evaluated sports (e.g., gym- cant relationships. 2. infant behavior that results
nastics, diving) or endurance sports (e.g., cross- in the infant gaining proximity to or contact
country running). with his or her caregiver. Its manifestations in-
50
attention-deficit/hyperactivity disorder not otherwise specified
clude crying, smiling, calling, and clinging. See tion. For example, past experience affects per-
attachment theory. [first described by John ceptual experience (we notice things that have A
bowlby] meaning for us), and some activities (e.g., read-
attachment bond the primary, enduring, spe- ing) require conscious participation (i.e., inten-
cial relationship that gradually develops be- tional attention). However, attention can also be
tween an infant and caregiver. captured (i.e., directed unintentionally) by qual-
ities of stimuli in the environment, such as in-
attachment disorder see reactive attach-
tensity, movement, repetition, contrast, and
ment disorder.
novelty.
attachment style the characteristic way peo-
ple relate to others in the context of intimate re- attentional control of consciousness the
lationships, which is heavily influenced by self- concept that selective attention to an event
worth and interpersonal trust. Theo- can increase the likelihood of the event becom-
retically, adults’ degree of attachment security is ing conscious.
related directly to how well they bonded to oth- attentional dyslexia a form of acquired dys-
ers as children. There are four distinct categories lexia (see alexia) in which a person is able to
of adult attachment that have been identified: read words but has difficulty identifying their
dismissive attachment, fearful attach- constituent letters. This is thought to be caused
ment, preoccupied attachment, and secure by a failure of the letter-to-word binding system,
attachment. resulting in the “migration” of letters between
attachment theory a theory that (a) postu- words. People with attentional dyslexia are able
lates an evolutionarily advantageous need, espe- to read letters or words significantly better when
cially in primates, to form close emotional bonds they are presented in isolation than when pre-
with significant others: specifically, a need for sented together with others as part of a text.
the young to maintain close proximity to and attention-control training (ACT) a pro-
form bonds with their caregivers; and (b) charac- gram that assists an individual to be more effec-
terizes the different types of relationships be- tive at maintaining appropriate attentional
tween human infants and caregivers. These focus. It is achieved by assessment of the individ-
relationships have been shown to affect the indi- ual’s attentional strengths and weaknesses, the
vidual’s later emotional development and emo- attentional demands of the environment in
tional stability. See also insecure attachment; which the individual’s performance occurs, en-
secure attachment; strange situation. vironmental and personal characteristics likely
[originally developed by John bowlby and later to induce stress and dictate behavior under pres-
expanded by Canadian-born U.S. psychologist sure, and typical error patterns and situations in
Mary D. Salter Ainsworth (1913–1999)] which they occur. This assessment leads to the
attempted suicide a deliberate but, by impli- planning of an intervention protocol, the pur-
cation, unsuccessful attempt to commit suicide. pose of which is to teach the individual to con-
Also called suicide attempt. centrate on all the task-relevant cues and ignore
all the task-irrelevant cues in a given situation.
attendant care 1. nonmedical, in-home assis-
tance with dressing, feeding, and other activities attention-deficit disorder (ADD) a former
of daily living provided to individuals with a and still commonly used name for attention-
physical or developmental disability who other- deficit/hyperactivity disorder.
wise are able to live independently. 2. one-on- attention-deficit/hyperactivity disor-
one direct supervision by a trained attendant of a der (ADHD; AHD) in DSM–IV–TR, a behavioral
juvenile who has been taken into custody in a syndrome characterized by the persistent pres-
nonsecure setting. ence (i.e., for 6 months or more) of six or more
attending behavior any behavior engaged in symptoms involving (a) inattention (e.g., failure
by an individual while attentively listening to to complete tasks or listen carefully, difficulty in
and observing a speaker, for example, exhibiting concentrating, distractibility) or (b) impulsivity
an open, interested posture and maintaining eye or hyperactivity (e.g., blurting out answers; im-
contact. Helpful attending behaviors, along with patience; restlessness; fidgeting; difficulty in or-
active listening, are considered cornerstones ganizing work, taking turns, or staying seated;
of a therapist’s or counselor’s general ability. excessive talking; running about; climbing on
attention n. a state of awareness in which the things). The symptoms, which impair social, ac-
senses are focused selectively on aspects of the ademic, or occupational functioning, start to ap-
environment and the central nervous system is pear before the age of 7 and are observed in more
in a state of readiness to respond to stimuli. Be- than one setting. ADHD has been given a variety
cause human beings do not have an infinite ca- of names over the years, including the still com-
pacity to attend to everything—focusing on monly used attention-deficit disorder (ADD).
certain items at the expense of others—much of attention-deficit/hyperactivity disor-
the research in this field is devoted to discern- der not otherwise specified in DSM–IV–
ing which factors influence attention and to un- TR, a disorder characterized by inattention, hy-
derstanding the neural mechanisms that are peractivity, or impulsivity that impair perfor-
involved in the selective processing of informa- mance in educational or social situations but do
51
attention disorder
not meet the diagnostic criteria for attention- rived from specific beliefs, emotions, and past
A deficit/hyperactivity disorder (ADHD). It behaviors associated with those objects. —atti-
may, for example, be marked by significant tudinal adj.
problems in attention that start after the age of 7 attitude–behavior consistency the extent
or that are not among the criteria listed for a di- to which behavior toward an attitude object is
agnosis of ADHD (e.g., daydreaming). consistent with the attitude associated with that
attention disorder a disturbance character- object. Positive attitudes are associated with ap-
ized by an inability to maintain focus on an ac- proach behaviors; negative attitudes are associ-
tivity or by difficulties in taking notice of, ated with withdrawal behaviors.
responding to, or being aware of the behavior, attitude change any alteration in an attitude,
demands, or requests of other people. Previ- which may result from active attempts by others
ously, this term was frequently used inter- to change the attitude or from processes initi-
changeably with minimal brain dysfunction, ated by the person holding the attitude.
as impairments of attention are among the most
attitude object any target of judgment that has
common manifestations of brain damage. See
an attitude associated with it. Attitude objects
also learning disability.
may be people, social groups, policy positions,
attention-getting adj. describing a type of be- abstract concepts, or physical objects.
havior, often inappropriate, that is used to gain
attitude therapy a form of reeducative treat-
attention. Childhood temper tantrums are an
ment that emphasizes current attitudes of the
example of such behavior.
client in terms of the origins of these attitudes,
attention level the degree to which a task or the purpose such attitudes serve, and their dis-
event is likely to be reportable or conscious. tortions.
Tasks with high attention-level demands are
attitudinal group 1. an aggregation, or set, of
likely to interfere with each other when they
individuals who are highly similar in their atti-
must be done at the same time. See also dual-
tudes toward a given subject. 2. any personal
task competition.
growth or therapy group in which the members
attention load measure a method that uses are given the chance to express and exchange
competing cognitive tasks to assess the process- feelings and thoughts in an accepting environ-
ing demands made by each task. The degrada- ment.
tion in performance of one task is taken to be a
attitudinal types in Carl Jung’s analytic psy-
measure of the attentional demands made by the
chology, two personality types defined by ha-
other task.
bitual extraversion on the one hand and
attention overload a psychological condition habitual introversion on the other. See intro-
that results from excessive demands on atten- version–extraversion. See also functional
tion. The effect is temporary depletion of avail- types.
able attention and an inability to cope with tasks attraction n. 1. the feeling of being drawn to
that demand attention. See also information one or more other individuals and desiring their
overload. company, usually but not necessarily always be-
attention span 1. the length of time an indi- cause of a personal liking for them. 2. power of
vidual can concentrate on one specific task or attraction: the extent to which any one individ-
other item of interest. 2. the maximum number ual is attractive to or liked by others. —attrac-
of distinct factors that can be comprehended tive adj.
from one brief exposure to an array of stimuli. attraction relations patterns of liking–dislik-
attenuated positive symptoms in schizo- ing, acceptance–rejection, and inclusion–exclu-
phrenia, a reduction in hallucinations, delusion among members of a group. Such patterns
sions, bizarre behavior, or conceptual thought are also known as sociometric structure, particu-
problems. See also positive symptom. larly when assessed through the use of
attenuated psychotic symptoms in schizo- sociometry.
phrenia and other psychotic disorders, an attributable risk in epidemiology, the inci-
increase in reality-based perceptions and a re- dence rate of a disease or disorder that can be
duction in symptoms, such as delusions, hallu- considered to have been caused by exposure to a
cinations, markedly incoherent speech, and dis- risk factor. A large portion of lung cancers can
orientation. be attributed to tobacco use, constituting a sub-
attenuation n. 1. the lessening or weakening in stantial attributable risk for this disease.
strength, value, or quality of a stimulus. 2. in sta- attribution n. an inference regarding the cause
tistics, a reduction in the estimated size of an ef- of a person’s behavior or an interpersonal event.
fect because of errors of measurement. The cause may be stable or unstable, internal or
attitude n. a relatively enduring and general external, and controllable or uncontrollable,
evaluation of an object, person, group, issue, or and the character of the reason affects motiva-
concept on a scale ranging from negative to position. See attribution theory; learned help-
tive. Attitudes provide summary evaluations of lessness.
target objects and are often assumed to be de- attributional style a person’s characteristic
52
atypical psychosexual dysfunction
tendencies when inferring the cause of behavior atypical depression a major depressive epi-
or events. Three dimensions are often used to sode or, less commonly, dysthymic disorder A
evaluate people’s attributional styles: the inter- characterized by atypical features.
nal–external dimension (whether they tend to atypical disorder in DSM–III and earlier edi-
attribute events to the self or to other factors), tions, a residual category that included unusual
the stable–unstable dimension (whether they or uncharacteristic variations of standard mental
tend to attribute events to enduring or transient disorders. The equivalent DSM–IV–TR category is
causes), and the global–specific dimension not otherwise specified.
(whether they tend to attribute events to causes
atypical dissociative disorder in DSM–III, a
that affect many events or just a single event).
residual category of dissociative disorders that in
attribution of emotion see schachter– DSM–IV–TR is labeled dissociative disorder
singer theory. not otherwise specified.
attribution theory the study of the processes atypical eating disorder in DSM–III and ear-
by which people ascribe motives to their own lier editions, a residual category of disorders that
and others’ behavior. The motives ascribed may in DSM–IV–TR is labeled eating disorder not
be either internal and personal (dispositional otherwise specified.
attribution) or external and circumstantial atypical features symptoms of a disorder
(situational attribution). According to U.S. other than the standard diagnostic criteria. For a
social psychologist Harold H. Kelley (1921– major depressive episode or dysthymic dis-
2003), observers choose between the two types order, for example, they would include im-
of attribution on the basis of three factors: provement of mood in response to positive
consistency (how has the same individual (actor) events or hypersomnia.
behaved in the same situation in the past?); dis-
atypical gender identity disorder in DSM–
tinctiveness (how has the actor behaved in dif-
III, a residual category for disorders of gender
ferent situations?); and consensus (how do other
identity that were not classifiable as any specific
people behave in the same situation?).
gender identity disorder. In DSM–IV–TR such
attribution therapy a form of therapy in disorders are designated gender identity dis-
which the therapist tries to change a client’s order not otherwise specified.
views concerning the causes of events and be- atypical impulse-control disorder in
havior. DSM–III and earlier editions, a residual category
attrition n. in experimentation and other re- of impulse-control disorders that in DSM–IV–TR
search, dropout or loss of participants. is labeled impulse-control disorder not other-
A-type personality see type a personality. wise specified (see impulse-control disor-
ders not elsewhere classified).
atypical antipsychotic a class of antipsy-
atypical mental disorder see atypical dis-
chotic drugs that, compared to conventional
order.
(typical or first-generation) antipsychotics, pro-
duce fewer extrapyramidal symptoms, are less atypical, mixed, or other personality
likely to alter serum levels of prolactin, and ap- disorder in DSM–III, a category of personality
pear to be less likely to cause tardive dys- disorders for which there is insufficient evidence
kinesia, all of which are significant adverse for a more specific designation. Cases that in-
effects of the conventional drugs. They show volve features of several personality disorders
some degree of activity as dopamine-receptor without meeting the criteria for any one type are
antagonists but also block the effects of seroto- described as mixed personality disorders; other
nin or other neurotransmitters. Atypical antipsy- personality disorders are unclassified cases, such
chotics are used in the treatment of schizo- as masochistic, impulsive, or immature person-
phrenias, delusional disorders, dementias, and ality disorder.
other disorders characterized by psychotic symp- atypical paraphilia in DSM–III, a residual cat-
toms. They are also used as adjunctive agents in egory of paraphilias that in DSM–IV–TR is la-
the treatment of some nonpsychotic conditions, beled paraphilia not otherwise specified.
such as obsessive-compulsive disorder, explosive atypical pervasive developmental disor-
disorder, or severe depression. The prototype of der in DSM–III, a diagnostic category for disor-
the group is clozapine; others in current clini- ders that in DSM–IV–TR are classified as
cal use include olanzapine, risperidone, ilo- pervasive developmental disorder not oth-
peridone, quetiapine, aripiprazole, and zi- erwise specified.
prasidone. Also called novel antipsychotic;
atypical psychosexual disorder a sexual
second-generation antipsychotic.
problem that does not meet diagnostic criteria
atypical autism see pervasive developmen- for sexual dysfunction or sexual deviancy. In
tal disorder not otherwise specified. DSM–IV–TR such disorders are categorized as
atypical conduct disorder in DSM–III, a di- sexual disorder not otherwise specified.
agnostic category for disorders that in DSM–IV– atypical psychosexual dysfunction in
TR are classified as disruptive behavior disor- DSM–III, a category that included psychosexual
der not otherwise specified. dysfunctions outside the standard specific cate-
53
atypical psychosis
gories. In DSM–IV–TR this is labeled sexual dys- memory. Also called auditory span. See also
A function not otherwise specified. memory span.
atypical psychosis in DSM–III, any of various auditory training helping people with hear-
conditions involving psychotic symptoms that ing loss to better distinguish sounds and under-
do not meet the criteria for any specific disorder. stand spoken language by teaching them how to
The equivalent DSM–IV–TR classification is psy- make the most effective use of their residual
chotic disorder not otherwise specified. hearing and to discern contextual clues related
to situations and environments.
atypical specific developmental disor-
der in DSM–III, a residual category for disorders auditory verbal learning test a memory
that in DSM–IV–TR are categorized as learning test that generally involves learning verbal mate-
disorder not otherwise specified or com- rial, usually single words, that is auditorily pre-
munication disorder not otherwise speci- sented over repeated trials. Recall or recognition
fied. may be employed as a measure of learning over
various delay periods.
atypical stereotyped-movement disor-
der in DSM–III and earlier editions, a diagnostic augmentation strategy a mechanism to in-
category for disorders that in DSM–IV–TR are crease the effectiveness of pharmacological
classified as tic disorder not otherwise spec- agents by the addition of other agents. Augmen-
ified or stereotypic movement disorder. tation strategies are most commonly used in the
treatment of depression.
atypical tic disorder in DSM–III, a diagnostic
category for tic disorders that in DSM–IV–TR are aura n. a subjective sensation that precedes an
labeled tic disorder not otherwise speci- epileptic seizure or migraine headache. It may
fied. include such phenomena as strange tastes or
odors, flashes of light (a visual aura), numbness,
audible thought a type of hallucination in and feelings of unreality or déjà vu.
which one hears one’s own thoughts as if they
autarchy n. 1. in psychiatry, the period of in-
were projected by an inner voice.
fancy in which the child exerts autocratic power
audit n. an evaluation or review of the health over others, including the parents who satisfy all
care services proposed or rendered by a provider. his or her instinctual demands. 2. more gener-
See medical audit; treatment audit. ally, supreme and absolute power. See also om-
auditory agnosia loss or impairment of the nipotence. —autarchic adj.
ability to recognize and understand the nature of autassassinophilia n. a paraphilia in which
verbal or nonverbal sounds. Subtypes are distin- sexual arousal and the achievement of orgasm
guished on the basis of the type of auditory stim- are facilitated by the belief that one is in danger
ulus the person has difficulty recognizing, for of being killed. This often includes the individ-
example, environmental sounds such as a dog ual staging a sexual encounter characterized by
barking or keys jingling (nonverbal auditory extreme masochism with the real potential for
agnosia or environmental sounds agnosia), spo- his or her own murder. Also called autassas-
ken words, or music. sinatophilia. Compare homicidophilia.
Auditory Consonant Trigram (ACT) a autemesia n. vomiting for which no organic
memory test in which a three-letter nonsense cause can be identified.
syllable consisting only of consonants, such as authenticity n. 1. in psychotherapy and coun-
DCJ, is presented verbally and the participant is seling, a characteristic of the therapist or coun-
asked to recall the sequence following delays of selor who is considered to be genuine and
varying lengths (e.g., 9, 18, and 36 s). During the caring. Authenticity is often demonstrated by a
delay intervals, the participant performs a professional but down-to-earth attitude that the
distractor task (e.g., counting backwards from a client senses to be a reflection of the true person
specified number by threes). See brown–peter- and not simply of the therapist acting in his or
son distractor technique. her professional role. 2. in existentialism, a
auditory hallucination the perception of mode of being that humans can achieve by ac-
sound in the absence of an auditory stimulus. cepting the burden of freedom, choice, and re-
Hallucinations may, for example, be of accusa- sponsibility and the need to construct their own
tory or laudatory voices or of strange noises and values and meanings in a meaningless universe.
other nonverbal sounds. Auditory hallucina- —authentic adj.
tions occur frequently in schizophrenia and authoritarian adj. describing an individual, es-
other psychotic disorders but may be associated pecially but not limited to one in a position of
with other conditions as well (e.g., delirium, de- authority, who uses or favors restrictive, auto-
mentia). cratic methods when interacting with others.
auditory memory span the number of simple See authoritarian personality. —authori-
items, such as words or numbers, that can be re- tarianism n.
peated in the same order by a person after hear- authoritarian conscience the type of con-
ing the series once. The auditory memory span science that is guided by (a) fear of an external
indicates the capacity of a person’s working authority or (b) the voice of an internalized ex-
54
autoerotic asphyxiation
ternal authority, such as the superego. Com- autoagonistophilia n. sexual arousal from
pare humanistic conscience. [defined by being observed or filmed while engaging in sex- A
Erich fromm] ual activity.
authoritarian personality a personality pat- autoassassinatophilia n. see autassassino-
tern characterized by strict adherence to highly philia.
simplified conventional values, an attitude of autobiographical memory 1. a type of epi-
great deference to authority figures while de- sodic memory comprising vivid recollections of
manding subservience from those regarded as significant instances in a person’s life. Thus, re-
lower in status, and hostility toward people who membering one’s wedding day involves autobio-
deviate from conventional moral prescriptions. graphical memory while remembering a theater
authority complex a pattern of emotionally performance one attended involves episodic
charged concepts of authority that are partially memory generally. Often, however, the two
or completely repressed. To satisfy an uncon- terms are used interchangeably. 2. more broadly,
scious need for authority, a person projects memory for any information about the self, in-
power onto certain other people (see projec- cluding not only personal experiences but also
tion) and experiences inferiority in the presence self-related factual knowledge, the self-schema,
of these others. Therefore, reactions to authority and so forth.
often take the form of oversubmission. Autobiographical Memory Interview
autism n. 1. abnormal preoccupation with the (AMI) a semistructured interview designed to as-
self and fantasy such that there is lack of interest sess memory for autobiographical information,
in or ability to focus on external reality. 2. a syn- impairment of which is often indicative of retro-
onym for autistic disorder. —autistic adj. grade amnesia and potentially associated with a
autistic disorder a severe neurologically based variety of neurological and psychiatric disorders.
pervasive developmental disorder characterized The AMI contains an Autobiographical Incidents
by markedly impaired social interactions and Schedule, which queries specific, personally ex-
verbal and nonverbal communication; narrow perienced events from childhood, early adult
interests; and repetitive behavior. Manifesta- life, and the recent past; and a Personal Semantic
tions and features of the disorder appear before Memory Schedule, which queries generic or se-
age 3 but vary greatly across children according mantic facts about the self, divided into child-
to developmental level, language skills, and hood, early adult life, and recent information.
chronological age. They may include a lack of [developed in 1989 by British neuropsychiatrist
awareness of the feelings of others, impaired Michael D. Kopelman, British clinical psycholo-
ability to imitate, absence of social play, abnor- gist Barbara A. Wilson, and British cognitive psy-
mal speech, abnormal nonverbal communica- chologist Alan D. Baddeley (1934– )]
tion, and a preference for maintaining autobiography n. in therapy or counseling, a
environmental sameness. technique in which a life history, written by
autistic fantasy a defense mechanism in the client from his or her own point of view, is
which a person deals with emotional conflict used to obtain information regarding the client’s
and stressors by indulging in excessive day- behavioral patterns and feelings. A structured
dreaming as a substitute for human relation- autobiography is based on explicit questions or
ships or more active and direct problem solving. topic guidelines supplied by the therapist or
counselor. An unstructured autobiography con-
autistic savant see savant. tains no guidelines. See also life review.
autistic spectrum disorder (ASD) any one autocentric adj. centered on or within the self.
of a group of disorders with an onset typically Compare allocentric.
occurring during the preschool years and charac-
terized by varying but often marked difficulties autochthonous adj. 1. native, indigenous, or
in communication and social interaction. The original. 2. denoting endogenous processes
group includes the prototype autistic disor- and events that originate within the individual,
der as well as rett syndrome, asperger’s disor- independently of external influences. Compare
der, and childhood disintegrative disorder. allochthonous.
This term is synonymous with pervasive de- autoenucleation n. an act of self-mutilation in
velopmental disorder but is now more com- which an individual excises an organ or tumor
monly used, given its reflection of symptom from his or her own body, as, for example, when
overlap among the disorders. Also called au- a person with a psychotic disorder removes an
tism spectrum disorder. eyeball (see enucleation). Also called self-
autistic thinking narcissistic, egocentric enucleation.
thought processes, such as fantasizing and day- autoerotic asphyxiation sexual pleasure ob-
dreaming, that have little or no relation to real- tained from being unable to breathe during mas-
ity. It is similar to dereistic thinking (see turbation. It may involve the person hanging
dereism), but the emphasis is on self-absorption him- or herself, a practice that has been found to
rather than disconnection from reality. See au- result in a number of accidental deaths each year
tism. when the person is unable to get free of the rope.
55
autoeroticism
autoeroticism n. 1. the creation of sexual ex- devices as audiotapes, videotapes, and digitized
A citement and gratification by the self, whether it media to facilitate the presentation of anxiety-
be through masturbation, other sexual behav- provoking and relaxing stimuli during system-
iors (e.g., stimulating nongenital portions of the atic desensitization. It is especially helpful in
body), or thoughts (e.g., daydreams, fantasies). situations where a client is reluctant to undergo
See also secondary autoeroticism. [defined desensitization in the presence of the therapist.
by British sexologist Havelock Ellis (1859–1939)] See device for automated desensitization.
2. formerly, genital arousal in sleep, which is automatic anxiety see primary anxiety.
now understood to be a normal component of
one stage of sleep and is not associated with automatic drawing the act of drawing images
erotic dreams. Also called autoerotism. Com- or objects while in a hypnotic trance or in a situ-
pare alloeroticism. —autoerotic adj. ation in which attention is distracted. It may be
used in hypnotherapy to provide a therapist
autoerythrocyte sensitization syndrome with access to unconscious material from the cli-
see gardner–diamond syndrome. ent. See also automatic writing.
autoflagellation n. sexual pleasure derived
automaticity n. the quality of a mental process
from striking, whipping, or beating oneself.
that can be carried out rapidly and without effort
autogenic training a relaxation technique in or intention (an automatic process). See also
which a quasi-hypnotic state is self-induced and conscious process; unconscious process.
deep relaxation is achieved through mental im-
agery, breath control, and exercises that focus at- automatic obedience excessive, uncritical, or
tention on physical sensations, including mechanical compliance with the requests, sug-
warmth and heaviness of the limbs, a regular gestions, or commands of others.
heartbeat, abdominal warmth, and cooling of automatic speech 1. speech that erupts invol-
the forehead. The aim is to reduce stress by gain- untarily, or without conscious control. It some-
ing control of autonomic arousal associated with times occurs as a consequence of senility,
anxiety and to obtain an ideal performance Tourette’s syndrome, or highly emotional states.
state. [developed in the early 20th century by 2. speech that is uttered with little or no con-
German neurologist Johannes Heinrich Schultz scious consideration of the spoken material,
(1884–1970)] such as the days of the week, numbers, the al-
autogenital stimulation any form of stimu- phabet, and other well-learned material.
lation by a human or an animal of its own geni- automatic thoughts 1. instantaneous, habit-
talia. It may take the form of pelvic thrusts, ual, but unconscious thoughts that affect a per-
masturbation, or self-stimulation preceding son’s mood and actions. Helping clients become
sexual intercourse. Autogenital stimulation may aware of the presence and impact of negative au-
occur in the presence of members of the same or tomatic thoughts and then test their validity is a
opposite sex or in the absence of other individu- central task of cognitive therapy. 2. thoughts
als. that have been so well learned and habitually re-
autognosis n. knowledge of self. peated that they occur without cognitive effort.
Also called routinized thoughts.
autohypnosis n. see self-hypnosis. —auto-
hypnotic adj. automatic writing the act of writing while
autohypnotic amnesia a Jungian term for re- one’s attention is not focused on the task or of
pression, based on the observation that hyp- writing without conscious awareness, as during a
notic amnesia may be induced by a person hypnotic trance. It may be used in hypnother-
under hypnosis. apy to provide a therapist with access to uncon-
scious material from the client. See also
autoimmunity n. a condition in which the automatic drawing.
body’s immune system fails to recognize its own
tissues as “self” and attempts to reject its own automatism n. nonpurposeful behavior per-
cells. It is a primary factor in the development of formed mechanically, without intention, and
such diseases as rheumatoid arthritis and sys- without conscious awareness. It may be motor or
temic lupus erythematosus (called autoimmune verbal and ranges from simple repetitive acts,
disorders). —autoimmune adj. such as lipsmacking or repeatedly using the same
phrase (e.g., as it were), to complex activities,
automasochism n. sexual pleasure derived such as sleepwalking and automatic writing. Au-
from inflicting pain on oneself during masturba- tomatism is seen in several disorders, including
tion or during sexual activity with a partner. catatonic schizophrenia and complex par-
automated assessment see computerized tial seizures.
assessment.
automatism defense a legal defense consist-
automated clinical records a computerized ing of the claim that criminal intent (see mens
database used for such purposes as monitoring rea) is lacking as a result of the defendant’s dis-
patient care, providing data for administrative sociated or unconscious state at the time the
decisions, and assisting the clinician in under- criminal act was committed. The defense is more
standing and treating patients. common in the United Kingdom and Canada
automated desensitization the use of such than in the United States.
56
autoscopy
automatization n. 1. the development of a depression characterized by agitation and self-

skill or habit to a point at which it becomes rou- criticism. A
tine and requires little if any conscious effort or autonomy n. a state of independence and self-
direction. 2. the state of individuals who obey determination in an individual, a group, or a so-
compulsive impulses so automatically that they ciety. According to some theories, an inordinate
may be described as automata. focus on self-determination and achievement
automutilation n. sexual pleasure derived represents a risk factor for the development of
from mutilating parts of one’s body or from fan- major depressive disorder. See also func-
tasy about mutilated parts of one’s body. It usu- tional autonomy. Compare heteronomy.
ally involves cutting some part of the body autonomy versus shame and doubt the
during masturbation. second of erikson’s eight stages of develop-
autonecrophilia n. sexual pleasure derived ment, between the ages of 1½ and 3 years. Dur-
from the fantasy that one is dead and that an- ing this stage, children acquire a degree of self-
other person is having sexual relations with reliance and self-confidence if allowed to de-
one’s dead body. velop at their own pace but may begin to doubt
their ability to control themselves and their
autoneprophilia n. sexual pleasure derived world if parents are overcritical, overprotective,
from dressing as a baby, pretending to be a baby, or inconsistent.
or having a fantasy about being a baby.
autopedophilia n. sexual pleasure derived
autonoetic adj. describing a level of knowledge from dressing as a child, pretending to be a child,
or memory in which one is aware not only of the or having a fantasy about being a child.
known or remembered thing but also of one’s
autophagy n. 1. the chewing or eating of one’s
personal experience in relation to that thing.
own flesh. 2. the body’s maintenance of nutri-
Autonoetic consciousness is a corresponding
tion by consumption of its own tissues, as in
level of consciousness in which one’s knowledge
times of excessive fasting. Also called
of facts, concepts, and meanings is mediated
autophagia.
through an awareness of one’s own existence in
time. Compare anoetic; noetic. [defined by Es- autoplasty n. 1. adaptation to reality by modi-
tonian-born Canadian psychologist Endel fying one’s own behavioral patterns, rather than
Tulving (1927– )] by altering one’s environment. Autoplastic be-
havior can be negative and psychologically
autonomic dysfunction see dysautonomia. harmful, as in the development of neurotic be-
autonomic hyperactivity arousal of the au- havior, or positive and psychologically healthy,
tonomic nervous system (ANS), particularly as in the tendency toward more adaptive think-
its sympathetic nervous system functions, re- ing and action following psychotherapeutic
sulting in the physiological symptoms associ- intervention. Also called autoplastic develop-
ated with anxiety and fear (e.g., sweating, ment. 2. surgical repair using tissue from an-
palpitations, dry mouth, lightheadedness, upset other part of the patient’s body. Compare
stomach). alloplasty. —autoplastic adj.
autonomic nervous system (ANS) the por- autopsychic delusion a delusion about one’s
tion of the nervous system innervating smooth personality. It is distinguished from allopsychic
muscle and glands, including the circulatory, di- delusions, which refer to the outside world, and
gestive, respiratory, and reproductive organs. It somatic delusions, which refer to one’s own
is divided into the sympathetic nervous sys- body. [defined by German neurologist Carl
tem and parasympathetic nervous system. Wernicke (1848–1905)]
Autonomic responses typically involve changes autopsychosis n. a delusional condition in
in involuntary bodily functions, such as heart which the individual maintains distorted ideas
rate, salivation, digestion, perspiration, pupil about him- or herself, such as being the world’s
size, hormone secretion, bladder contraction, savior, the devil incarnate, or an unrecognized
and engorgement of the penis and clitoris. The genius. —autopsychotic adj.
system is called autonomic because it was once
thought to function independently of the cen- autoreceptor n. a molecule in the membrane of
tral nervous system. a presynaptic neuron that regulates the synthesis
and release of a neurotransmitter by that neuron
autonomic neuropathy see dysautonomia. by monitoring how much transmitter has been
autonomic restrictors people with general- released and “telling” the neuron.
ized anxiety disorder (GAD), who have lower autoscopophilia n. sexual pleasure derived
heart rate, blood pressure, skin conductance, from observing oneself disrobing, being nude, or
and respiration rate than do people with other watching oneself during sexual activity. It may
anxiety disorders. involve viewing videos or pictures of these situa-
autonomous depression 1. a major depres- tions.
sive episode that does not occur in response to autoscopy n. seeing a double of oneself in exter-
any obvious psychosocial stressor. See also en- nal space. The image is generally short-lived and
dogenous depression. 2. an obsolete name for hazy, filmy, and colorless. Also called auto-
57
autosexuality
scopic phenomenon. See also doppelganger egy may lead to errors of judgment when infor-
A phenomenon; out-of-body experience. mation that is highly available in memory (e.g.,
autosexuality n. any form of sexual arousal or about well-publicized events, such as plane
stimulation that occurs without the participa- crashes) leads people to believe that those kinds
tion of another person or animal, for example, of events are more probable than they actually
masturbation, sexual dreams, or sexual fantasies. are, or when the relative unavailability of infor-
mation (e.g., about less well-publicized causes of
autosomal aberration any disorder of struc- death, as from diabetes) leads people to believe
ture, function, or both that is associated with an that those kinds of events are less probable than
alteration in the structure or number of any of they are. Compare representativeness heuris-
the pairs of chromosomes that are not sex chro- tic. See heuristic.
mosomes (see autosome). An example of such a
disorder is down syndrome. Also called auto- Aventyl n. a trade name for nortriptyline.
somal abnormality; autosomal anomaly. averse conditioning see aversive condi-
autosomal dominant see dominant allele. tioning.
autosomal recessive see recessive allele. aversion n. a physiological or emotional re-
sponse indicating dislike for a stimulus. It is usu-
autosomal trisomy of group G the condi-
ally accompanied by withdrawal from or
tion in which either of the chromosome pairs 21
avoidance of the objectionable stimulus (an
or 22 (known as group G) includes an additional
aversion reaction). —aversive adj.
autosome. The most common of these two
autosome abnormalities is trisomy 21. See also aversion conditioning see aversive condi-
down syndrome. tioning.
autosome n. any chromosome that is not a sex aversion reaction a response expressed by
chromosome. A human normally has a total of avoiding a distasteful, threatening, or otherwise
44 autosomes (arranged in 22 homologous objectionable stimulus.
pairs) in the nucleus of each body cell, although aversion system neuroticism as represented
irregular numbers may occur through the loss or by an individual’s relative sensitivity to aversive
addition of one or more autosomes. If a homolo- (negative, punishing) cues and stimuli and his or
gous pair of autosomes has an extra chromo- her processes for avoiding them. Compare ap-
some, the condition is called trisomy. If one petition system. [proposed by Hans eysenck]
member of a homologous pair is absent, the con-
aversion therapy a form of behavior ther-
dition is called monosomy.
apy in which the client is conditioned to change
autosuggestibility n. susceptibility to being or eliminate undesirable behavior or symptoms
influenced by one’s own suggestions, as in self- by associating them with noxious or unpleasant
hypnosis. experiences, such as a bitter taste (for nail biting)
autosuggestion n. the process of making posi- or nausea (for alcoholism). Also called aversive
tive suggestions to oneself for such purposes as therapy; deterrent therapy.
improving morale, inducing relaxation, or pro- aversive conditioning the process by which a
moting recovery from illness. Also called self- noxious or unpleasant stimulus is paired with an
suggestion. See also autogenic training; undesired behavior. This technique may be used
suggestion. therapeutically, as in aversion therapy. Also
autotomy n. self-mutilation or the cutting off called aversion conditioning.
by an individual of his or her body parts. aversive control the use of an aversive out-
auxiliary ego in psychodrama, a group mem- come, such as punishment or negative reinforce-
ber, other than the therapist, who assumes the ment, to control behavior.
role of a significant figure in the protagonist’s aversive stimulus any stimulus or occurrence
life. that evokes avoidance behavior or escape be-
auxiliary therapist a therapist who takes part havior. Also called aversive event. See also
in cotherapy. avoidance conditioning.
ava n. see kava. aversive therapy see aversion therapy.
availability n. the presence of information in aviophobia n. see fear of flying.
memory storage. Availability should be distin- avoidance n. the practice or an instance of keep-
guished from accessibility, which refers to the ing away from particular situations, environ-
ability of a portion of information to be re- ments, individuals, or things because of either
trieved. (a) the anticipated negative consequences of
availability heuristic n. a common strategy such an encounter or (b) anxious or painful feel-
for making judgments about likelihood of occur- ings associated with those things or events. Psy-
rence in which the individual bases such judg- chology brings several theoretical perspectives
ments on the amount of information held in his to the study of avoidance: its use as a means of
or her memory about the particular type of coping; its use as a response to fear or shame; and
event: The more information there is, the more its existence as a component in anxiety disor-
likely the event is judged to be. Use of this strat- ders.
58
axon
avoidance–avoidance conflict a situation avoidant paruresis inability to urinate in the

involving a choice between two equally objec- presence of other people. Also called bashful A
tionable alternatives, for example, when an indi- bladder syndrome.
vidual must choose between unemployment or a avoidant personality a personality trait char-
salary cut. Also called double-avoidance con- acterized by feeling uncomfortable when psy-
flict. See also approach–approach conflict; chologically close to others, resulting in a
approach–avoidance conflict. tendency not to form intimate relations.
avoidance behavior any act that enables an avoidant personality disorder in DSM–IV–
individual to avoid or anticipate unpleasant or
TR, a personality disorder characterized by (a)
painful situations, stimuli, or events, including
hypersensitivity to rejection and criticism, (b) a
conditioned aversive stimuli. See avoidance
desire for uncritical acceptance, (c) social with-
conditioning. Compare escape behavior.
drawal in spite of a desire for affection and ac-
avoidance conditioning the establishment ceptance, and (d) low self-esteem. This pattern is
of behavior that prevents or postpones aversive long-standing and severe enough to cause objec-
stimulation. In a typical conditioning experi- tive distress and seriously impair the ability to
ment a buzzer is sounded, then a shock is applied work and maintain relationships. [first defined
to the subject (e.g., a dog) until it performs a par- in 1969 by U.S. psychologist Theodore Millon
ticular act (e.g., jumping over a fence). After sev- (1929– )]
eral trials, the dog jumps as soon as the buzzer
avolition n. failure to engage in goal-directed
sounds, avoiding the shock. Also called avoid-
behavior, occasionally occurring in severe
ance learning; avoidance training. See also
major depressive episodes.
escape conditioning.
avoidance gradient the variation in the awareness n. conscious realization, perception,
strength of a drive as a function of the organ- or knowledge. See also self-awareness.
ism’s proximity to an aversive stimulus. For awareness-training model an approach in
example, a rat’s withdrawal behavior increases psychology and education that stresses self-
in intensity as it nears a feared stimulus (e.g., an awareness, self-realization, exploration, and in-
electric shock). The avoidance gradient appears terpersonal sensitivity. The awareness-training
steeper than the approach gradient. See also model is associated with such writers as German-
approach–approach conflict; approach– born U.S. psychologist Frederick (Fritz) S. Perls
avoidance conflict. (1893–1970) and U.S. psychologist William C.
avoidance response a response in which an Schutz (1925–2002).
organism anticipates an aversive stimulus and awe n. the experience of admiration and eleva-
consequently attempts to prevent contact with tion in response to physical beauty, displays of
this stimulus. The avoidance response is a form exceptional ability, or moral goodness. The awe-
of abient behavior (see abience). Also called inspiring stimulus is experienced as “vast” and
avoidance reaction. difficult to comprehend.
avoidant attachment in the strange situa- awfulizing n. an irrational thought pattern
tion, a form of insecure attachment in which characterized by the tendency to overestimate
infants do not seek proximity to their parent the potential seriousness or negative conse-
after separation. Instead, the infant does not ap- quences of events, situations, or perceived
pear distressed by the separation and avoids the threats.
returning parent. axis n. (pl. axes ) 1. in DSM–IV–TR, any of the di-
avoidant attachment style an adult inter- mensions that are helpful for describing individ-
personal style characterized by a discomfort in ual behavior and thus facilitate clinical
being close to others. Also called anxious– assessment. DSM–IV–TR uses a multiaxial
avoidant attachment style. See also anx- classification based on five axes: clinical dis-
ious–avoidant attachment; attachment orders (Axis I), personality disorders and mental
theory. retardation (Axis II), general medical condi-
avoidant disorder of childhood or ado- tions (Axis III), psychosocial and environmen-
lescence in DSM–III, a disorder lasting at least 6 tal problems (Axis IV), and global assessment of
months between the ages of 2½ and 18 and char- functioning (Axis V). 2. an imaginary line that
acterized by persistent, excessive retreating from bisects the body or an organ in a particular
strangers. It interferes with peer relationships, plane. For example, the long (or cephalocaudal)
but satisfying relationships with family mem- axis runs in the median plane, dividing the body
bers may be intact. In DSM–IV–TR, this diagnos- into right and left halves. 3. the second cervical
tic category has been subsumed under social vertebra, on which the skull rotates. 4. a system
phobia. Also called shyness disorder. See also made up of interrelated parts, as in the hypo-
avoidant personality disorder. thalamic–pituitary–adrenocortical system
avoidant marriage a long-lasting marriage in (or axis).
which the partners seldom argue because they axon n. the long, thin, hollow, cylindrical exten-
have “agreed to disagree” and accept their differ- sion of a neuron that normally carries a nerve
ences of opinions with no apparent rancor. impulse away from the cell body. An axon
59
ayahuasca
often branches extensively and may be sur- nating and practiced primarily in the Indian sub-
A rounded by a protective myelin sheath. Each continent, that has spread to some extent in
branch of an axon ends in a terminal button (or Western cultures. It includes diet and herbal
synaptic bouton) from which an impulse is remedies and emphasizes the use of body, mind,
transmitted, through discharge of a neuro- and spirit in disease prevention and treatment.
transmitter, across a synapse to a neighboring azapirone n. any of a class of nonbenzo-
neuron. Also called nerve fiber. —axonal adj. diazepine anxiolytics of which the prototype
ayahuasca n. a powerful hallucinogenic bever- is buspirone. They relieve anxiety by acting as
age made from the stems of a tropical South partial agonists at the 5-HT1A serotonin recep-
American woody vine, Banisteriopsis caapi, and tor (see serotonin-receptor agonists). Other
the plant Psychotria viridis. It has been used for drugs in this class include gepirone, tando-
centuries by indigenous peoples of the Amazon spirone, and ipsapirone. Azapirones produce less
for religious, spiritual, and medicinal purposes sedation than the benzodiazepines and they
and more recently in the United States to evoke lack the abuse potential of these drugs. However,
anomalous experiences. The pharmacolo- their onset of action is 2–3 weeks, and they
gically active ingredients are harmine and cannot therefore be used to manage acute or
harmaline from B. caapi and dimethyltryp- paroxysmal anxiety. Also called azapirode-
tamine (see dmt)from P. viridis. In smaller doses, canedione.
these ingredients have hallucinogenic and eu- azathioprine n. a drug used to suppress the
phoric effects but in larger doses cause nausea immune response. It is the most widely used
and vomiting, tinnitus, and collapse, followed drug in support of organ transplantation and
by sedation. Also called caapi; yagé. other potentially severe cases of immune reac-
Ayurveda n. a holistic system of healing, origi- tions. U.S. trade name (among others): Imuran.
60
Bb
baah-ji n. see bah-tschi. parental disapproval that in turn gives rise to
baby blues a colloquial name for the transient anxiety and self-doubt. Compare good me. See
depressive symptoms experienced by many also not me.
women during the first 10 days after giving bad object in the psychoanalytic theory of
birth. It should be distinguished from Melanie klein, an introjected part-object per-
postpartum depression. Also called mater- ceived as having negative qualities (see
nity blues; postpartum blues. introjection). It is an early object representa-
backup reinforcer in behavior modification that derives from splitting of the object
tion, a reward given to a client or patient in re- into parts containing negative qualities (i.e., the
turn for tokens he or she has earned. See also bad object) and positive qualities (i.e., the good
token economy. object).
baclofen n. a skeletal muscle relaxant that in- bad trip an acute psychotic episode that is
hibits transmission of synaptic reflexes at the caused by ingestion of hallucinogens. The epi-
spinal cord level. It is often used in the treatment sode may also be marked by flashbacks at a
of reversible spasticity associated with multiple later date. See also hallucinogen intoxica-
sclerosis or spinal cord injury. U.S. trade name: tion; hallucinogen-induced mood disor-
Lioresal. der.
bacterial endocarditis inflammation of the bah-tschi (bah-tsi; baah-ji) n. a culture-
heart lining (endocardium) due to bacterial in- bound syndrome found in Thailand, with
fection and causing damage to the heart valves symptoms similar to those of latah.
and impaired pumping action of the heart. Fever
and other systemic symptoms ensue, including BAI abbreviation for beck anxiety inventory.
embolism and heart failure. The infection can be balance 1. n. a harmonious relationship or equi-
acquired by unhygienic intravenous drug ad- librium of opposing forces or contrasting el-
ministration or abuse. ements. See balance theory; homeostasis.
bad breast in the psychoanalytic theory of 2. n. the sense of equilibrium mediated by the
Melanie klein, the internalized representation vestibular system of the inner ear. 3. vb. to ad-
(see introjection) of the mother’s breast as unjust forces to maintain something at a level from
satisfying. According to Klein, the infant first ex- which it would ordinarily deviate.
periences the mother and the nourishing breast balance theory a particular cognitive consis-
as part-objects with positive qualities—the tency theory specifying that people prefer ele-
good breast—and negative qualities—the bad ments within a cognitive system to be internally
breast. consistent with one another (i.e., balanced). Bal-
bad faith an individual’s denial of his or her anced systems are assumed to be more stable and
freedom as a human being or unwillingness to psychologically pleasant than imbalanced sys-
accept the undetermined and unforced nature tems. The theory has been primarily specified
of his or her actions. This often entails a denial and tested within the context of systems involv-
of responsibility for the consequences of one’s ing three elements. These systems are sometimes
actions and choices or hiding the truth from referred to as P-O-X triads, in which P = person
oneself intentionally. See also existential psy- (i.e., self), O = other person, and X = some stimu-
chotherapy. [proposed by French existentialist lus or event. See also cognitive consistency
philosopher Jean-Paul Sartre (1905–1980)] theory. [first proposed in 1946 by Austrian-
bad is stronger than good the tendency for born U.S. psychologist Fritz Heider (1896–1988)]
negative events, information, or feedback to balance training a form of physical or occupa-
have significantly more impact or influence on tional therapy for individuals who experience
emotions, thoughts, or behavior than an equiva- difficulty with balance control (maintaining bal-
lent positive event, information, or feedback. ance when standing, walking, or performing
bad me in the self-system theory of U.S. psy- other activities). It involves a series of exercises
choanalyst Harry Stack Sullivan (1892–1949), designed to enhance muscular control and im-
the internalized personification of impulses and prove interpretation of information from the
behaviors that are considered to be negative by senses and may make use of trainer bicycles, tri-
the self and, therefore, need to be hidden or dis- cycles with body supports and foot attachments,
guised from others or from the self. In a child, for stilts, pogo sticks, rocker boards, and a rubber
instance, the bad me may arise out of a sense of bouncing tube used like a trampoline. Balance
61
Bálint’s syndrome
training is also used by many athletes to en- barbiturate intoxication see sedative, hyp-
hance fitness, coordination, and performance. notic, or anxiolytic intoxication.
Bálint’s syndrome a spatial and attentional barbiturates pl. n. a family of drugs, derived
B disorder resulting from lesions in the parieto- from barbituric acid, that depress activity of the
occipital region of the brain. It consists of inabil- central nervous system (see cns depressant)
ity to visually guide the hand to an object (optic and were previously widely used as anxiolytics,
ataxia), inability to change visual gaze (optic sedatives, and hypnotics. They typically induce
apraxia), and inability to recognize multiple profound tolerance and withdrawal symp-
stimuli in a scene and understand their nature as toms and depress respiration: They can depress
a whole (simultanagnosia; see visual agnosia). breathing completely—hence their use by indi-
[first described in 1909 by Rudolf Bálint (1874– viduals wishing to commit suicide. Barbiturates
1929), Hungarian physician] are commonly categorized according to their
B and D abbreviation for bondage and disci- rates of action (including onset of effect, absorp-
pline. tion, and excretion) as long acting, intermediate
Bandura, Albert (1925– ) Canadian-born acting, short acting, or ultrashort acting. Their
U.S. psychologist. Born and raised in Alberta, use became common in the 1930s, but they were
Canada, Bandura received his PhD from the Uni- rapidly supplanted in the 1970s by the benzo-
versity of Iowa in 1952 under the direction of diazepines, which lack the lethality associated
Arthur L. Benton (1909–2006). He then joined with overdose of the barbiturates. The group
the faculty of Stanford University, where he includes amobarbital, butabarbital, pento-
remained throughout his career. Bandura is best barbital, phenobarbital, primidone, and
known for his work on social learning theory. thiopental, among others. The prototype of
Early in his career, he studied the familial origins the group, barbital was introduced into medical
of antisocial aggression in adolescent boys, cul- practice in 1903. See sedative, hypnotic, and
minating in his first book, Adolescent Aggression anxiolytic drugs.
(1959), and the later Aggression: A Social Learning barbiturate withdrawal see sedative, hyp-
Analysis (1973). These books showed that adoles- notic, or anxiolytic withdrawal.
cents whose parents’ behavior included hostile barbiturate withdrawal delirium see sed-
attitudes were more likely to display aggression, ative, hypnotic, or anxiolytic withdrawal
even when aggressive behavior was openly dis- delirium.
couraged at home. Bandura and his colleagues
went on to explore the role of observational bar hustlers see male homosexual prostitu-
learning. In famous studies using a Bobo doll tion.
(an inflatable plastic toy), Bandura showed bariatrics n. a field of medicine that focuses on
that, contrary to the predictions of then- the study of overweight: its causes, prevention,
dominant behaviorist theory, humans could and treatment.
learn through social modeling in the absence
of positive reinforcement. Bandura’s subse- barK abbreviation for beta-adrenergic recep-
quent work centered on various topics in the tor kinase.
field of social-cognitive theory, especially barricade incidents hostage and high-risk in-
self-regulatory processes and their role in moti- cidents, which require crisis management and
vation and behavior. Among his other impor- negotiation capabilities.
tant works are Social Learning Theory (1977), barrier n. something that restricts, impedes, or
Social Foundations of Thought and Action: A Social blocks progress or the achievement of an ulti-
Cognitive Theory (1986), and Self-Efficacy: The Ex- mate objective or end. In psychological contexts
ercise of Control (1997). Bandura served as presi- barriers are mental, emotional, or behavioral
dent of the American Psychological Association limitations in individuals and groups.
and was elected to the American Academy of
Arts and Sciences and the Institute of Medicine barrier-free environment a built space that
of the National Academy of Sciences. is free of obstacles to individuals with physical
and cognitive disabilities and permits safe, unin-
bangungut n. a culture-bound syndrome
hibited movements. Environmental barriers can
observed mainly among young, healthy, Fili-
include street curbs, revolving doors or doors too
pino males. The individual is often overheard
narrow to admit wheelchairs, inaccessible toilets
screaming or moaning during sleep, apparently
and washbowls, and elevator buttons that can-
experiencing a terrifying nightmare; this is fol-
not be read by people with visual impairment.
lowed by unexpected death. Also called orien-
See also universal design.
tal nightmare-death syndrome.
barbiturate abuse see sedative, hypnotic, Barthel Index a form of functional status
or anxiolytic abuse. measurement that includes 10 items assessing an
individual’s ability to perform the activities of
barbiturate addiction see sedative, hyp- daily living independently. An individual is
notic, or anxiolytic dependence. rated on a point scale regarding the degree of as-
barbiturate dependence see sedative, hyp- sistance required to perform each item, and the
notic, or anxiolytic dependence. ratings are then combined to yield a total score.
62
Basic Nordic Sleep Questionnaire
[Dorothea W. Barthel, 20th-century U.S. psy- categories of bases: The affective basis refers to
chologist] the emotions, feelings, and moods associated
Bartlett technique a study of memory based with the attitude object; the cognitive basis
on the theory that memory should be viewed as refers to beliefs about attributes associated with B
constructive and reconstructive (see construc- the attitude object; and the behavioral basis re-
tive memory; reconstructive memory), rather fers to responses, such as past behaviors and fu-
than being simply reproductive. In the original ture intentions, associated with the attitude
1932 study, British college students attempted to object. Also called components of an atti-
recall a particular Native American folk tale. Suc- tude.
cessive reproductions of the tale demonstrated bashful bladder syndrome see avoidant
that the students’ own cultural knowledge and paruresis.
expectations intruded into the recall, rationaliz- basic anxiety in ego psychology, a feeling of
ing and eliminating unusual elements and struc- being helpless, abandoned, and endangered in a
turing unrelated items of the tale into a more hostile world. According to German-born U.S.
coherent and familiar framework. Also called psychoanalyst Karen D. Horney (1885–1952), it
Bartlett tradition. [Sir Frederic Charles Bart- arises from the infant’s helplessness and depend-
lett (1886–1969), British psychologist] ence on his or her parents or from parental indif-
BAS abbreviation for behavioral approach sys- ference. Defenses against basic anxiety and
tem. hostility may produce neurotic needs and
neurotic trends, such as a submissive attitude,
basal ganglia a group of nuclei (neuron cell
the need to exert power over others, or with-
bodies) deep within the cerebral hemispheres of
drawal from relationships. See also basic hos-
the brain that includes the caudate nucleus,
tility.
putamen, globus pallidus, substantia nigra,
and subthalamic nucleus. The putamen and basic conflict in ego psychology, the conflict
globus pallidus are together known as the lentic- between a person’s dominant neurotic trend
ular (or lentiform) nucleus, the lenticular nu- and his or her incompatible nondominant neu-
cleus and caudate nucleus are together known as rotic needs, which must be kept repressed.
the corpus striatum, and the caudate nucleus [first described by German-born U.S. psychoana-
and putamen are together called the striatum. lyst Karen D. Horney (1885–1952)]
The basal ganglia are involved in the generation basic emotion see primary emotion.
of goal-directed voluntary movement. Also basic encounter a meaningful experience in
called basal nuclei. one person’s relating to another that is charac-
baseline n. a stable level of performance used as terized by mutual trust and empathy. The devel-
a yardstick to assess the effects of particular ma- opment and occurrence of such encounters in
nipulations or interventions. For example, ex- therapy and counseling contexts is considered to
perimental treatments are expected to modify be beneficial to the therapeutic process and out-
behavior relative to baseline measures. See also come for the client. See also client-centered
behavioral baseline. therapy.
baseline assessment 1. the measurement of basic hostility in ego psychology, a feeling
characteristics of an individual or population of hostility and resentment toward the parents
prior to planned interventions in order to evalu- that develops as a result of the basic anxiety
ate the intervention effects. 2. the measurement that the infant feels at being dependent on
of characteristics of humans and other animals them. To the extent that the infant fears the par-
at a particular point in development in order to ents, basic hostility and anxiety are repressed
evaluate natural changes in these characteristics and give rise to neurotic needs and neurotic
over time. trends. [defined by German-born U.S. psycho-
baseline measures observations of partici- analyst Karen D. Horney (1885–1952)]
pants’ responses before the administration of BASIC ID see multimodal therapy.
any experimental intervention. basic mistake in the psychology of Alfred
baseline performance the measured rate of a adler, a factor arising in early childhood that af-
behavior before introduction of an intervention, fects a person’s lifestyle in later life and that may
which allows comparison and assessment of the need to be corrected in order to resolve conflicts.
effects of the intervention. basic mistrust see basic trust versus mis-
base rate the naturally occurring frequency of a trust.
phenomenon in a population. This rate is often basic need see physiological need.
contrasted with the rate of the phenomenon Basic Nordic Sleep Questionnaire (BNSQ)
under the influence of some changed condition a standardized questionnaire that uses a five-
in order to determine the degree to which the point quantitative scale, ranging from never (1)
change influences the phenomenon. to every night (5), for measuring the frequency
bases of an attitude the types of information of occurrence during the previous 3 months of
from which an attitude is derived. Traditionally, various sleep disturbances and complaints. The
researchers have distinguished between three questionnaire was initially developed in 1988 by
63
basic rest–activity cycle
the Scandinavian Sleep Research Society for use sociated with the aftermath of an armed conflict,
in Denmark, Norway, Sweden, Finland, and Ice- such as recovering casualties and bodies and
land (i.e., the Nordic countries). identifying and burying the dead.
B basic rest–activity cycle (BRAC) cyclic alter- battle inoculation training in simulated oper-
nations between activity and nonactivity during ational conditions (such as fire from real weap-
waking and sleep, thought typically to involve a ons) to prepare soldiers for deployment in
90-min cycle. combat. The battlefield performance of a soldier
basic rule the fundamental rule of psychoanaly- is directly related to the quality and amount of
sis that the patient must attempt to put all spon- realistic unit and individual training that the sol-
taneous thoughts, feelings, and memories into dier has received. Training must be related to the
words without censorship, so that they can be wartime mission of a unit and to the climatic
analyzed to reveal unconscious wishes and emo- conditions it can expect to face. Live-fire train-
tions. Also called fundamental rule. ing prepares soldiers for the shock and noise of
basic trust versus mistrust the first of combat. Realistic training not only helps to inoc-
erikson’s eight stages of development, be- ulate soldiers to the stresses of operations (in-
tween birth and 18 months of age. During this cluding combat) but also enables them to learn
stage, the infant either comes to view other peo- methods for coping with their reactions to these
ple and himself or herself as trustworthy or stresses. Previous operational experience (espe-
comes to develop a fundamental distrust of his cially in combat) helps to prepare soldiers for fu-
or her environment. The growth of basic trust, ture situations. See also stress training.
considered essential for the later development of battle shock psychological impairment result-
self-esteem and positive interpersonal relation- ing from combat stress reactions. The ex-
ships, is attributed to a primary caregiver who is pression was used in the Israeli Yom Kippur war
responsively attuned to the baby’s individual to describe the condition of a combat stress ca-
needs while conveying the quality of trustwor- sualty who was unable to tolerate further mili-
thiness, while the growth of basic distrust is at- tary combat.
tributed to neglect, lack of love, or inconsistent
treatment. Bayesian approach the use of conditional
probabilities as an aid in selecting between vari-
BAT abbreviation for behavioral approach ous options involving a degree of uncertainty,
task. for example, in the delivery of health care ser-
bath therapy the use of water immersion in vices or utilization of limited resources. [Thomas
therapy. See also hydrotherapy. Bayes (1702–1761), British mathematician and
battered-child syndrome (BCS) the effects theologian]
on a child of intentional and repeated physical Bayley Scales of Infant and Toddler De-
abuse by parents or other caregivers. In addition velopment scales for assessing the develop-
to sustaining physical injuries, the child is at in- mental status of infants and young children
creased risk of experiencing longer-term prob- aged 1 month to 42 months. Test stimuli, such as
lems, such as depression, posttraumatic stress form boards, blocks, shapes, household objects
disorder, substance abuse, decreased self- (e.g., utensils), and other common items, are
esteem, and sexual and other behavioral difficul- used to engage the child in specific tasks of in-
ties. See also child abuse. creasing difficulty and elicit particular responses.
battered-woman syndrome (BWS) the psy- The Bayley scales currently have five compo-
chological effects of being physically abused by nents. Tasks from the Mental scale are designed
a spouse or domestic partner. The syndrome to evaluate such functions as perception, mem-
includes learned helplessness in relation to ory, and learning; those from the Motor scale
the abusive spouse, as well as symptoms of post- measure gross and fine motor abilities, such as
traumatic stress. See also cycle of violence. crawling, sitting, grasping, and object manipula-
battered women women who are physically tion. The Behavior Rating scale (formerly called
abused by their spouses or domestic partners. the Infant Behavior Record) contains detailed
Woman beating is considered to surpass rape as descriptions of specific categories of behavior
the most underreported act of violent assault in that are graded on a 5-point scale. It supple-
the United States. Data suggest that violence ments the Mental and Motor scales and provides
against women is common and occurs in all so- an assessment of overall attention and arousal,
cial classes and ethnic and religious groups, as orientation and engagement, emotional regula-
well as between same-sex partners. tion, and motor quality. The final two compo-
nents, the Social–Emotional scale and the
battering men’s excuses rationalizations Adaptive Behavior scale, use questionnaires to
given by men who beat their spouses or domes- obtain parent or caregiver perceptions of their
tic partners. These may include claims of provo- child’s development. The Bayley scales were
cation, or that beating a spouse or partner is originally published in 1969 and subsequently
acceptable in the batterer’s culture, or that the revised in 1993; the most recent version is the
batterer was angry. Bayley–III, published in 2005. [developed by
battlefield recovery tasks stressful tasks as- Nancy Bayley (1899–1994), U. S. psychologist]
64
behavioral baseline
BBBG syndrome see telecanthus-hypospad- bed-wetting n. the involuntary discharge of

ias syndrome. urine during sleep. Bed-wetting is considered
B-cognition n. see being cognition. problematic if it occurs in children older than 4
BCS abbreviation for battered-child syn-
or 5 years of age; it is twice as common in boys. B
Also called sleep enuresis. See also elimina-
drome.
tion disorder; enuresis.
BDD abbreviation for body dysmorphic disor-
before–after design an experimental design
der.
in which one or more groups of participants are
BDI abbreviation for beck depression inven- measured both prior to and following adminis-
tory. tration of the treatment or manipulation. Also
BDS abbreviation for blessed dementia scale. called pre–post design; pretest–posttest de-
beast fetishism a paraphilia involving con- sign.
tact with animal furs or hides, which serve as an behavior n. 1. an organism’s activities in re-
aphrodisiac. sponse to external or internal stimuli, including
beating fantasy in the classical psycho- objectively observable activities, introspectively
analysis of Sigmund freud, a male or female observable activities (see covert behavior),
child’s fantasy of being beaten by his or her fa- and unconscious processes. 2. more restrictively,
ther or mother. For both sexes, the fantasy is in- any action or function that can be objectively
terpreted as an expression of the child’s oedipal observed or measured in response to controlled
desires toward the father and is said to be based stimuli. Historically, behaviorists contrasted ob-
on the child’s belief that the father beats the jective behavior with mental activities, which
mother in the primal scene. were considered subjective and thus unsuitable
Beck Anxiety Inventory (BAI) a self-report, for scientific study. See behaviorism. —behav-
21-item measure used to assess the severity of ioral adj.
anxiety in adults and to discriminate anxiety behavioral approach system (BAS) a brain
from depression. [Aaron T. Beck (1921– ), U.S. system theorized to underlie incentive moti-
psychiatrist] vation by activating approach behaviors in
Beck Depression Inventory (BDI) a self- response to stimuli related to positive reinforce-
report questionnaire designed to assess the se- ment. It has been suggested that the BAS is asso-
verity of depressive symptoms in adolescents ciated as well with the generation of positive
and adults. Extensively used in both clinical and affective responses, and that a strong or chroni-
research settings, it consists of 21 item groups, cally active BAS tends to result in extraversion.
each of which includes four statements of in- Also called behavioral activation system.
creasing severity. Each group reflects a symptom Compare behavioral inhibition system. [de-
or attitude associated with depression (e.g., loss scribed by British psychologist Jeffrey Alan Gray
of energy, self-dislike), and each statement has a (1934–2004)]
numerical value from 0 to 3. Participants choose behavioral approach task (BAT) an obser-
the statement within each group that most accu- vational assessment technique in which an indi-
rately reflects how they have felt within the past vidual approaches a feared situation until he or
two weeks. The BDI was originally published in she is unable to go further. The BAT is used to as-
1961; the most recent version is the BDI–II, pub- sess levels of avoidance and fear of specific situa-
lished in 1996. [Aaron T. Beck and colleagues] tions associated with phobias. It may also be
Beck Hopelessness Scale (BHS) a scale of 20 used to corroborate information obtained in the
true–false statements used to measure an indi- clinical interview and to measure treatment
vidual’s attitudes about the future, loss of moti- progress and outcome. Variables that can be
vation, and expectations in order to predict measured using the BAT include physical symp-
suicide risk. [Aaron T. Beck] toms (e.g., increased heart rate), escape or avoid-
ance strategies, and subjective ratings of fear.
Beck Scale for Suicide Ideation (BSS) a Also called behavioral approach test; be-
measure of the necessity for detailed questioning havioral avoidance test.
about a patient’s intentions, administered to pa-
tients who are considered to be at risk of suicide. behavioral assessment the systematic study
[Aaron T. Beck] and evaluation of an individual’s behavior using
a wide variety of techniques, including direct ob-
Beck therapy a cognitive behavior therapy, servation, interviews, and self-monitoring. When
with individuals or groups, in which the thera- used to identify patterns indicative of disorder,
pist collaborates with the client to design in- the procedure is called behavioral diagnosis and
session and homework tasks to test the validity is essential in deciding upon the use of specific
of maladaptive thoughts and perceptions. Cli- behavioral or cognitive-behavioral interven-
ents identify the negative thought or perception, tions.
label it (e.g., overgeneralization, polarized think-
ing), test its validity, devise alternative explana- behavioral avoidance test see behavioral
tions, discuss the implications of these alter- approach task.
natives, and complete homework to practice the behavioral baseline a steady state of behav-
alternatives. [Aaron T. Beck] ior against which the effects of introducing an
65
behavioral clinic
independent variable may be compared. For behavioral deficit the lack of certain age-
example, a child may throw between six and specific aspects of behavior in an individual,
eight tantrums per week over the course of sev- who is therefore not developmentally on target.
B eral weeks. This level of tantrums could then Also called behavior deficit.
serve as a behavioral baseline to assess the effec- behavioral diagnosis see behavioral assess-
tiveness of a treatment regime. Also called be- ment.
havior baseline.
behavioral diary a tool used to collect data in
behavioral clinic see mental health clinic. which the research participant keeps a record of
behavioral congruence consistency between events at the time they occur.
the aims, attitudes, and values professed by an behavioral disorder see behavior disorder.
individual or group and observable behaviors. In
personality research, behavioral congruence oc- behavioral economics the application of eco-
curs when individuals’ self-ratings are consis- nomic principles (e.g., the law of supply and de-
tent with their actions. mand) to the prediction, analysis, and potential
modification of behavior. For example, sub-
behavioral contagion the rapid copying of stance abuse may be discussed in terms of the
the behavior of one or a few people by others in price of and demand for the substance in ques-
the vicinity, often in response to a salient re- tion.
warding or threatening stimulus. After the initia-
tors first perform the behavior, the action is behavioral endocrinology the study of the
quickly adopted and copied by the others in an relationships between behavior and the func-
almost compulsive manner, with little analysis tioning of the endocrine glands and neuro-
of the situation. Also called behavior conta- endocrine cells (see neuroendocrinology). A
gion. See also contagion; emotional conta- variety of endocrine glands, including the hypo-
gion; mass contagion. thalamus, the pituitary gland, and the adrenal
glands, have been shown to affect behavior. For
behavioral contract an agreement between example, gonadal secretion of sex hormones
therapist and client in which the client agrees to affects sexual behavior, and secretion of cortico-
carry out certain behaviors, usually between ses- steroids by the adrenal glands affects physiologi-
sions but sometimes during the session as well. cal and behavioral responses to stress.
Also called behavior contract. See also con-
tract; contingency contract. behavioral family therapy a family treat-
ment that is characterized by behavioral analysis
behavioral contrast in clinical practice, an in- of presenting problems and a focus on overt be-
crease in the occurrence of a behavior in a havior change through application of learning-
nontreatment setting when a decrease in that based behavioral principles and techniques of
behavior has been achieved in a treatment set- behavior therapy. Techniques used to modify
ting. For example, an intervention decreases tan- targeted behavior patterns include behavioral
trums in school, but the rate of tantrums contracts, instruction, modeling, and rehearsal.
increases at home, where the intervention is not
in use. behavioral genetics the study of familial or
hereditary behavior patterns and of the genetic
behavioral counseling a system of counsel- mechanisms of behavior traits. Also called be-
ing in which the primary focus is on changing havior genetics.
client behavior through self-management, op-
erant conditioning, and related techniques. behavioral group therapy a form of group
Specific behaviors are targeted for modification, therapy that applies learning-based behavioral
and intervention strategies and environmental principles and techniques, including modeling,
changes are then established in order to bring rehearsal, social reinforcement, systematic de-
about the desired modification. sensitization, and other methods of behavior
therapy, in the context of a group. See also
behavioral couples therapy a couples cognitive behavioral group therapy.
therapy that focuses on interrupting negative
interaction patterns through instruction, model- behavioral health an interdisciplinary
ing, rehearsal, feedback, positive behavior ex- subspecialty of behavioral medicine that pro-
change, and structured problem solving. This motes a philosophy of health emphasizing indi-
therapy can be conducted with individual cou- vidual responsibility in the maintenance of
ples or in a couples group format. When prac- one’s own health and in the prevention of illness
ticed with legally married partners, it is called and dysfunction by means of self-initiated activ-
behavioral marital therapy, though some prac- ities (jogging, exercising, healthy eating, no
titioners use this term interchangeably with smoking, etc.). [proposed by U.S. psychologist
behavioral couples therapy. See also communi- Joseph D. Matarazzo (1925– )]
cation skills training; integrative behav- behavioral hierarchy see behavior hierar-
ioral couples therapy. chy.
behavioral criterion an aspect of actual behavioral homeostasis an organism’s ten-
(rather than self-reported) behavior that must dency to maintain stability or equilibrium
exist in a person for an accurate diagnosis to be through various behavioral processes. For ex-
made. Also called behavior criterion. ample, temperature regulation is achieved via
66
behavioral procedure
shivering, sweating, or panting, and satiety is of illness and disease and interventions to treat
achieved by the initiation and then cessation of and manage diseases, promote good health, and
feeding behavior. Also called behavior ho- maintain healthy behaviors. See also behav-
meostasis. See also homeostasis. ioral health. B
behavioral homology functional similarity behavioral model a conceptualization of psy-
(i.e., common behavior) across species, sugges- chological disorders in terms of overt behavior
tive of a shared ancestral origin. Also called be- patterns produced by learning and the influence
havior homology. of reinforcement contingencies. Treatment
behavioral immunogen a behavior or life- techniques, including systematic desensitiza-
style associated with a decreased risk of illness tion and modeling, focus on modifying inef-
and with longer life. Examples of behavioral fective or maladaptive patterns.
immunogens are moderate consumption of al- behavioral neurochemistry the study of the
cohol, regular exercise, adequate sleep, and a relationships between behavior and biochemical
healthy diet. Compare behavioral pathogen. influences, including the effects of drugs on met-
behavioral incident a single, separate behav- abolic processes within the brain and the roles of
ioral event with a clearly defined start and finish different neurotransmitters and neuroregu-
(e.g., brushing one’s teeth), which may be com- latory substances.
bined with other events to form a behavioral behavioral neuroscience a branch of neuro-
sequence. science and biological psychology that
seeks to understand and characterize the specific
behavioral inhibition a temperamental pre-
neural circuitry and mechanisms underlying be-
disposition characterized by restraint in engag-
havioral propensities or capacities.
ing with the world combined with a tendency to
scrutinize the environment for potential threats behavioral pathogen a behavior or lifestyle
and to avoid or withdraw from unfamiliar situa- that may increase the risk of developing illness
tions or people. [first described by U.S. psycholo- or disability and may reduce life expectancy. Ex-
gists Jerome Kagan (1929– ) and J. Steven amples of behavioral pathogens are smoking,
Reznick (1951– )] drug abuse, poor diet, unprotected sexual activ-
ity, and a sedentary lifestyle. Compare behav-
behavioral inhibition system (BIS) a brain
ioral immunogen.
system theorized to underlie behavioral inhi-
bition by activating avoidance behaviors in behavioral pattern see behavior pattern.
response to perceived threats. It has been sug- behavioral pediatrics a multidisciplinary
gested that the BIS is associated as well with the specialty in psychology that is often part of pedi-
generation of negative affective responses, and atric psychology, clinical child psychology,
that a strong or chronically active BIS tends to and health psychology. In prevention and in-
result in introversion. Compare behavioral ap- tervention, practitioners address such problems
proach system. [described by British psycholo- as habit disorders, oppositional behavior, sleep
gist Jeffrey Alan Gray (1934–2004)] and eating disorders, and physical health prob-
behavioral integration 1. the combination lems (e.g., traumatic brain injury). In the medi-
of separate individual behaviors into a synchro- cal literature, it is also called developmental-
nized or coordinated behavioral unit. 2. a model behavioral pediatrics.
for environmentally sound behavior that speci- behavioral pharmacology a branch of phar-
fies the relevant cognitions and affects and their macology concerned with the physiological and
interactions. Also called behavior integra- behavioral mechanisms by which drugs operate,
tion. encompassing not only the effects of drugs on
behavioral interview an approach to clinical behavior but also how behavioral factors con-
interviewing that focuses on relating a problem tribute to the actions of drugs and the ways in
behavior to antecedent stimuli and the conse- which they are used.
quences of reinforcement. behavioral phenotype a pattern of motor,
behavioral marital therapy see behav- cognitive, linguistic, and social abnormalities
ioral couples therapy. that is consistently associated with a biological
disorder. In some cases, the behavioral pheno-
behavioral medicine a field that applies be- type may constitute a discrete psychiatric disor-
havioral theories and methods to the preven- der; in others, the abnormalities are usually not
tion and treatment of medical and psychological regarded as symptoms of a psychiatric disorder.
disorders. Areas of application include chronic
illness, lifestyle issues (e.g., tobacco, drugs, alco- behavioral plasticity the degree to which a
hol, obesity), somatoform disorders, and the person’s behavior can be influenced and modi-
like. Behavioral medicine is a multidisciplinary fied by social experience and learning. High plas-
field in which physicians, psychologists, psychi- ticity leaves ample room for change, whereas
atrists, social workers, and others work together; low plasticity involves inflexible behavior pat-
it includes strong integration of biological, terns.
psychosocial, behavioral, and interpersonal per- behavioral procedure any psychological pro-
spectives in developing biopsychosocial models cedure based on the principles and techniques of
67
behavioral profile
behavior theory. It may be used in basic re- who use this knowledge to provide empirically
search or in applied settings. See applied behav- validated, nonpharmacological interventions.
ior analysis. For example, a BSM practitioner would help a cli-
B behavioral profile an overall representation ent with insomnia to fall asleep faster, wake up
of the behavioral characteristics of a participant less frequently, and sleep more efficiently using
in a test or experiment, obtained not only from specialized behavioral and cognitive techniques
the scores on each individual characteristic but that normalize the person’s sleep schedule and
also from the general pattern of these scores. The condition him or her to see the bedroom as a
scores on each characteristic are often made restful place.
more directly comparable by using percentiles or behavioral technology experimentally estab-
standard scores of one type or another. lished procedures (influenced by scientific be-
behavioral psychology an approach to un- havior analysis) that are designed to produce
derstanding psychological phenomena that fo- behavioral change.
cuses on observable aspects of behavior and behavioral teratology the study of impair-
makes use of behavior theory for explanation. ments in behavior that are produced by embry-
See also behaviorism. onic or fetal exposure to teratogens, that is, toxic
behavioral psychotherapy see behavior substances that affect the developing organism
therapy. (see teratogen).
behavioral rehearsal see behavior re- behavioral toxicity an adverse behavioral
hearsal. change produced by psychotropic drugs, for ex-
behavioral relaxation training a form of ample, insomnia, sedation, impaired psycho-
relaxation training and behavior therapy that motor activity, or changes in mental status.
emphasizes labeling of sensations, modeling, re- behavioral toxicology the study of the be-
inforcement, and therapist feedback. See also havioral impact of toxic exposure. There is
progressive relaxation. increasing evidence that many toxins produce
behavioral repertoire see repertoire. subtle behavioral changes, often in neuro-
behavioral risk factor any specific behavior sensory functioning, at levels far below thresh-
or pattern of behaviors that increases an individ- olds for detectable neurological damage. Perhaps
ual’s likelihood of developing a disorder, disease, the best known example is lead, which is now
or syndrome (e.g., overeating or smoking). banned from gasoline and interior paint in
many countries because of its low-level, behav-
behavioral segment see behavior segment.
ioral-toxicological effects on developing chil-
behavioral self-control training a tech- dren.
nique in behavior therapy that uses self-
monitoring, self-evaluation, self-reinforcement, behavioral weight control therapies in-
coaching, behavioral contracts, and relapse pre- terventions that use the principles and tech-
vention techniques to help clients achieve active niques of behavior therapy to help clients
coping strategies, to increase their sense of mas- change eating and exercise habits to achieve and
tery, and to decrease undesired habits (e.g., nail maintain a healthy weight. Practiced in group or
biting). See also behavioral weight control individual sessions, these techniques include
therapies. self-monitoring, behavioral contracts, environ-
mental change (e.g., eating seated and only in a
behavioral sequence a combination of be- specific room), and reinforcement (e.g., social or
havioral incidents directed toward a particu- monetary). See also behavioral self-control
lar goal or outcome (e.g., getting ready for work training.
in the morning).
behavior analysis the decomposition of be-
behavioral sex therapy a form of sex ther-
havior into its component parts or processes.
apy that focuses on behavioral analysis of pre-
This approach to psychology is based on the ex-
senting problems and on changes to behavioral
perimental analysis of behavior, in which behav-
sequences that hinder healthy sexual function-
ior is the subject matter for research rather than
ing through behavior therapy methods. Be-
an indicator of underlying psychological entities
havioral sequences can include those that are
or processes. Emphasis is placed on interactions
relationship-based (e.g., communication behav-
between behavior and the environment. See ap-
iors) or specifically sexually based (e.g., avoid-
plied behavior analysis. [originally developed
ance of sexual stimuli). *
by B. F. skinner]
behavioral sleep medicine (BSM) a growing
clinical specialty area combining aspects of behavior change 1. a systematic approach to
health psychology and sleep disorders medicine. changing behavior through the use of operant
Practitioners include psychologists, physicians, conditioning. 2. any alteration or adjustment
nurse practitioners, and other health-care proof behavior that affects a patient’s functioning,
fessionals certified in the discipline who seek to brought about by psychotherapeutic or other in-
understand the cognitive and behavioral factors terventions or occurring spontaneously.
that contribute to the development and mainte- behavior checklist a list of behaviors that are
nance of adult and pediatric sleep disorders and to be recorded each time they are observed by an
68
behavior rehearsal
experimental investigator or participant or by a psychology a naturalistic science, Watson pro-

clinician. posed to limit it to quantitative events, such as
behavior clinic see mental health clinic. stimulus–response relationships, effects of con-
behavior-constraint theory the concept
ditioning, physiological processes, and a study B
of human and animal behavior, all of which can
that an individual may acquire learned help-
best be investigated through laboratory experi-
lessness when repeated efforts fail to gain con-
ments that yield objective measures under con-
trol over excessive or undesirable environmental
trolled conditions. Historically, behaviorists
stimuli.
held that mind was not a proper topic for scien-
behavior contract see behavioral con- tific study since mental events are subjective and
tract. not independently verifiable. With its emphasis
behavior control 1. the use of any type of psy- on activity as an adaptive function, behaviorism
chological manipulation, such as threats or is seen as an outgrowth of functionalism. See
promises, to steer individual or group behavior descriptive behaviorism; methodological
in a desired direction. 2. the misuse of invasive behaviorism; neobehaviorism; radical be-
or intrusive treatments (e.g., drugs or aversive haviorism.
conditioning) to achieve control over the lives of behaviorist n. a person who espouses the prin-
individuals, including patients. ciples of behaviorism and whose activities are
behavior criterion see behavioral crite- consciously guided by those principles. See also
rion. behavior analysis; behavior modification.
behavior deficit see behavioral deficit. behavior modification the use of operant
behavior determinant any factor that pro- conditioning, biofeedback, modeling, avers-
duces a behavioral effect. ive conditioning, reciprocal inhibition, or
behavior disorder any persistent and repeti- other learning techniques as a means of chang-
tive pattern of behavior that violates societal ing human behavior. For example, behavioral
norms or rules or that seriously impairs a per- modification is used in clinical contexts to im-
son’s functioning. The term is used in a very prove adaptation and alleviate symptoms and in
general sense to cover a wide range of disorders industrial and organizational contexts to en-
or other syndromes. Also called behavioral courage employees to adopt safe work practices.
disorder. See also attention-deficit/hyper- The term is often used synonymously with be-
activity disorder; disruptive behavior dis- havior therapy.
order; primary behavior disorder. behavior observation a recording or evalua-
behavior disorders of childhood and ad- tion (or both) of the ongoing behavior of one or
olescence observable behaviors in young peo- more research participants by one or more ob-
ple that deviate from the norm. The term is often servers. Observations may be made—using
used in special education and school place- charts, checklists, rating scales, etc.—either di-
ment. rectly as the behavior occurs or from such media
behavior dysfunctions classification the as film, videotape, or audiotape.
classification of personal problems on the basis behavior pattern a complex arrangement of
of behaviors rather than symptoms or hypothet- two or more responses that occur in a prescribed
ical constructs. Such a classification leads the cli- order. Behavior patterns are also referred to as
nician to work on helping the patient change chains of behavior, highlighting their nature as a
behaviors rather than treating syndromes or dis- complex linking of simpler segments of behav-
eases. ior. They may be formed via the operant con-
behavior episode a unit or sequence of activity ditioning of various segments presented in the
with a relatively well-defined start and end. Also appropriate order. Also called behavioral pat-
called behavior unit. tern.
behavior field any set of stimuli or conditions, behavior problem a pattern of disruptive be-
or accumulation of factors, that produces a behavior that generally falls within social norms
havioral effect. and does not seriously impair a person’s func-
behavior hierarchy a ranking of possible re- tioning.
sponses based on the relative probabilities of behavior rating a rating of the degree to which
their being elicited, with more probable behav- a participant shows each of several behaviors in a
iors ranked higher than less probable behaviors. given situation.
Also called behavioral hierarchy.
behavior rehearsal a technique used in be-
behavior integration see behavioral inte- havior therapy or cognitive behavior ther-
gration. apy for modifying or enhancing social or inter-
behaviorism n. an approach to psychology, for- personal skills. The therapist introduces effective
mulated in 1913 by John B. watson, based on interpersonal strategies or behavior patterns to
the study of objective, observable facts rather be practiced and rehearsed by the client until
than subjective, qualitative processes, such as these are ready to be used in a real-life situation.
feelings, motives, and consciousness. To make The technique is also commonly used in asser-
69
behavior reversal
tiveness training. Also called behavioral re- manistic psychology of Abraham maslow,
hearsal. an exceptional type of cognition that can be dis-
behavior reversal a method of behavior tinguished from one’s everyday perception of re-
B modification in which the client, supervised ality (deficiency cognition or D-cognition).
by the therapist, practices desirable responses to Being cognition takes one of two forms: In the
interpersonal conflicts, which are often opposite first, a person is aware of the whole universe and
to his or her usual behavior. the interrelatedness of everything within it, in-
cluding the perceiver; in the second, a person be-
behavior sampling the process of recording a comes entirely focused on a single object (e.g., a
set of observations of a participant’s behavior natural phenomenon, a work of art, or a loved
during a designated time frame. Behavior sam- person) to the extent that the rest of the uni-
pling may be conducted over multiple periods of verse, including the perceiver, seems to disap-
observation in either natural or laboratory set- pear. According to Maslow, self-actualizers (see
tings, with or without the awareness of the par- self-actualization) frequently experience
ticipant. being cognitions. See also peak experience;
behavior segment a distinct response or be- timeless moment. 2. awareness of the inner
havior episode that, when linked with other core of one’s existence, that is, one’s self or iden-
responses, forms a behavior pattern or chain. tity.
Also called behavioral segment. being-in-the-world n. in theories and clinical
behavior shaping see shaping. approaches derived from existentialism, the
behavior system 1. the different activities that particular type of being characteristic of hu-
can be undertaken to reach the same goal or mans, in contrast to the type of being of animals,
carry out the same function, for example, com- inanimate objects, or abstractions. The term is
munication is achieved through writing, speak- roughly synonymous with dasein, the term
ing, or gestures. 2. the expression of important used by German philosopher Martin Heidegger
motives (e.g., hunger, sex, aggression), which (1889–1976). The word “being” is meant to em-
varies between cultures and among individuals phasize that human existence is an activity more
within the same culture who have had different than a state or condition. Similarly, “world” is
training and experiences. Also called activity meant to convey a much richer and more mean-
system. ingful ground for human life than would be
conveyed by a more sterile term, such as “envi-
behavior theory the assumption that behav- ronment.” Being-in-the-world is by its very na-
ior, including its acquisition, development, and ture oriented toward meaning and growth; while
maintenance, can be adequately explained by it characterizes the type of being of all humans,
principles of learning. Behavior theory attempts it is also unique for every person, and can be
to describe environmental influences on be- seen to be offering an explanation of what in
havior, often using controlled studies of ani- other psychological traditions might be called
mals. Behavior theory encompasses historical identity or self. Compare being-beyond-the-
approaches to formal theorizing, such as those of world.
C. L. hull and K. W. spence, and the operant
theory of B. F. skinner, as well as contemporary
being love (B-love) in Abraham maslow’s hu-
manistic psychology, a form of love charac-
approaches to behavior. Also called general be-
terized by mutuality, genuine concern for
havior theory.
another’s welfare and pleasure, and reduced de-
behavior therapy a form of psychotherapy pendency, selfishness, and jealousy. B-love is
that applies the principles of learning, operant one of the qualities Maslow ascribes to self-
conditioning, and pavlovian conditioning actualizers (see self-actualization). Compare
to eliminate symptoms and modify ineffective deficiency love.
or maladaptive patterns of behavior. The focus
being motivation see metamotivation.
of this therapy is upon the behavior itself and
the contingencies and environmental factors being–not being a paraphrase of the fun-
that reinforce it, rather than exploration of the damental question that, according to German
underlying psychological causes of the behavior. philosopher Martin Heidegger (1889–1976), mo-
A wide variety of techniques are used in behavior tivates human beings, namely, the worry or con-
therapy, such as behavior rehearsal, biofeed- cern about dying and not being here any longer.
back, modeling, and systematic desensitiza- See also dasein.
tion. Also called behavioral psychotherapy; being psychology a psychological perspective
conditioning therapy. that deals with “persons insofar as they are ends-
being-beyond-the-world n. in existential in-themselves.” It is concerned with the sacred,
psychology, the potential for human beings to the unique, and the incomparable in people and
transcend the limitations of being-in-the- things. [developed by Abraham maslow]
world, usually through selfless love. See also being values see metaneeds.
dasein. [introduced by Swiss psychologist Lud- belief–desire reasoning the process by which
wig Binswanger (1881–1966)] one explains and predicts another’s behavior on
being cognition 1. (B-cognition) in the hu- the basis of one’s understanding of the other’s
70
benzodiazepine antagonists
desires and beliefs. Belief–desire reasoning is the then redraws them from memory (Recall Phase).
basis for theory of mind. See also mindblind- All reproductions are scored on a 5-point scale,
ness. ranging from 0 (no resemblance) to 4 (nearly
belladonna alkaloids substances obtained perfect). The test is appropriate for individuals B
from the shrub Atropa belladonna (commonly aged 4 years and older and is used to assess
known as belladonna or deadly nightshade). visual–motor functioning and perceptual abil-
They were known to the ancient Hindus and ity as well as to diagnose neuropsychological
were used in the Middle Ages as poisons (the impairment. It is sometimes also used, albeit
genus is named for Atropos, eldest of the mytho- controversially, in conjunction with other per-
logical Fates, who cuts the thread of life). Their sonality tests to determine the presence of emo-
pharmacology was unknown until the 1860s, tional and psychological disturbances, such as
when they were found to affect heart rate, sali- schizophrenia. Originally developed in 1938,
vary secretion, and other body functions. atro- the test (often shortened to Bender–Gestalt) is
pine and scopolamine are the best known now in its second edition (published in 2003).
examples. [Lauretta Bender (1897–1987), U.S. psychiatrist]
belladonna delirium delirium due to the ef- benign adj. 1. in mental health, denoting a disor-
fects on the central nervous system of large doses der or illness that is not serious and has a favor-
of belladonna alkaloids, such as atropine and able prognosis. 2. denoting a disease condition
scopolamine. Symptoms, in addition to delir- that is relatively mild, transient, or not associ-
ium, include hallucinations and overactive coor- ated with serious pathology. See also neoplasm.
dinated limb movements. Compare malignant.
bell and pad a device used in treatments aimed benign stupor 1. a state of unresponsiveness,
at controlling nocturnal enuresis (bed-wetting) immobility, and indifference to one’s surround-
in children. If the child urinates, an electric cir- ings that is unlikely to be permanent. 2. psycho-
cuit is closed via the wetted pad and a bell rings, motor retardation and apathy that often
awakening the child. occur in severe major depressive episodes.
bell curve the characteristic curve obtained by benny n. (pl. bennies) slang for an amphet-
plotting a graph of a normal distribution. amine tablet. See amphetamines.
With a large rounded peak tapering off on either Benzedrine n. a trade name for amphetamine.
side, it resembles a cross-sectional representation Benzedrine dependence see amphetamine
of a bell. Also called bell-shaped curve. dependence.
belle indifférence see la belle indifférence. benzene a volatile solvent that, when chroni-
Bell’s mania see lethal catatonia. [Luther cally inhaled, can cause kidney failure and
Vose Bell (1806–1862), U.S. physician ] death. See inhalant. See also inhalant abuse;
below average denoting a range of intellectual inhalant dependence.
functioning that is just below the average range, benzisoxazoles pl. n. a class of atypical
roughly between 80 and 90 on most IQ scales, antipsychotics that include risperidone and
and is inconsistent with the presence of mental iloperidone.
retardation. Such a range may also be described
benzodiazepine n. any of a family of drugs that
as low normal or dull normal, but below average
depress central nervous system activity (cns
is now the preferred term.
depressants) and also produce sedation and re-
Bem Sex Role Inventory (BSRI) a masculin- laxation of skeletal muscles. Benzodiazepines in-
ity–femininity test in which participants rate clude the prototype chlordiazepoxide and the
themselves on 60 traits regarded as characteristi- common sedatives diazepam and alprazolam.
cally masculine or feminine. Masculinity and They are commonly used in the treatment of
femininity are treated as independent variables; generalized anxiety and insomnia and are useful
people with high scores for both types of traits in the management of acute withdrawal from al-
(e.g., assertiveness plus warmth) are classified as cohol and in seizure disorders. Clinically intro-
androgynous (see androgyny), and people with duced in the 1960s, they rapidly supplanted the
low scores for both feminine and masculine barbiturates, largely due to their significantly
traits are classified as undifferentiated. [Sandra lower toxicity in overdose. Members of the
Bem (1944– ), U.S. psychologist] group show considerable variation in abuse po-
Benadryl n. a trade name for diphenhydra- tential: Prolonged use can lead to tolerance and
mine. psychological and physical dependence.
benchmark n. a measure of best performance benzodiazepine agonists drugs that facilitate
for a particular process or outcome, which can be the binding of benzodiazepines to subunits of
used as a reference to improve performance in the benzodiazepine receptor complex (see gabaa
other settings. receptor).
Bender Visual–Motor Gestalt Test a benzodiazepine antagonists agents that
visuoconstructive test in which the participant prevent the binding of benzodiazepines and re-
first copies line drawings of 16 geometric figures lated chemicals to the benzodiazepine receptor
onto blank pieces of paper (Copy Phase) and site on the gabaa receptor complex. Benzo-
71
benzothiadiazides
diazepine antagonists in clinical use include ple) dilation of blood vessels and widening of
flumazenil. airways. Also called beta adrenoceptor; beta
benzothiadiazides pl. n. see thiazide diuret- adrenoreceptor; beta receptor. Compare
B ics. alpha-adrenergic receptor.
benztropine n. an anticholinergic drug beta-adrenergic receptor kinase (barK) a
used in the management of adverse side effects cyclic amp-dependent enzyme that is responsi-
of conventional or first-generation antipsy- ble for inactivating beta-adrenergic recep-
chotic drugs and as an adjunct in the treatment tors, thereby inhibiting the ability of these
of Parkinson’s disease. U.S. trade name: receptors to activate second messengers
Cogentin. within the cell. BarK is a member of a family of g
protein-coupled receptor kinases that function
berdache n. see two-spirit. only when receptors are occupied by an agonist.
bereavement n. a feeling of loss, especially over beta-adrenoreceptor blocking agent see
the death of a friend or loved one. The bereaved adrenergic blocking agent.
person may experience emotional pain and dis-
tress (see grief; traumatic grief) and may or beta alcoholism one of five types of alcohol-
may not express this distress to others (see ism defined by U.S. physician Elvin M. Jellinek
mourning; disenfranchised grief); individ- (1890–1963), the others being alpha alcohol-
ual grief and mourning responses vary. Bereave- ism, gamma alcoholism, delta alcoholism,
ment may also signify a change in social status and epsilon alcoholism. It is characterized by
(e.g., from wife to widow). —bereaved adj. serious medical complications (e.g., liver dam-
age, gastritis, nutritional deficiency) associated
bereavement program any of a variety of with undisciplined drinking but does not in-
treatment services (e.g., support groups, grief volve physical or psychological dependence.
counseling) offered to individuals coping with
the death of a loved one. beta-amyloid ( -amyloid) n. a protein that ac-
cumulates—via aberrant processing of amyloid
bereavement therapy therapy or counseling precursor protein (APP)—in the brains of pa-
provided to individuals who are experiencing tients with Alzheimer’s disease, forming senile
loss and grief following the death of a loved one. plaques and contributing to neuronal impair-
The therapy may include issues of separation, ment and eventual loss. Significant progress has
grieving, and carrying on with life. See also grief been made recently toward developing therapies
counseling. that target this processing pathway and several
Bernoulli distribution see binomial distri- promising pharmacological agents are now in
bution. [Jacques Bernoulli (1654–1705), Swiss advance-stage clinical trials.
mathematician and scientist] beta blocker see adrenergic blocking agent.
Bernoulli trial see binomial distribution. beta coefficient see beta weight.
[Jacques Bernoulli]
beta-endorphin n. a neuropeptide involved in
Berry syndrome see treacher collins syn- pain and hunger that produces its analgesic ef-
drome. [reported in 1889 by George Andreas fects by binding to opioid receptors and
Berry (1853–1929), British physician] disinhibiting dopamine pathways. See endoge-
berserk 1. adj. destructive or violent. 2. n. one nous opioid; endorphin.
who is destructive or violent. The term is derived beta error see type ii error.
from an Old Norse word literally meaning beta level the probability of failing to reject the
“bearshirt,” used to describe ancient Norse war- null hypothesis when it is in fact false, that is,
riors who wore bearskins during battle and making a type ii error.
fought with great strength and fury.
beta wave in electroencephalography, the type
bestiality n. see zooerasty. of brain wave (frequency 13–30 Hz) associated
best interests of the child a standard used by with alert wakefulness and intense mental activ-
courts to make child custody decisions in di- ity. Also called beta rhythm.
vorce proceedings, namely that the potential for beta weight (symbol: β) in regression analy-
the child to lead a happy and successful life sis, the multiplicative constant that reflects a
should be given greater weight than the rights of variable’s contribution to the prediction of a cri-
either parent. terion, given the other variables in the predic-
beta (symbol: β) n. the probability of a type ii tion equation (e.g., b in y = a + bx). Also called
error. beta coefficient.
beta-adrenergic blocking agent see adren- betel nut the seed of the areca palm (Areca
ergic blocking agent. catechu), which is chewed as a stimulant by local
beta-adrenergic receptor a receptor that populations of India and the islands of the In-
binds norepinephrine. There are two main dian and Pacific Oceans. It contains the drug
types, designated β1 and β2. The former mediate arecoline.
stimulation of heart muscle, causing a faster and bethanechol n. a cholinergic drug used to
stronger heartbeat. The latter are associated with stimulate movement in the bladder in the man-
relaxation of smooth muscle, causing (for exam- agement of such conditions as lower motor
72
bilis
neuron disease and postoperative or postpar- bibliotherapy n. a form of therapy that uses
tum urinary retention. U.S. trade name: structured reading material. Bibliotherapy is
Urecholine. often used as an adjunct to psychotherapy for
betrayal trauma theory a conceptual model such purposes as reinforcing specific in-session B
for explaining why some children are unable to concepts or strategies or enhancing lifestyle
access memories of prior sexual or physical changes. Carefully chosen readings are also used
abuse. According to the theory, this sort of re- by some individuals as self-help tools to foster
pression occurs when the perpetrator of the personal growth and development, for example,
abuse is an adult on whom the child is emotion- by facilitating communication and open discus-
ally dependent and it develops out of the child’s sion of problems or enhancing self-concept.
need to preserve the attachment bond; hence bicalutamide n. see antiandrogen.
the child is unable to access the stored memories bicameralism n. a highly controversial theory
of the abuse while the need for attachment is of primitive human mentality (posited to pre-
still strong. [first proposed in 1991 by U.S. cogni- date the development of consciousness) in
tive psychologist Jennifer J. Freyd] which cognitive functions are separated into one
between-groups design see between-subjects section of the brain that “speaks” or “orders,”
design. specifically through auditory hallucination, and
between-groups variance the variation in another section that “listens” or “obeys.” The
experimental scores that is attributable only to concept, proposed by U.S. psychologist John
membership in different groups and exposure to Jaynes in his 1976 publication The Origins of Con-
different experimental conditions. It is reflected sciousness in the Breakdown of the Bicameral Mind,
in the analysis of variance by the degree to has not received significant attention in neuro-
which the several group means differ from one psychological research, although analogies have
another and is compared with within-group been drawn to neurological models describing
variance to obtain an f ratio. the differing functions of the right and left hemi-
spheres of the brain.
between-subjects design any of a large num-
ber of experimental designs in which each per- bicuculline n. an alkaloid derived from the
son, or other sampling unit, experiences only plant Dicentra cucullaria that acts as a competi-
one experimental condition (treatment) and tive gaba antagonist at gabaa receptors and
therefore contributes only a single final score to has strong convulsant effects. It has no modern
enter into the analysis. Compare within- clinical applications but may be used experi-
subjects design. mentally in laboratory animals for various re-
search purposes.
bewildered adj. confused or puzzled, especially
when presented with conflicting situations or Biemond’s syndrome a disorder that com-
statements. See also disorientation. —bewil- bines mental retardation, growth impair-
derment n. ment, abnormalities in the iris (a hole, split, or
cleft), and excess fingers or toes. [A. Biemond
beyond reasonable doubt the standard of (1902– ), French physician]
proof required in a criminal trial. In order to con-
vict a defendant, a jury must be convinced of bigamy n. the crime of marrying someone when
the defendant’s guilt “beyond any reasonable already married to someone else. In cultures that
doubt,” meaning there is no justifiable, rational permit individuals to have more than one
cause for jury members to doubt the defendant’s spouse this practice should be referred to as po-
guilt. This standard is considered to be equiva- lygamy and not bigamy. Compare monogamy.
lent to a moral certainty but is less than an abso- —bigamist n. —bigamous adj.
lute certainty. Big Five personality model a model of the
bhang n. the mildest preparation of cannabis, primary dimensions of individual differences in
consisting of the whole Cannabis sativa plant, personality. The dimensions are usually labeled
dried and powdered. extraversion, neuroticism, agreeableness,
conscientiousness, and openness to experi-
BHS abbreviation for beck hopelessness scale. ence, though the labels vary somewhat among
BIA abbreviation for body image assessment. researchers. See also five-factor personality
bias n. 1. partiality: an inclination or predisposi- model. [described by (among others) U.S. psy-
tion for or against something. See also preju- chologists Lewis R. Goldberg (1932– ) and
dice. 2. a tendency or preference, such as a Gerard T. Saucier]
response bias or test bias. 3. in research, sys- bigorexia n. see muscle dysmorphia.
tematic and directional error arising during sam- bilis n. a culture-bound syndrome found
pling, data collection, data analysis, or data among Latino groups, who attribute it to ex-
interpretation. 4. in statistics, the difference be- tremely strong anger or rage. Symptoms include
tween the expected value of a statistic and the abrupt nervous tension, headache, screaming,
actual value that is obtained. —biased adj. stomach disturbances, vomiting, loss of weight,
biastophilia n. a paraphilia involving sexual tremors, chronic tiredness, and—in extreme
arousal and excitement based on surprising or cases—loss of consciousness or death. The ex-
attacking a stranger sexually. treme anger is said to disturb the center of bal-
73
bill of rights
ance of hot and cold in the body, which upsets eating disorder not otherwise specified. Com-
the material and spiritual aspects of the person. pare bulimia nervosa.
Also called colera; muina. binomial distribution the distribution of the
B bill of rights in health care, a document stating outcomes in a sequence of Bernoulli trials, exper-
the entitlements a patient has with respect to iments of chance that are independent of one
providers, institutions, and third-party pay- another and each have one of two possible out-
ers. See patients’ rights. comes (0 or 1; success or failure), with a fixed
bimodal distribution a set of scores that has probability of each outcome on each trial. Also
two modes (represented by two peaks in their called Bernoulli distribution.
graphical distribution), reflecting a tendency for Binswanger’s disease a progressive vascular
scores to cluster around two separate values. See dementia characterized by demyelination and
also unimodal distribution. multiple infarctions of subcortical white mat-
binary choice in decision making, a choice be- ter associated with hypertension and subsequent
tween two alternatives. arteriosclerosis. Symptoms include loss of cogni-
binary variable a variable that may take on tive functioning, memory impairment, and
only two values, for example, male versus fe- changes in mood and behavior. Also called
male, or 0 versus 1 in computer code. subcortical arteriosclerotic encephalop-
athy. [Otto Ludvig Binswanger (1852–1929),
binding hypothesis a theory, proposing that German neurologist]
the neural mechanism responsible for drawing
together disparate information from separate bioavailability n. the quantity of an adminis-
cortical areas and “binding” it into unified per- tered drug that is available for distribution
cepts is temporal synchrony: that is, the simulta- within the body to the target organ or site after
neous firing of action potentials from individual absorption into the bloodstream.
neurons—each coding different properties—is biochemical approach 1. the study of behav-
the means by which they are organized into a ioral patterns, including mental disorders, from
single representation. Recently, some individu- the standpoint of chemical changes. An example
als have emphasized feature binding as essential of this approach is the view that a mental disor-
to consciousness, providing a requisite coher- der can be explained in terms of an excess or de-
ence of mental contents. ficiency of certain substances in the nervous
Binet, Alfred (1857–1911) French psychologist. system, such as serotonin. 2. the use of psycho-
Although he had no formal training in psychol- tropic drugs in the treatment of mental disor-
ogy, Binet became a pioneer investigator of sug- ders. See psychopharmacotherapy.
gestion and the thought processes of mentally biochemical defect any of numerous chemi-
gifted individuals and those with mental retar- cal imbalances or aberrations in the brain that
dation. Opposing James McKeen Cattell’s (1860– may be associated with neurological or psychiat-
1944) reduction of mental abilities to sensory ric disorder. Such disorders may be related to the
and motor capacities, as measured by “brass in- production of specific neurotransmitters or
struments,” Binet developed a variety of verbal the availability of other biochemical substances
and numerical test items in 1905, with the assis- necessary for brain function.
tance of French psychologist Théodore Simon biochemical marker a variation in the chemi-
(1873–1961). These were used to determine a cal activity of an organism that accompanies a
child’s mental age and to identify pupils with disorder, irrespective of whether it directly
mental retardation who might not be able to causes the disorder; an example is demonstrated
succeed in an ordinary academic curriculum. in the dexamethasone suppression test. See
Later revisions of the Binet–Simon Scale led ulti- also biological marker; clinical marker.
mately to the development of the stanford–
binet intelligence scale, which is in wide use biodata pl. n. see biographical data.
today. See also iq. biodynamics n. the study of dynamic processes
binge drinking 1. a single occasion of intense, within living organisms. See dynamic.
extremely heavy drinking that often results in bioecological model a paradigm that treats
intoxication. 2. a pattern of alcohol consump- human development as a process that continues
tion characterized by the setting aside of re- both through the life span and across successive
peated periods of time for intense, extremely generations, thus according importance to his-
heavy drinking, with or without sobriety in be- torical continuity and change as forces indirectly
tween. affecting human development through their im-
binge-eating disorder a disorder marked by pact on proximal processes.
recurring episodes of binge eating (i.e., discrete bioenergetics n. a form of alternative psycho-
periods of uncontrolled consumption of abnor- therapy that combines work with the body and
mally large quantities of food) and distress asso- the mind in treating emotional problems.
ciated with this behavior. There is an absence of Bioenergetics proposes that body and mind are
distinct inappropriate compensatory behaviors functionally identical: What happens in the
(e.g., vomiting, laxative misuse, excessive exer- mind reflects what is happening in the body,
cise, fasting). In DSM–IV–TR it is classified as and vice versa. It uses exercises and postural
74
biological measures
changes in an attempt to relieve chronic muscu- biographical data information gathered by a

lar tensions and rigidity attributed to emotional therapist or medical professional about a client’s
stress and unresolved emotional conflicts. The history and behavioral patterns, primarily from
approach was developed by U.S. physician Alex- the client but sometimes—when permitted by B
ander Lowen (1910–2008) and is based on the the client or deemed necessary—from individu-
work of Austrian psychoanalyst Wilhelm Reich als who know or are related to the client. Also
(1897–1957). called biodata.
bioequivalence n. a measure comparing the Biographical Evaluation and Screening
relative bioavailability of two forms or prep- of Troops a program used for the selection and
arations of a drug. In bioequivalent drug prep- classification of military personnel. Formerly
arations, the same proportion of unchanged, called the Air Force Medical Evaluation Test
active drug reaches the systemic circulation. (AFMET), it is used to identify individuals who
Bioequivalence may be a clinical issue when are unlikely to complete the Air Force basic train-
comparing two preparations of a drug (i.e., im- ing or who might find it difficult to function in a
mediate-release versus delayed-release) or when military system.
comparing trademarked drugs and their generic bioinformational theory a general theory of
counterparts. —bioequivalent adj. emotional–motivational organization, integrat-
bioethics n. the study of ethics and values rel- ing cognitive and psychophysiological levels of
evant to the conduct of clinical practice and analysis. It is concerned with how emotions are
research in medicine and the life sciences. elicited and displayed and with how they inter-
—bioethical adj. act; specifically, information about emotions is
contained in associative memory networks that
biofeedback n. information about bodily pro-
include action information (motor programs)
cesses and systems provided by an organism’s re-
and connections to subcortical motivation cir-
ceptors to enable it to maintain a physiologically
cuits. Emotions are viewed as context-specific
desirable internal environment and make ad-
action or response dispositions activated by
justments as necessary.
input that modifies concepts in the emotion net-
biofeedback training a technique by which a work. The model, originally forwarded in the
person learns to control a normally involuntary 1970s as a theory of emotional imagery, was de-
autonomic response (e.g., blood pressure, heart rived from research on fear and anxiety but has
rate, or alpha rhythm in the brain) by watching since evolved and acquired diverse applications
the output of a device that monitors the response across a variety of behavioral and emotional
continuously (e.g., a blood pressure monitor, an phenomena.
electrocardiograph, or an electroencephalograph).
biological clock the mechanism within an or-
Biofeedback training is sometimes used to treat
ganism that controls the periodicity of biologi-
stress disorders, such as migraine headaches and
cal rhythms, even in the absence of any
hypertension. It is also used as an adjunctive
external cues. Also called internal clock.
treatment for other disorders, such as insomnia,
substance abuse, attention-deficit/hyperactivity biological determinism the concept that
disorder, and epilepsy. See also alpha wave. psychological and behavioral characteristics are
entirely the result of constitutional and biologi-
biogenesis n. the origin of living things from
cal factors. Environmental conditions serve only
other living things. Biogenetics is the scientific
as occasions for the manifestation of such char-
study of the principles and processes governing
acteristics. Compare environmental determin-
the production of living organisms from other
ism. See determinism; genetic determinism;
living organisms, including the mechanisms of
nature–nurture.
heredity. —biogenetic adj.
biological drive an innate motivational state
biogenic adj. 1. produced by living organisms or produced by depletion or deprivation of a
biological processes. 2. necessary for the mainte- needed substance (e.g., water, oxygen) in order
nance of life. to impel behavior that will restore physiological
biogenic amine any of a group of amines equilibrium. See also drive.
(chemical compounds that contain one or more biological factor any physical, chemical, ge-
amino groups [–NH2]) that affect bodily pro- netic, or neurological condition associated with
cesses and nervous system functioning. Biogenic psychological disturbances.
amines are divided into subgroups (e.g., cate-
cholamines, indoleamines) and include the biological family a person’s blood relations as
neurotransmitters dopamine, epinephrine, his- opposed to relations acquired through marriage,
tamine, norepinephrine, and serotonin. adoption, or fostering.
biogenic amine hypothesis any of a variety biological marker a variation in the physio-
of hypotheses, such as the catecholamine hy- logical processes of an organism that accompa-
pothesis and dopamine hypothesis, that con- nies a disorder, irrespective of whether it directly
sider abnormalities in the physiology and causes the disorder. Also called biomarker. See
metabolism of biogenic amines essential to the also biochemical marker; clinical marker.
etiology of certain mental disorders. biological measures assessments or other
75
biological perspective
markers of processes or outcomes that are drawn biosocial theory any approach that explains
from bodily activity or other natural biological personality or human behavior in terms of bio-
systems or events. Such measures include assess- logical predispositions that are influenced by so-
B ments of cardiopulmonary, endocrine, nervous- cial or environmental factors.
system, and immune-system activity. biostatistics n. 1. data compiled about a popu-
biological perspective an approach to abnor- lation, including rates of birth, disease, and
mal psychology that emphasizes physiologically death. See also demography. 2. a branch of sta-
based causative factors, such as the senile tistics concerned with the application of statisti-
plaques in Alzheimer’s disease, and conse- cal methods to biological processes, especially in
quently tends to focus primarily upon biologi- medicine and epidemiology. Also called
cal therapies. biometrics. —biostatistical adj. —biostat-
biological psychology the science that deals istician n.
with the area of overlap between psychology and biosynthesis n. 1. the production of chemical
biology and with the reciprocal relations be- compounds by living organisms from nutrients
tween biological and psychological processes. It by means of enzyme-catalyzed reactions. 2. the
includes such fields as behavioral neurosci- production of molecules of biological or medical
ence, clinical neuroscience, cognitive neu- interest, either in the laboratory or commer-
roscience, behavioral endocrinology, and cially, for example, by recombinant DNA tech-
psychoneuroimmunology, and involves re- nology. —biosynthetic adj.
ciprocal interactions between the neural, endo-
biotaxis n. 1. the classification of living organ-
crine, and immune systems as they affect and are
isms by their anatomical features and traits. 2.
affected by behavior. It was formerly known as
the ability of living cells to orient themselves
physiological psychology. Also called biopsy-
with respect to their environment. See
chology.
neurobiotaxis. —biotactic adj.
biological rhythm any periodic variation in a
biotransformation n. the metabolic process
living organism’s physiological or psychological
by which a substance (e.g., a drug) is changed
function, such as energy level, sexual desire, or
from one chemical to another by means of a
menstruation. Such rhythms are usually linked
chemical reaction within a living system. The
to cyclical changes in environmental cues, such
metabolites, or products, of this change may be
as daylength or passing of the seasons, and tend
active or inactive within the system.
to be daily (circadian rhythm) or annual (circ-
annual rhythm). They also can vary with indi- biperiden n. a synthetic anticholinergic
viduals and with the period of the individual’s drug closely related to trihexyphenidyl but
life. Also called biorhythm; endogenous having greater affinity for nicotinic receptors
rhythm; internal rhythm; life rhythm. than for muscarinic receptors, compared
with trihexyphenidyl. It is used to manage
biological therapy any form of treatment for
symptoms of Parkinson’s disease and parkin-
mental disorders that attempts to alter phys-
sonian symptoms induced by antipsychotic
iological functioning, including various drug
drugs. U.S. trade name: Akineton.
therapies, electroconvulsive therapy, and
psychosurgery. Also called biomedical ther- biphasic sleep see polyphasic sleep.
apy. bipolar adj. denoting something with two oppo-
biology n. the study of living organisms and life sites or extremities, such as bipolar disorders.
processes. —biological adj. —biologist n. —bipolarity n.
biomechanics n. the application of the princi- bipolar concept the notion, often applied to
ples of mechanics to the study of the structure mood and affect, that a particular phenome-
and function of biological systems, which in- non can accurately be described by reference to a
cludes the study of the physical stresses and dimension characterized by opposing attributes,
strains on organisms while at rest and in motion. such as happiness versus sadness. It is contrasted
—biomechanical adj. with a unidimensional concept, which is charac-
biomedical therapy see biological ther- terized by the extent of one particular attribute,
apy. such as a greater or lesser degree of sadness.
bion n. a hypothetical microscopic vesicle bipolar disorder any of a group of mood dis-
charged with sexual energy, postulated by Aus- orders in which symptoms of mania and de-
trian psychoanalyst Wilhelm Reich (1897–1957) pression alternate. DSM–IV–TR distinguishes
as the ultimate source of the orgasm. See also between bipolar I disorder, in which the individ-
orgone; orgone therapy. ual has experienced one or more manic epi-
sodes or mixed episodes and usually (but not
biopsychology n. see biological psychol- necessarily) one or more major depressive epi-
ogy. sodes, and bipolar II disorder, characterized by
biopsychosocial adj. denoting a systematic in- one or more major depressive episodes and at
tegration of biological, psychological, and social least one hypomanic episode. Also categorized
approaches to the study of mental health and as bipolar disorders in DSM–IV–TR are cyclo-
specific mental disorders. thymic disorder and bipolar disorder not oth-
76
blank screen
erwise specified, which does not meet the attracted sexually to both sexes and is usually
criteria for more specific bipolar disorders. In able to achieve orgasm in contact with members
DSM–III the bipolar disorders were grouped into of either sex.
the types depressive, manic, and mixed, accord- bisexuality n. 1. sexual attraction to or sexual B
ing to the nature of the current or most recent behavior with both men and women. Although
episode. The former official name for bipolar dis- much psychological research demonstrates the
orders, manic-depressive illness, is still in frequent existence of a continuum of sexual attraction
use. within most individuals, equal responsiveness to
bipolar factor in factor analysis, a factor both sexes over the life span is rare, appearing to
(variable) characterized as having a neutral as- be more common in women than in men. Same-
pect at a relatively central position on a spec- sex attractions and behaviors generally occur
trum ranging from positive to negative extremes after those to the opposite sex for bisexual
at either end, for example, attitudes toward work women, whereas bisexual men typically experi-
ranging from strong engagement to neutrality to ence their first homosexual attractions and be-
sheer boredom. havior before or at the same age as their first
bipolar rating scale a rating scale anchored at heterosexual experiences. Anthropological stud-
each end by opposite terms (e.g., very fast to very ies note that bisexuality is present in many cul-
slow). It is distinguished from a unipolar rating tures. 2. the existence of both male and female
scale (e.g., very fast to not at all fast, or very slow genitals in the same organism. See hermaphro-
to not at all slow). ditism; intersexuality. —bisexual adj., n.
birth control voluntary regulation of the num- biting stage see oral-biting phase.
ber and spacing of offspring, including the pre- bivariate adj. characterized by two variables or
vention of conception using intrauterine attributes. See also multivariate; univariate.
devices, oral contraceptives, spermicides, bizarre behavior behavior that is odd, strange,
the rhythm method, male contraceptive de- or unexpected, particularly if it is out of the ordi-
vices, surgical methods of sterilization (e.g., nary for a given person. It may be a symptom of
salpingectomy, vasectomy), and the termination brain damage or a mental disorder, especially a
of pregnancy by induced abortion. psychotic disorder, such as schizophrenia.
birth defect see congenital defect. bizarre delusion a belief that is clearly fantas-
birth order the ordinal position of a child in the tic and implausible but is nonetheless main-
family (first-born, second-born, youngest, etc.). tained with conviction. For example, an indi-
There has been much psychological research vidual with schizophrenia may believe that
into how birth order affects personal adjustment external forces are removing the thoughts from
and family status, but the notion that it has his or her mind (see thought withdrawal).
strong and consistent effects on psychological blacking out see falling out.
outcomes is not supported. Early interest in birth
blackout n. 1. total loss of consciousness pro-
order appears in the work of British scientist
duced, for example, by sudden lowering of the
Francis Galton (1822–1911) and Sigmund freud,
blood supply to the brain or by decreased oxy-
but it was Alfred adler who first proposed that
gen supply. 2. amnesia produced by alcoholic
birth order is an important factor in personality
intoxication. Also called alcoholic blackout.
development. Current family-structure research
sees birth order not so much as a causal factor blaming the victim a social psychological
but rather as an indirect variable that follows phenomenon in which individuals or groups at-
more process-oriented variables (e.g., parental tempt to cope with the bad things that have hap-
discipline, sibling interaction, and genetic and pened to others by assigning blame to the victim
hormonal makeup) in importance. of the trauma or tragedy. Victim blaming serves
to create psychological distance between the
birth trauma the psychological shock of being blamer and the victim, may rationalize a failure
born, due to the sudden change from the secu- to intervene if the blamer was a bystander, and
rity of the womb to being bombarded with stim- creates a psychological defense for the blamer
uli from the external world. Sigmund freud against feelings of vulnerability.
viewed birth as the child’s first anxiety experi-
ence and the prototype of separation anxiety. To blank hallucination a hallucination in-
Austrian psychoanalyst Otto Rank (1884–1939), volving a sense of floating in space, changes in
who first proposed the idea of birth trauma, it equilibrium or body size, or other hazy sensa-
was the crucial factor in causing neuroses. See tions, occurring mostly in response to stress or
also primal anxiety; primal trauma. when falling asleep. In psychoanalytic theory, a
blank hallucination is thought to repeat an early
BIS abbreviation for behavioral inhibition sys- defensive mechanism by reproducing the sooth-
tem. ing experience of suckling at the breast.
biserial correlation a measure of the associa- blank screen in psychoanalysis, the metaphori-
tion between a continuous variable and a di- cal backdrop onto which the patient projects his
chotomous variable. or her feelings and fantasies during the trans-
bisexual behavior behavior of a person who is ference process. The screen is the psychoana-
77
blended family
lyst, who is described as blank because he or she better eye. In the United States, the criterion for
must remain passive and neutral to enable the legal blindness is visual acuity of 20/200 or
patient to feel free to give voice to his or her in- worse in the better eye with best correction or a
B nermost thoughts. visual field of 20% or less in the widest meridian
blended family see stepfamily. of the better eye. 2. absence of usable vision with
the exception of light perception. See also func-
Blessed Dementia Scale (BDS) a behavioral tional blindness; low vision; visual impair-
rating scale used in the assessment of dementia ment. —blind adj.
severity. It is administered to a caregiver and has
subscales measuring changes in the performance blind review a review of a manuscript or grant
of everyday tasks, changes in daily activities and proposal to evaluate its quality and suitability
habits, and changes in personality and motiva- for publication or funding by a person who does
tion. [developed in 1968 by Gary Blessed, British not know the identity of the author.
psychogeriatrician; Bernard E. Tomlinson, Brit- blindsight n. the capacity of some individuals
ish neuropathologist; and Martin Roth, British with blindness in parts or all of the visual field to
psychiatrist] detect and localize visual stimuli presented
Bleuler’s theory a theory proposing a basic un- within the blind field region. Discrimination of
derlying symptomatology for schizophrenia. It movement, flicker, wavelength, and orientation
defined four fundamental symptoms required may also be present. However, these visual ca-
for a diagnosis of the condition; the more obvi- pacities are not accompanied by awareness: They
ous manifestations of schizophrenia (e.g., delu- have been demonstrated only in experimental
sions, hallucinations) were regarded as accessory conditions, when participants are forced to
symptoms (see secondary symptoms) because guess. Blindsight therefore does not help indi-
they are shared with other disorders. [Eugen viduals to compensate for their loss of vision.
Bleuler (1857–1939), Swiss psychiatrist] blind spot a lack of insight or awareness—often
blind adj. 1. denoting a lack of sight. See blind- persistent—into a specific area of one’s behavior
ness. 2. denoting a lack of awareness. In re- or personality, typically because recognition of
search, a blind procedure may be employed one’s true feelings and motives would be pain-
deliberately to enhance experimental control: A ful. In classical psychoanalysis, it is regarded as a
single blind is a procedure in which participants defense against recognition of repressed im-
are unaware of the experimental conditions pulses or memories that would threaten the pa-
under which they are operating; a double blind tient’s ego. See scotomization.
is a procedure in which both the participants blind walk a trust exercise used in a group
and the experimenters interacting with them are setting (e.g., an encounter group) to help
unaware of the particular experimental condi- members develop mutual trust. Half of the group
tions; and a triple blind is a procedure in which close their eyes; the other half become their part-
the participants, experimenters, and data ana- ners and lead the “blind” people through various
lysts are all unaware of the particular experimen- events and experiences. Roles are then reversed,
tal conditions. and finally all members discuss their reactions to
blind analysis a study or interpretation of data the experience.
or conditions without specific knowledge or pre- BLM (BLMS) abbreviation for buccolingual
vious information about the topic being exam- masticatory syndrome.
ined. For example, a clinical psychologist might bloating n. a feeling of distension in the abdo-
diagnose a patient without having information men, which may be a feature of irritable
concerning any previous psychological diagno- bowel syndrome and is also frequently en-
ses. countered as a symptom of somatization dis-
blind judgment an evaluation made without order. Also called abdominal bloating.
knowledge of information that might influence block 1. n. an abrupt, involuntary interruption
one’s assessment of the situation. Such an ap- in the flow of thought or speech in which the in-
proach is used to eliminate conscious or uncon- dividual is suddenly aware of not being able to
scious bias. Blind judgments are often used in perform a particular mental act, such as finding
clinical experiments, for example, judging pa- the words to express something he or she wishes
tients’ current level of depression in the absence to say. Also called mental block. See re-
of information about which, if any, treatment trieval block; tip-of-the-tongue phenome-
they have received; and in scholarly peer review non. 2. n. in psychotherapy, an obstacle to
of manuscripts, in which the author’s institu- progress that is perceived as a barrier that cannot
tional affiliation is not disclosed to the reviewer. be crossed. 3. n. any physical, biochemical, or
blindness n. 1. profound, near-total, or total im- psychological barrier or obstacle that obstructs
pairment of the ability to perceive visual stimuli. or impedes a process, function, or activity. 4. n.
According to the World Health Organization’s in an experimental block design, any of the rela-
international classification (1977), blindness is tively homogeneous subsets or levels into which
defined as visual acuity worse than 20/400 in the the entire sample of participants is subdivided.
better eye with best correction or a visual field 5. vb. to subdivide the participants into such
less than 10% in the widest meridian in the subsets.
78
body disfigurement
blocking n. a process in which one’s flow of blunted affect a disturbance in which emo-
thought or speech is suddenly interrupted (see tional responses to situations and events are
block). Also called thought deprivation; dulled.
thought obstruction. blushing n. an involuntary reddening of the B
Blocq’s disease see astasia–abasia. [Paul O. face, sometimes associated with feelings of em-
Blocq (1860–1896), French physician] barrassment, self-consciousness, modesty, or
blood–brain barrier a semipermeable barrier shame.
formed by cells lining the blood capillaries that BMI abbreviation for body mass index.
supply the brain and other parts of the central B-motivation n. see metamotivation.
nervous system. It prevents large molecules, in-
cluding many drugs, passing from the blood to BNSQ abbreviation for basic nordic sleep ques-
the fluid surrounding brain cells and to the tionnaire.
cerebrospinal fluid, and thus protects the brain board certified denoting a physician or other
from potentially harmful substances. Ions and health care professional who has passed an ex-
small molecules, such as water, oxygen, carbon amination set by a specialty board and has been
dioxide, and alcohol, can cross relatively freely. certified as a specialist in that area. A board-
Entry is also possible for lipid-soluble com- certified (or boarded) individual is known as a
pounds, such as anesthetics, which diffuse diplomate.
through plasma membranes. Several anatomical boarding home see adult home; group
features contribute to the barrier. Cells lining the home; halfway house.
capillary walls are joined together by tight junc-
boarding-out system a system in which pa-
tions, which block the passage of molecules
tients with psychoses are cared for in private
through the intercellular spaces found in capil-
homes.
laries elsewhere. Also, the brain capillaries lack
pores, called fenestrations, which normally pro- body awareness the perception of one’s physi-
mote the passage of fluid and solutes. Further- cal self or body at any particular time.
more, the brain capillaries are tightly enveloped body boundaries a component of the body
in a sheath formed by star-shaped glial cells, image consisting of the definiteness or indefi-
called astrocytes. The barrier formed by these niteness of the boundary of the body. Barrier re-
features helps maintain a constant environment sponses in rorschach inkblot tests, such as
in which the brain can function, but it also “turtle with shell” and “man in armor,” indicate
means that many potentially useful drugs can- a definite body boundary, while penetration
not enter the brain from the bloodstream. See responses, such as “person bleeding” and “torn
also area postrema. coat,” indicate indefinite boundaries.
blood phobia a persistent and irrational fear of body buffer zone the physical distance a per-
blood, specifically of seeing blood. An individual son prefers to maintain between him- or herself
confronting blood experiences a subjective feel- and one or more other individuals to avoid feel-
ing of disgust and fears the consequences of the ing uncomfortable. This zone varies depending
situation, such as fainting. In certain diagnostic on the relationship with the others; it is smaller,
classifications, such as DSM–IV–TR, the broader for example, when there is a close relationship. It
term blood-injection-injury phobia is used in- also varies according to culture.
stead. Blood phobia rarely is called hemato- body-build index an index of constitutional
phobia or hemophobia. types. Individuals are grouped according to
blood poisoning a severe or significant bacte- the formula: (height × 100)/(transverse chest di-
rial infection of the bloodstream, usually by mi- ameter × 6). Mesomorphs, who are muscular, fall
croorganisms invading from an infection site within one standard deviation of the mean;
elsewhere in the body. Blood poisoning may be leptomorphs one standard deviation or more
characterized by fever, chills, and skin eruptions. above the mean; and broadly built eurymorphs
A particularly hazardous complication is spread one standard deviation or more below the mean.
of the infection to tissues of the nervous system. [proposed by Hans Jürgen eysenck]
Also called bacteremia; septicemia. See also
body cognitions beliefs or attitudes about the
sepsis.
features of one’s appearance. Characteristically
B-love n. see being love. negative and self-defeating thoughts are related
blow 1. n. slang for cocaine. 2. vb. to inhale co- to subjective dissatisfaction.
caine or to smoke marijuana. See also cocaine body concept the thoughts, feelings, and per-
intoxication; cannabis intoxication. ceptions that constitute the way an individual
blow job slang for oral stimulation of the penis views his or her body: that is, the conceptual
by a partner, which may occur as a part of fore- image of one’s body. Compare body percept.
play or may be continued to the point of or- See body image.
gasm. body disfigurement an objective defect of ap-
blues pl. n. a colloquial name for depressive pearance related to a congenital malformation,
symptoms, especially sadness or anhedonia. physical injury, or any disease process that mod-
See also baby blues. ifies the physical integrity of the individual.
79
body distortion
body distortion a tendency to overestimate ing) to obscure and hide aspects of the body with
one’s body size or to have bizarre perceptual ex- which one is dissatisfied.
periences. See also body-size overestimation; body-image distortion distortion in the sub-
B body-image distortion. jective image or mental representation of one’s
body dysmorphia an extreme disparagement own body appearance, size, or movement. The
of some aspect of appearance that is not sup- term is usually applied to overestimation of body
ported by the objective evidence. There may be a size or used to define the perceptual experiences
mild defect in the body feature or, in extreme of individuals with psychoses. Also called body-
cases, there may be no objective evidence of any image disturbance. See also anorexia ner-
malformation or oddity of appearance. See also vosa; body distortion. Compare body dys-
body dysmorphic disorder; muscle dysmor- morphic disorder.
phia. body-image ideals personal standards of opti-
body dysmorphic disorder (BDD) in DSM– mal appearance for various body features: ideal-
IV–TR, a somatoform disorder characterized ized features as opposed to actual attributes of
by excessive preoccupation with an imagined appearance.
defect in physical appearance or markedly ex- body language the expression of feelings and
cessive concern with a slight physical anomaly, thoughts, which may or may not be verbalized,
formerly called dysmorphophobia. The preoccu- through posture, gesture, facial expression, or
pation is typically accompanied by frequent other movements. For example, anger is usually
checking of the defect. BDD shares features of indicated by a facial expression in which there
obsessive-compulsive disorder, such as ob- are downward lines in the forehead, cheeks, and
sessions with appearance and associated com- mouth, and the fist may be clenched. Although
pulsions (e.g., mirror-checking), and causes body language is often called nonverbal com-
significant distress or impairment in social, oc- munication, such movements may be uninten-
cupational, or other important areas of function- tional, and many investigators therefore believe
ing. the term “communication” is often inappropri-
body ego in psychoanalytic theory, the part of ate in this context.
the ego that develops out of self-perceptions of body mass index (BMI) a widely used measure
the body. It is the core of the ego around which of adiposity or obesity based on the following
all perceptions of the self are grouped, including formula: weight (kg) divided by height squared
2
individual memories, sensations, ideas, wishes, (m ).
strivings, and fantasies. body memory a sensory recollection of trauma
body esteem the degree of positiveness with in the form of pain, arousal, tension, or discom-
which individuals regard the various parts of fort, usually unaccompanied by words or im-
their body and the appearance of those parts. ages. Body memory is frequently the result of
trauma occurring during the period of child-
body ideal the body type considered most at- hood amnesia, leading to a sensorimotor,
tractive or most appropriate to one’s age and sex
rather than cognitive, encoding of the traumatic
by a particular individual, culture, or generation.
event. See also sensorimotor memory.
See body image.
body–mind problem see mind–body prob-
body image the mental picture one forms of lem.
one’s body as a whole, including both its physi-
cal and functional characteristics (body per- body narcissism 1. an exaggerated preoccupa-
cept) and one’s attitudes toward these charac- tion or fascination with one’s own body and its
teristics (body concept). Also called body erogenous zones. See also narcissism. 2. in psy-
identity. See also body schema. choanalytic theory, the primary narcissism of
the young infant.
Body Image Assessment (BIA) a measure of
body percept the mental image one forms of
body image in which a participant is shown sil-
the physical characteristics of one’s own body,
houettes of figures that increase incrementally
that is, whether one is slim or stocky, strong or
in size from very thin to very overweight and is
weak, attractive or unattractive, tall or short.
asked to choose the one that represents his or
Compare body concept. See body image.
her actual figure and the one that represents his
or her ideal figure. In addition to the BIA for body rocking see rocking.
adults, there are three other forms of the instru- body schema the cognitive organization of
ment: BIA-O for obese adults, BIA-C for younger one’s appearance, including internal image,
children, and BIA-P for preadolescents. [origi- thoughts, and feelings. See body percept.
nally developed in 1985 by U.S. psychologist body-size overestimation the specific ten-
Donald A. Williamson (1950– ) and colleagues] dency to overestimate the size of body features
body-image avoidance behavioral manifesta- (e.g., width of waist, hips, or thighs) in relation
tions of excessive concern with one’s appear- to objective size measurements. It was once
ance, evidenced by such behaviors as avoiding thought to be an essential feature of anorexia
social functions and engaging in cover-up activi- nervosa. See body distortion; body-image
ties (e.g., wearing bulky and loose-fitting cloth- distortion.
80
borderline state
body therapies a group of physical therapies notes a method for estimating the variability of a
that seek the relief of psychological tensions and parameter associated with a batch of data, such
other symptoms through body manipulation, as the standard error. A number of samples of
relaxation, massage, breathing exercises, and equal size are obtained from the original data by B
changes in posture and position of body parts. sampling with replacement, the parameter is cal-
The therapies are based on the theory that the culated for each, and the individual parameters
body and its functioning embody an individ- are combined to provide an estimate of the over-
ual’s basic personality and way of life. See also all parameter for the entire sample. —boot-
bodywork. strap vb.
body type a classification of individuals accord- borderline 1. adj. pertaining to any phenome-
ing to body build or physique. Some have theo- non difficult to categorize because it straddles
rized an association between aspects of physique two distinct classes, showing characteristics of
and psychological traits, proposing a variety of both. Thus, borderline intelligence is sup-
constitutional types and somatotypes. posed to show characteristics of both the average
bodywork n. an adjunctive treatment (see ad- and subaverage categories. See also borderline
junctive therapy) that may be recommended disorder; borderline state. 2. n. an inappro-
in addition to psychotherapy. It typically in- priate designation for someone with border-
cludes massage, movement, and exercises in- line personality disorder or its symptoms.
volving touch. borderline disorder 1. borderline person-
ality disorder or, more broadly, any personal-
bond 1. n. a relationship between two or more
ity disorder. 2. historically, any psychological
individuals that signifies trust and alliance. In a
condition that lies between normality and
social context, the existence of such an attach-
neurosis, between normality and psychosis, or
ment enables individuals to provide emotional
between normal intelligence and mental retar-
support for each other (see also pair bond). In
dation. See also borderline intelligence.
psychotherapy, the bond of a therapeutic alli-
ance between therapist and client is considered borderline intelligence a level of measured
beneficial to the treatment. 2. n. a chemical intellectual performance between average and
bond, such as an ionic or covalent bond, by significantly subaverage intelligence. Some re-
which atoms are bound into a molecule. 3. vb. to searchers define it as an IQ between 68 and 83,
form a bond of either of these types. others as any IQ in the 70s, but it is most often
associated with IQs in the range 70–75. IQs in
bondage n. physical restraint of one person by
the borderline range, especially above 75, do not
another to arouse sexual pleasure in one or both
justify a basis for diagnosis of mental retarda-
partners.
tion. Also called borderline intellectual
bondage and discipline (B and D) a phase of functioning; borderline mental retarda-
sexual bondage that is accompanied by such tion.
acts as whipping or spanking. Because of the po-
borderline personality disorder in DSM–
tential physical danger, the partners usually
IV–TR, a personality disorder characterized by a
agree on a signal, called a safe word, to be used
long-standing pattern of instability in mood, in-
when the erotic activity exceeds the pleasurable
terpersonal relationships, and self-image that is
limits.
severe enough to cause extreme distress or inter-
bonding n. the process in which attachments fere with social and occupational functioning.
or other close relationships are formed between Among the manifestations of this disorder are (a)
individuals, especially between mother and in- self-damaging behavior in such areas as gam-
fant. An early, positive relationship between a bling, sex, spending, overeating, and substance
mother and a newborn child is considered to be use; (b) intense but unstable relationships; (c)
essential in establishing unconditional love on uncontrollable temper outbursts; (d) uncertainty
the part of the parent, as well as security and about self-image, gender, goals, and loyalties; (e)
trust on the part of the child. In subsequent de- shifting moods; (f) self-defeating behavior, such
velopment, bonding establishes friendship and as fights, suicidal gestures, or self-mutilation;
trust (see bond). and (g) chronic feelings of emptiness and bore-
bone pointing see voodoo death. dom. An alternative name for this disorder, un-
stable personality disorder, was proposed in the
booster sessions in therapy, particularly cog- DSM–III task force.
nitive behavior therapy, occasional periodic
sessions, after the main sessions are officially borderline psychosis see borderline state.
ended, in order to reinforce progress or trouble- borderline schizophrenia historically, a
shoot obstacles to continuance of positive condition in which an individual inconsistently
changes made during the therapy. displays symptoms of schizophrenia (e.g., only
bootstrapping n. any process or operation in under circumstances of high stress) but is in
which a system uses its initial resources to de- touch with reality most of the time. In DSM–II,
velop more powerful and complex processing this condition was included within the diagnos-
routines, which are then used in the same fash- tic category of latent schizophrenia.
ion, and so on cumulatively. In statistics, it de- borderline state any condition in which an in-
81
boredom
dividual’s presenting symptoms are difficult to by both the therapist and client is an important
classify. Historically, borderline state (or border- concept in the therapeutic relationship.
line psychosis) more specifically referred to a con- boundary ambiguity uncertainty that arises
B dition in which an individual may become psy- in a family system when an individual’s status,
chotic if exposed to unfavorable circumstances role, or family membership is brought into ques-
but has not currently lost touch with reality. tion, most often as a result of separation, di-
boredom n. a state of weariness or ennui result- vorce, and remarriage. See permeable family.
ing from a lack of engagement with stimuli in boundary issues 1. ethical issues relating to
the environment. —bored adj. the proper limits of a professional relationship
Börjeson–Forssman–Lehmann syndrome between a provider of services (e.g., a physician
a disorder characterized by microcephaly, se- or a psychotherapist) and his or her patient or
vere mental retardation, short stature, and client, such that the trust and vulnerability of
hypogonadism. Affected individuals have severe the latter are not abused (see boundary). A par-
to profound mental retardation and little or no ticular area of concern is professional–client
pubic hair, even as adults. The syndrome is re- sexual relations. 2. in health care, issues relat-
lated to an X-linked recessive mutant gene (locus ing to the demarcations between different areas
Xq26–27). [Mats Gunnar Börjeson (1922– ), and levels of expertise and questions of who is
Hans Axel Forssman (1912–1994), and J. O. Orla best qualified to give certain types of treatment
Lehmann (1927– ), Swedish physicians] or advice.
Boston Naming Test (BNT) a 60-item fluency boundary system in general systems the-
test of word retrieval used to evaluate dysphasia ory, the semipermeable boundaries between liv-
(see aphasia). Line drawings of objects—ranging ing systems, permitting information to flow in
in difficulty from the commonly encountered either direction but posing the question of how
(e.g., tree, bed) to the rarely encountered (e.g., much interpenetration and interdependence is
sphinx, abacus)—are presented, and the parti- feasible in a given social system. See also ego
cipant provides the name of each object. [ori- boundary.
ginally developed in 1978 by U.S. neuropsy-
bounded rationality decision making in
chologist Edith F. Kaplan (1924–2009), U.S. clin-
which the processes used are rational within the
ical psychologist Harold Goodglass (1920–2002),
constraints imposed by (a) limitations in the in-
and U.S. neuropsychologist Sandra Weintraub
dividual’s knowledge; (b) human cognitive limi-
(1946– )]
tations generally; and (c) empirical factors
BOT abbreviation for bruininks–oseretsky test arising from the complex, real-life situations in
of motor proficiency. which decisions have to be made. The concept
bottoming out a state of despair characterized was introduced by U. S. economist and psychol-
by financial ruin, suicide attempts, or shattered ogist Herbert Simon (1916–2001) as a corrective
family and other intimate interpersonal rela- to the assumption of classical economic theory
tionships that is frequently experienced by peo- that individuals can and will make ideally in-
ple with severe depression or addiction disorders formed and rational decisions in pursuit of their
(e.g., substance abusers and pathological gam- own self-interest.
blers). bound energy in psychoanalytic theory, psy-
bottom-up analysis an inductive approach to chic energy that is located within the ego and
problem solving that begins with specific in- focused on the individual’s external reality.
stances or empirical data and works up to a more Bound energy is associated with the secondary
abstract level of analysis, such as a general prin- processes and is contrasted with the free en-
ciple or hypothesis. See inductive reasoning. ergy of the id.
Compare top-down analysis. bowel disorder any disorder of the small or
bouffée délirante see acute delusional psy- large intestine, which frequently occurs as a re-
chosis. sponse to stress and anxiety, (e.g., chronic con-
Boulder model see scientist-practitioner stipation, irritable bowel syndrome).
model. bowel incontinence see fecal inconti-
boulimia n. see bulimia. nence.
boundary n. 1. a psychological demarcation Bowen family systems theory see family
that protects the integrity of an individual or systems theory.
group or that helps the person or group set realis- Bowlby, Edward John Mostyn (1907–1990)
tic limits on participation in a relationship or ac- British psychiatrist. Bowlby received his MD in
tivity. 2. in psychotherapy, an important limit 1933 from University College in London and
that is usually set by the therapist as part of the trained as a psychoanalyst. Influenced by the
ground rules in treatment. Boundaries may studies of imprinting in animals that Austrian
involve areas of discussion (e.g., the therapist’s ethologist Konrad Lorenz (1903–1989) con-
personal life is off limits) or physical limits (e.g., ducted, Bowlby integrated psychoanalytic ideas
rules about touching), which are guided by ethi- with evolutionary biology and cognitive psy-
cal codes and standards. Respect for boundaries chology to create his attachment theory. He
82
brain growth
argued that the attachment of human infants to forebrain, and the midbrain and hindbrain
their caregivers and their distress at being sepa- structures are often considered together as the
rated from them have an evolutionary advan- brainstem. Also called encephalon. See also
tage: They increase the infants’ likelihood of brain localization theory; evolution of B
survival by keeping them close to their care- the brain; split brain.
givers. Patterns of attachment (secure and inse- brain biorhythm a biological rhythm in-
cure) established in early childhood affect later volving recurring periods of altered excitability
emotional development and emotional stability or activity of the brain. Some practitioners claim
in the child and adult. Bowlby’s work has been to be able to predict an individual’s brain bio-
very influential in developmental psychology rhythms from his or her birthdate, and to use
since the 1970s, initiating a rich body of research this information to improve performance.
on the importance of early attachment patterns
brain concussion mild injury to the brain, due
to psychological well-being.
to trauma or jarring, that disrupts brain function
boxer’s dementia a chronic, slowly progres- but is typically followed by spontaneous recov-
sive dementia resulting from scattered hemor- ery. Concussion usually involves at least brief
rhages in the brain produced by repeated blows unconsciousness, although it may be diagnosed
to the head. Affected individuals are often de- in the absence of unconsciousness. The symp-
scribed as “punch-drunk.” Common symptoms toms may include memory loss, headache, irrita-
include poorly articulated speech (see dys- bility, inappropriate emotional reactions, and
arthria), poor balance, impaired memory and changes in behavior. Concussions may be classi-
concentration, and involuntary movements. fied by severity based on the period of uncon-
The term is often applied to the more advanced sciousness or the extent of memory loss for
cases, while boxer’s traumatic encephalopathy events before and after the trauma. See head in-
refers to all types of cases. Also called dementia jury.
pugilistica.
brain damage injury to the brain. It can have
BPRS abbreviation for brief psychiatric rat- various causes, including prenatal infection,
ing scale. birth injury, head injury, toxic agents, brain
BPS abbreviation for british psychological so- tumor, brain inflammation, severe seizures, cer-
ciety. tain metabolic disorders, vitamin deficiency,
BRAC abbreviation for basic rest–activity intracranial hemorrhage, stroke, and surgical
cycle. procedures. Brain damage is manifested by im-
Brachmann–de Lange syndrome see am- pairment of cognitive, motor, or sensory skills
sterdam dwarf disease; de lange’s syndrome. mediated by the brain.
[described in 1916 by Winfried Brachmann brain death the cessation of neurological signs
(1888–c. 1915), German physician, and in 1933 of life. Medical criteria for brain death include
by Cornelia de Lange (1871–1950), Dutch pedia- absence of reflex response or response to nox-
trician] ious stimuli, fixed pupils, and absence of electro-
bradyarthria n. see bradylalia. encephalogram (EEG) activity. The absence of
EEG activity alone is not a final diagnostic sign,
bradycardia n. see arrhythmia. but brain death cannot be diagnosed if there is
bradykinesia n. abnormal slowness in the exe- any sign of EEG activity.
cution of voluntary movements. Also called brain disorder 1. any condition marked by dis-
bradykinesis. Compare hypokinesis. —brady- ruption of the normal functioning of the brain.
kinetic adj. 2. an older (DSM–I) term for an acute or chronic
bradylalia n. abnormal slowness or hesitation mental disorder caused by or associated with im-
in speech. Also called bradyarthria; brady- pairment of brain function and characterized by
logia. mild to severe impairment of cognition and
bradylogia n. see bradylalia. mood. Also called brain syndrome.
bradyrhythmia n. slowness of the rhythms of brain fag a culture-bound syndrome origi-
the heart. nating in west Africa and most often experi-
braid cutting a hair fetish in which a person’s enced by high school or college students.
hair is cut as part of sexual activity. Symptoms typically include difficulties with
concentration, memory, and understanding in-
brain n. the enlarged, anterior part of the cen-
formation; feelings of pain, tightness, and burn-
tral nervous system within the skull. The
ing around the head and neck; blurred vision;
young adult human brain weighs about 1,450 g,
and tiredness associated with excessive thinking.
and its outer layer (the cerebral cortex) con-
tains over 10 billion nerve cells. The brain devel- brain graft the surgical transplantation or im-
ops by differentiation of the embryonic neural plantation of brain tissue to replace a damaged
tube along an anterior–posterior axis to form part or compensate for a defect.
three main regions—the forebrain, midbrain, brain growth the increase in size, mass, and
and hindbrain—that can be further subdivided complexity of the brain. In humans, the brain
on the basis of anatomical and functional crite- grows very rapidly in the fetus and during the
ria. The cortical tissue is concentrated in the early postnatal years, reaching its maximum
83
brain imaging
mass at about 20 years, after which there is a explain the observation that many individuals
slow decline. Some regions of the brain grow with Alzheimer’s disease who had extensive se-
more rapidly than others, well into the teenage nile plaques and neurofibrillary tangles in
B years. their brains nonetheless showed few decrements
brain imaging study of the anatomy or activity in their intellectual abilities. This same discrep-
of the brain through the intact skull by non- ancy has since been observed in different types
invasive computerized techniques, such as mag- of dementia, Parkinson’s disease, and other dis-
netic resonance imaging, computed tomog- orders. Indeed, the lack of a direct relationship
raphy, and positron emission tomography. between the degree of brain pathology and the
See also nuclear imaging. clinical manifestation of that damage makes it
difficult to diagnose these conditions in their
brain lesion any damage to an area of brain tis- early stages during which degenerative alter-
sue caused by injury, disease, surgery, tumor, ations of cerebral anatomy have begun accumu-
stroke, or infection. Also called cerebral le- lating and intervention would be most effective.
sion. Various operational definitions of brain reserve
brain localization theory any of various the- capacity are used in studies, including overall
ories that different areas of the brain serve differ- brain volume, component structure volumes,
ent functions. Since the early 19th century, head circumference, cerebral glucose metabo-
opinion has varied between notions of highly lism, cortical thickness, the number of brain
precise localization and a belief that the brain, or neurons, the density of their interconnections,
large portions of it, function as a whole. In 1861 regional cerebral blood flow, neural transmis-
French physician Paul Broca (1824–1880) de- sion speed, and various parameters of the sen-
duced from localized brain lesions that the sory evoked potential. The term brain reserve
speech center of the brain is in the left frontal at times is used interchangeably with cognitive
lobe (see broca’s area). Since then, many tech- reserve, despite the differing theoretical em-
niques, including localized electrical stimulation phases of the two concepts. Also called neural
of the brain, electrical recording from the brain, reserve. See also functional plasticity.
and brain imaging, have added information brain scan any of a variety of techniques de-
about localization of function in the brain. For signed either to reveal structural or functional
many investigators, however, the concept of ex- abnormalities of the diseased brain or to measure
treme parcellation of functions has given way to activity of the healthy brain. See brain imaging.
concepts of distributed control by collective ac-
tivity of different regions. See also mass action. brain splitting surgical separation of the cere-
bral hemispheres of the brain. See commissur-
brain mapping the creation of a visual repre- otomy; split brain.
sentation of the brain in which different func-
tions are assigned to different brain regions. brainstem n. the part of the brain that connects
Mapping may be based on a variety of sources of the cerebrum with the spinal cord. It includes
information, including effects of localized brain the midbrain, pons, and medulla oblongata
lesions, recording electrical activity of the brain, and is involved in the autonomic control of vis-
and brain imaging during various behavioral ceral activity, such as salivation, respiration,
states. See also brain localization theory. heartbeat, and digestion.
brain plasticity 1. the capacity of the brain to brainstorming n. a problem-solving strategy in
compensate for losses in brain tissue caused by which ideas are generated spontaneously and
injury or disease. 2. the capacity of the brain to uninhibitedly, usually in a group setting, with-
change as a function of experience. The term out any immediate critical judgment about their
plasticity in this sense was first used by William potential value. See also creative thinking; di-
james in 1890. vergent thinking. —brainstorm vb.
brain reserve an ability of the adult brain to tol- brain trauma physical injury to the brain. It
erate pathological changes without overt signs can be produced by, for example, a blow to the
of disturbance that stems from the capacity of re- head, a gunshot wound, or a cerebrovascular ac-
maining neurons in the central nervous system cident. See brain concussion; head injury.
to compensate for damaged or destroyed tis- brain tumor any abnormal tissue growth (see
sue. In other words, a person with a high brain neoplasm) within the confines of the skull.
reserve can sustain a greater amount of brain in- Damage may occur by the destruction of healthy
jury or deterioration before manifesting symp- tissue or through increased intracranial pres-
toms than a person with low brain reserve can. sure as there is little room for the tumor to grow
Implicit to this concept is the notion of a critical within the skull without compressing healthy
threshold level of functioning neurons below tissue and interfering with the flow of blood and
which normal activities can no longer be main- nutrients into the brain. Brain tumors can occur
tained and symptoms of disorder appear. The va- at any age, producing initial symptoms of head-
lidity of this hypothesis has been difficult to ache, nausea, or sudden vomiting without ap-
establish empirically, but the concept nonethe- parent cause. As the tumor progresses, the
less has been influential within neurology and patient may experience disturbances of vision,
cognitive science since it was first proposed to hearing, and smell, loss of coordination, changes
84
brief psychodynamic psychotherapy
in mental status, weakness, and paralysis. Sei- disruption due to breathing difficulties during
zures sometimes are caused by a tumor. sleep, for example, sleep apnea. See dyssomnia.
brainwashing n. a broad class of intense and breathing retraining a technique used in be-
often coercive tactics intended to produce pro- havior therapy and cognitive behavior B
found changes in attitudes, beliefs, and emo- therapy, particularly in the treatment of hyper-
tions. Targets of such tactics have typically been ventilation in anxiety and panic disorders. The
prisoners of war and members of religious cults. technique teaches clients slow diaphragmatic
See also psychological kidnapping. breathing through various methods, including
brain waves spontaneous, rhythmic electrical therapist modeling and corrective feedback. See
impulses emanating from different areas of the also progressive relaxation; stress manage-
brain. Electroencephalographic brain-wave re- ment.
cordings are used to study sleep stages and cog- breathwork n. see rebirthing.
nitive processes. According to their frequencies, bridge to reality see remotivation.
brain waves are classified as alpha waves (8–12 bridging n. a method used in multimodal
Hz), beta waves (13–30 Hz), delta waves (1–3 therapy in which the therapist first focuses on
Hz), gamma waves (31–80 Hz), or theta waves the client’s preferred aspect of treatment (e.g.,
(4–7 Hz). The first substantial account of brain cognitions) before moving to another aspect
waves was given in 1929 by German neuro- (e.g., sensations) that the therapist believes may
psychiatrist Hans Berger (1873–1944). be more effective.
brain-wave therapy an alternative or adjunc- brief group therapy group psychotherapy
tive therapy in which alpha waves and theta conducted on a short-term (time- or session-
waves are stimulated because they are posited to limited) or crisis-intervention basis and fo-
have a vital role in learning and memory and, cused clearly upon a specific treatment goal. See
hence, in therapeutic insight. time-limited psychotherapy.
brain weight the weight of a brain, which is brief intensive group cognitive behavior
about 1,450 g for a young adult human. Brain therapy a form of cognitive behavior ther-
weights for elephants and whales may exceed apy conducted in a group setting over a rela-
7,000 g and 9,000 g, respectively. Human brain tively brief period of time but in lengthy sessions
sizes usually increase until around the age of 20, (e.g., all day) and often on consecutive days (e.g.,
then gradually diminish. Brain weight correlates weekends). The therapy is typically used to treat
significantly (r = .4) with intelligence. See also anxiety disorders, particularly panic disorder.
brain growth.
Brief Psychiatric Rating Scale (BPRS) a
bravery n. see courage. system of evaluating the presence and severity of
Brazelton Neonatal Behavioral Assess- clinical psychiatric signs on the basis of 24 fac-
ment Scale an instrument used in both re- tors, such as bizarre behavior, hostility, emo-
search and clinical settings to assess the tional withdrawal, and disorientation. Each
neurological and behavioral status of newborns factor is rated on a 7-point scale ranging from
and infants up to 2 months old, as indicated by “not present” to “extremely severe,” based on
their responses to various stimuli (a light di- the judgments of trained observers. [introduced
rected to the eye, a moving ball, a rattle, etc.). in its original version in 1962 by U.S. psychiatrist
The Brazelton scale currently contains 14 neuro- John E. Overall and U.S. clinical psychologist
logically and 26 behaviorally oriented items; the Donald R. Gorman]
former are graded on a 4-point scale of intensity brief psychodynamic psychotherapy a
of response, and the latter on a 9-point scale. collection of time-limited psychodynamic psy-
Originally developed in 1973, the Brazelton chotherapy approaches intended to enhance
Neonatal Behavioral Assessment Scale was re- client self-awareness and understanding of the
vised in 2000. Also called Neonatal Behav- influence of the past on present behavior. One
ioral Assessment Scale (NBAS). [Thomas particularly important issue is identified as the
Berry Brazelton (1918– ), U.S. pediatrician] central focus for the treatment, thus creating a
breakdown n. see nervous breakdown. structure and establishing a goal for the sessions.
breakthrough n. 1. a significant, sometimes Rather than allowing the client to associate
sudden, forward step in therapy, especially after an freely and discuss unconnected issues, as occurs
unproductive plateau. 2. a major or significant in more traditional psychoanalytic practice, the
advance in knowledge, research, or treatment. brief psychodynamic therapist is expected to be
fairly active in keeping the session focused on
breast envy in the psychoanalytic theory of the main issue. The number of sessions varies
Melanie klein, the idea that infants envy the from one approach to another, but brief psy-
nourishing capacity and creative power of the chodynamic therapy is typically considered to
mother’s breast. Such envy may later be trans- be no more than 20–25 sessions. Also called
formed into penis envy. short-term psychodynamic psychother-
breathing-related sleep disorder in DSM– apy. [originally developed by Hungarian psy-
IV–TR, a primary sleep disorder marked by ex- choanalyst Franz Alexander (1891–1964) and his
cessive sleepiness or insomnia arising from sleep colleague Thomas French]
85
brief psychotherapy
brief psychotherapy any form of psychother- hemisphere that is associated with the
apy intended to achieve change during a short production of speech. It is located on the left
period (generally 10–20 sessions). Brief psycho- hemisphere of right-handed people and of most
B therapies rely on active techniques of inquiry, left-handed individuals. [discovered in the 1860s
focus, and goal setting and tend to be symptom and studied and researched by Pierre Paul Broca]
specific. They may be applied on an individual Brodmann’s area an area of cerebral cortex
or group level and are used in the treatment of a characterized by variation in the occurrence and
variety of behavioral and emotional problems. arrangement of cells from that of neighboring
There are numerous different types, such as brief areas. These areas are identified by numbers and
cognitive behavior therapy, brief play ther- in many cases have been associated with specific
apy, brief psychodynamic psychotherapy, brain functions, such as area 17 (striate cortex or
focal psychotherapy, and interpersonal primary visual cortex), areas 18 and 19 (pre-
psychotherapy. Also called short-term psy- striate cortex), area 4 (motor area), and area 6
chotherapy. (premotor area). Brodmann’s original map of
brief psychotic disorder in DSM–IV–TR, a 1909 identified 47 different cortical areas, but in-
disturbance involving the sudden onset of at vestigators have refined the mapping to identify
least one psychotic symptom (e.g., incoherence more than 200 distinctive cortical areas. Also
or loosening of associations, delusions, halluci- called Brodmann’s cytoarchitectonic area.
nations, or grossly disorganized or catatonic be- [Korbinian Brodmann (1868–1918), German
havior). The condition is often accompanied by neurologist]
emotional turmoil and lasts from 1 day to 1 brofaromine n. an antidepressant drug that is a
month, with complete remission of all symp- reversible monoamine oxidase inhibitor
toms and a full return to previous levels of func- (RIMA) and relatively selective for monoamine
tioning. It may develop following a period of oxidase A. It therefore lacks many of the food
extreme stress, such as the loss of a loved one; in interactions that limit the use of irreversible
DSM–III, brief psychotic disorder involving a pre- nonselective MAO inhibitors. Brofaromine is
cipitating stressor was termed brief reactive psy- not currently available in the United States. Eu-
chosis. ropean trade name: Consonar.
brief stimulus therapy (BST) electro- bromazepam n. a benzodiazepine used for the
convulsive therapy (ECT) in which the elec- treatment of anxiety. It has a short to intermedi-
tric current is modified significantly to decrease ate duration of action (serum half-life up to 30
the duration of stimulus needed to produce a sei- hours) and a slow onset of action due to its low
zure. Some researchers and clinicians claim that lipid solubility (see blood–brain barrier).
this technique not only achieves satisfactory Bromazepam is not currently available in the
clinical results comparable to those of standard United States. Canadian trade name: Lectopam.
ECT but also diminishes the duration of confu-
sion or memory impairment. Also called brief
bromide n. a class of drugs formerly used as
anticonvulsants and as sedatives in the treat-
stimuli therapy; brief stimulus tech-
ment of anxiety. Because of their toxicity and
nique.
the frequency of adverse side effects, bromides
bright light therapy see phototherapy. were largely supplanted by phenobarbital in the
Briquet’s syndrome a former name for early 20th century. Bromide intoxication was a
somatization disorder. [Paul Briquet (1796– recognized complication, manifested in early
1881), French physician, who provided the first stages by cognitive impairment and emotional
systematic description of its characteristics in disturbances and in later stages by psychosis,
1859] coma, and death.
British Psychological Society (BPS) a pro- bromocriptine n. a dopamine-receptor ago-
fessional organization, founded in 1901, that is nist used to relieve the symptoms of parkin-
the representative body for psychologists and son’s disease and, due to its ability to inhibit
psychology in the United Kingdom. By royal release of the pituitary hormone prolactin, to
charter, it is charged with national responsibility treat galactorrhea. It is also used to treat
for the development, promotion, and applica- amenorrhea, infertility, prolactin-secreting aden-
tion of psychology for the public good. omas, and parkinsonism, including drug-induced
Broca’s aphasia one of eight classically identi- extrapyramidal symptoms of conventional
fied aphasias, characterized by nonfluent con- (typical or first-generation) antipsychotic agents.
versational speech and slow, halting speech U.S. trade name: Parlodel.
production. Auditory comprehension is rela- bronchodilator medications drugs admin-
tively good for everyday conversation, but there istered to widen the airways in the treatment of
is considerable difficulty with complex syntax or asthma, bronchitis, and related respiratory disor-
multistep commands. It is associated with injury ders. They include methylxanthines and
to broca’s area of the brain. [Pierre Paul Broca sympathomimetic drugs.
(1824–1880), French physician] brooding compulsion an irresistible drive to
Broca’s area a region of the posterior portion of mentally review trivial details or ponder abstract
the inferior frontal convolution of a cerebral concepts as a means of reducing distress or pre-
86
bufotenin
venting some dreaded event or situation. This is Bruininks–Oseretsky Test of Motor Pro-
a common symptom of obsessive-compulsive ficiency (BOT) a set of standardized tests to as-
disorder. sess fine motor and gross motor skills in
brotherliness n. the feeling of human unity or children aged 4 to 21 years. Its 53 items are B
solidarity, as expressed in productive involve- grouped into eight subtests: fine motor pre-
ment with others, care for their well-being, and cision, fine motor integration, manual dexter-
concern for society as a whole. According to Erich ity, bilateral coordination, balance, running
fromm, brotherliness represents the positive or speed and agility, upper-limb coordination,
ideal resolution of the search for rootedness. and strength. The BOT, originally published in
1978 as a revision of the 1923 Oseretsky Tests
Brown, Roger (1925–1997) U.S. psychologist. of Motor Proficiency, is now in its second edi-
Brown earned his doctorate at the University of tion (published in 2005). [Robert H. Bruininks
Michigan in 1952 with a study of the social psy- (1942– ), U.S. psychologist; N. I. Oseretsky,
chology of the authoritarian personality. 20th-century Russian psychologist]
He then joined the faculty of Harvard Univer-
brujeria n. see rootwork.
sity, where he remained throughout his career
except for a relatively brief interlude (1957–1962) Brushfield–Wyatt syndrome a form of
at the Massachusetts Institute of Technology. mental retardation associated with several other
His most important contributions to psychol- anomalies, including an extensive port-wine
ogy were in the fields of social psychology and birthmark, paralysis on the side opposite to the
psycholinguistics. At Harvard, Brown became causal lesion, and cerebral tumor. [Thomas
involved with the research group of U.S. devel- Brushfield (1858–1937), British physician]
opment psychologist Jerome Bruner (1915– ) bruxism n. persistent grinding, clenching, or
studying cognitive processes and he became in- gnashing of teeth, usually during sleep. It can
terested in the relationship between language be associated with feelings of tension, anger,
and mind. His Words and Things (1957) is consid- frustration, or fear. Also called bruxomania;
ered a classic in the field of psycholinguistics. Ar- stridor dentium.
guably his most important contribution to that
BSRI abbreviation for bem sex role inventory.
field was his intensive study of language devel-
opment in three children, published as A First BSS abbreviation for beck scale for suicide
Language: The Early Stages (1973). Brown is also ideation.
noted for devising successful scientific experi- BST abbreviation for brief stimulus therapy.
ments to study cognitive problems not previ- B-type personality see type b personality.
ously thought amenable to scientific inquiry,
such as the tip-of-the-tongue phenomenon, buccal intercourse see orogenital activity.
and he coined the term flashbulb memory. buccolingual masticatory syndrome
Among Brown’s other important writings are the (BLM; BLMS) a movement disorder associated
two editions of his widely used textbook Social with the use of conventional antipsychotic
Psychology (1965; 1986). He was elected to the agents and characterized by involuntary move-
American Academy of Arts and Sciences and the ments of the tongue and musculature of the
National Academy of Sciences and received the mouth and face. Patients may involuntarily
Distinguished Scientific Contribution Award chew, protrude the tongue, or make grimacing
from the American Psychological Association. or pursing movements of the lips and cheeks.
Brown–Peterson distractor technique a Also called buccal–lingual masticatory syn-
technique used in memory studies in which par- drome; oral–lingual dyskinesia. See also
ticipants are allowed a brief period for remem- tardive dyskinesia.
bering during which rehearsal is minimized. buffer 1. n. see buffer item. 2. n. a temporary
Typically, three items (e.g., words) are presented, store in memory. For example, short-term
after which the participant is asked to count memory is a buffer. 3. vb. see buffering.
backward for a certain time (as a distractor) be- buffering n. the protection against stressful ex-
fore attempting to recall the presented items. periences that is afforded by an individual’s so-
[John A. Brown; Lloyd R. Peterson (1922– ) and cial support. —buffer vb.
Margaret Jean Peterson (1930– ), U.S. psychol-
buffer item an irrelevant item interspersed be-
ogists]
tween others in a test or experiment. For exam-
brucine n. an alkaloid obtained from the Brucea ple, a buffer item may be a question that is not
genus of shrubs that is an antagonist at receptor scored and is introduced only to separate or dis-
sites for the inhibitory neurotransmitter gly- guise other items.
cine. Brucine is also found (with strychnine) in bufotenin a naturally occurring, mildly halluci-
nux vomica; it resembles strychnine but is less nogenic substance found on the skin of a species
potent. of toad (genus Bufo) and in plants of the genus
Bruck–de Lange type see de lange’s syn- Anadenanthera; it is also reported to be a compo-
drome. [described in 1889 by F. Bruck, German nent of the urine of certain patients with schizo-
physician, and in 1934 by Cornelia de Lange phrenia. Bufotenin is related chemically to lsd,
(1871–1950), Dutch pediatrician] psilocin, and dmt. See also hallucinogen.
87
buggery
buggery n. sodomy or anal intercourse. with people (e.g., social workers, teachers, correc-
bulimia n. insatiable hunger for food. It may tional officers) in service-oriented vocations and
have physiological causes, such as a brain lesion experience chronic high levels of stress. It can
B or endocrine disturbance, or be primarily a psy- be particularly acute in therapists or counselors
chological disorder (see binge-eating disor- doing trauma work, who feel overwhelmed by
der; bulimia nervosa). See also hyperbulimia; the cumulative secondary trauma of witnessing
hyperphagia. —bulimic adj., n. the effects. Burnout is also experienced by ath-
letes when continually exposed to stress associ-
bulimia nervosa an eating disorder involv- ated with performance without commensurate re-
ing recurrent episodes of binge eating (i.e., dis- wards or rest. See also overtraining syndrome.
crete periods of uncontrolled consumption of
abnormally large quantities of food) followed by buspirone n. a nonbenzodiazepine anxiolytic of
inappropriate compensatory behaviors (e.g., the azapirone class. Both it and its primary met-
self-induced vomiting, misuse of laxatives, fast- abolic product, 6-hydroxybuspirone, produce re-
ing, excessive exercise). Compare binge-eating lief of subjective symptoms of anxiety without
disorder. the sedation, behavioral disinhibition, and risk
of dependence associated with the benzo-
bullying n. persistent threatening and aggres-
diazepines. Its use has been limited due to its
sive physical behavior or verbal abuse directed
relative lack of efficacy compared with benzo-
toward other people, especially those who are
diazepines. U.S. trade name: BuSpar.
younger, smaller, weaker, or in some other situa-
tion of relative disadvantage. butabarbital n. an intermediate-acting barbi-
buprenorphine n. an opioid analgesic with turate used in the treatment of insomnia and
both agonist and antagonist activity at opioid re- for daytime and preoperative sedation. Like
ceptors, used for the treatment of moderate to se- other barbiturates, it is a nonselective cns de-
vere pain and also for the management of opioid pressant and therefore quite toxic in overdose.
dependence. Because of its ability to partially Because tolerance to its sedative and hypnotic ef-
block the mu opioid receptor, it can attenuate fects accrues much more rapidly than tolerance
the euphoria and other subjective and physio- to its CNS depressant effects, its therapeutic
logical effects associated with opioids, and there- index drops and its potential lethality increases
fore may be useful in both opioid withdrawal as the dose is increased. These factors, plus its po-
and as a substitute for illicit opioids in long-term tential for abuse, have caused a decline in its
maintenance treatment of opioid dependence. clinical use. U.S. trade name: Butisol Sodium.
U.S. trade name: Buprenex. butorphanol n. a synthetic opioid that acts as
bupropion n. an aminoketone agent commonly a mixed agonist–antagonist: It is an agonist at
used in the treatment of depression. It is also ap- kappa opioid receptors but an antagonist at
propriate as an adjuvant to behavioral treatment mu opioid receptors. It is used clinically for the
for smoking cessation. It is occasionally used in management of moderate to severe pain, includ-
combination with other antidepressants to aug- ing migraine headaches, and as a preoperative
ment antidepressant response (see augmenta- medication. It is available in an injectable prepa-
tion strategy), and has also been used in the ration and an intranasal spray, but the ease of
treatment of attention-deficit/hyperactivity disuse of the latter has made it a common drug of
order. Bupropion is available in both immediate- abuse. As with other opioid agents, butorphanol
release and extended-release preparations. U.S. may cause respiratory depression, nausea, and
trade names: Wellbutrin; Zyban. dependence. U.S. trade name: Stadol.
burned out 1. describing an individual who is butyrophenone n. any of a class of high-
mentally or physically exhausted or overwhelmed. potency antipsychotics used primarily in the
See burnout. 2. historically, describing individ- treatment of schizophrenia, mania, and severe
uals with chronic schizophrenia who are apa- agitation. They are associated with numerous
thetic, withdrawn, and show progressive dete- extrapyramidal symptoms, as well as neuro-
rioration, with little hope of significant improve- leptic malignant syndrome and tardive
ment, personal growth, or adaptive functioning. dyskinesia. The prototype is haloperidol.
burnout n. physical, emotional, or mental ex- butyrylcholinesterase (BuChE) n. see cho-
haustion, especially in one’s job or career, ac- linesterase.
companied by decreased motivation, lowered buzz group a subdivision of a group that has
performance, and negative attitudes toward one- been broken up so that each member may be in-
self and others. It results from performing at a volved in more direct and active discussion to as-
high level until stress and tension, especially certain his or her feelings or opinions. The
from extreme and prolonged physical or mental results are then typically conveyed to the pri-
exertion or an overburdening workload, take mary (i.e., entire) group by a spokesperson. Also
their toll. The word was first used in this sense in called buzz session.
1975 by U.S. psychologist Herbert J. Freuden-
berger (1926–1999) in referring to workers in B-values pl. n. see metaneeds.
clinics with heavy caseloads. Burnout is most BWS abbreviation for battered-woman syn-
often observed in professionals who work closely drome.
88
Cc
caapi n. see ayahuasca. calcium-channel blocker any of a class of
cachexia n. an extreme state of poor health, drugs, the prototype of which is verapamil, used
physical wasting away, and malnutrition, usu- in the treatment of hypertension and abnormal
ally associated with chronic illnesses, such as heart rhythms (arrhythmias). Calcium-channel
cancer and pulmonary tuberculosis. blockers inhibit the flow of calcium ions into the
cacoethes n. an irresistible, and sometimes irra- smooth-muscle cells of blood vessels and the
tional, desire or compulsion. cells of heart muscle, which need calcium to
contract, thus inducing prolonged relaxation of
cafard n. a culture-bound syndrome found in the muscles.
Polynesia, with symptoms similar to those of
amok. Also called cathard. calcium-deficiency disorders diseases caused
by a deficiency of calcium in the tissues. Absorp-
Cafergot n. a trade name for ergotamine.
tion of calcium from food and its deposition in
caffeine n. a cns stimulant found in coffee, tea, bone is facilitated by vitamin D, and deficiency
cola, cocoa, chocolate, and certain prescribed and of this vitamin is the usual cause of rickets, a dis-
over-the-counter medications. It is an antagonist ease of childhood marked by deformed bones
of the neuromodulator adenosine. Caffeine be- and teeth and lax muscles, and osteomalacia,
longs to the methylxanthine group of alka- the adult form of rickets. Osteoporosis, in which
loids, and its effects include rapid breathing, the bones become brittle and break easily, is
increased pulse rate and blood pressure, and di- caused by resorption (loss) of calcified bone, due
minished fatigue. Precise effects vary with the to disease or aging (it is common in postmeno-
amount ingested and the tolerance of the indi- pausal women). Tetany (muscle spasms) is due to
vidual. Moderate doses produce an improved a deficiency of calcium in the blood.
flow of thought and clearness of ideas, together
with increased respiratory and vaso-motor activ- calendar method of birth control at-
ity; large doses may make concentration or con- tempting to avoid pregnancy by not having in-
tinued attention difficult and cause insomnia, tercourse during the middle days of the woman’s
headaches, and confusion in some individuals (see menstrual cycle, when ovulation occurs. How-
caffeine intoxication; substance-induced ever, because ovulation is not completely regu-
anxiety disorder). Because of its stimulant ef- lar, and sperm have been found to stay active for
fects, caffeine is used in keep-awake pills and in up to 3 days in the uterus, this method is not
certain analgesics and cold remedies containing very successful. See also rhythm method.
ingredients that usually cause drowsiness. See California Psychological Inventory (CPI)
also aspirin combinations. a self-report inventory designed to evaluate
caffeine intoxication intoxication due to re- adult and adolescent personality characteristics,
cent consumption of large amounts of caffeine interpersonal behavior, and social interaction. It
(typically over 250 mg), in the form of coffee, currently consists of 434 true–false statements (a
tea, cola, or medications, and involving at least 260-statement short form is also available) that
five of the following symptoms: restlessness, produces scores on 20 scales divided into four
nervousness, excitement, insomnia, flushed measurement classes: (a) poise, ascendancy, self-
face, diuresis (increased urination), gastrointesti- assurance, and interpersonal adequacy; (b) so-
nal complaints, muscle twitching, rambling cialization, responsibility, intrapersonal values,
thought and speech, rapid or irregular heart and character; (c) achievement potential and in-
rhythm, periods of inexhaustibility, or tellectual efficacy; and (d) intellectual and inter-
psychomotor agitation. Brewed coffee contains est modes. Originally published in 1957, the CPI
100–150 mg caffeine per cup; tea contains about is now in its third edition (published 1996). Also
50 mg, and cola about 35 mg. Also called called California Psychological Inventory
caffeinism. Test. [devised by U.S. psychologist Harrison G.
Gough (1921– ) at the University of California,
CAGE n. a screening instrument to detect alcohol
Berkeley]
dependence. It consists of the following four
questions: (a) Have you ever felt you should Cut California Verbal Learning Test (CVLT) a
down on your drinking? (b) Have people word-list learning test consisting of 16 items be-
Annoyed you by criticizing your drinking? (c) longing to one of four categories. Currently in its
Have you ever felt bad or Guilty about your second edition (CVLT–II), the test assesses imme-
drinking? (d) Have you ever used a drink as an diate free recall following each of five learning
Eye-opener? trials as well as an interference trial. Free recall
89
call boy
and cued recall are also assessed following a impulses and hence its establishment as
short-term delay (immediately after the interfer- permanent. 3. in psychology, the channeling by
ence trial) and a long-term (20-min) delay. an organism of its needs into fixed patterns of
Finally, long-term recognition is assessed using gratification, for example, food preferences and
distractors that vary in their likelihood of elicit- recreational preferences.
ing false positive errors. In addition to the adult cancer n. any one of a group of diseases charac-
C version, a 9-item version has been developed for terized by the unregulated, abnormal growth of
use with individuals with memory impairment cells to form malignant tumors (see neoplasm),
(CVLT–II short form). There is also a 15-item ver- which invade neighboring tissues; the abnormal
sion for children aged 5–16, California Verbal cells are generally capable of spreading via the
Learning Test for Children (CVLT–C). bloodstream or lymphatic system to other body
call boy see male homosexual prostitution. areas or organs by the process of metastasis.
call girl n. a female prostitute who does not work Causes of cancer are numerous but commonly
out of a brothel or by soliciting in the street. In- include viruses, environmental toxins, diet, and
stead, her services are ordered by telephone, and inherited gentic variations. Cancers are gener-
she may then be collected by the client or come ally classified as carcinomas if they involve the
to the client’s home or hotel. Call girls typically epithelium (e.g., cancers of the lungs, stomach,
charge higher prices than other types of prosti- or skin) and sarcomas if the affected tissues are
tutes. connective (e.g., bone, muscle, or fat). More
than 150 different kinds of cancer have been
CAM abbreviation for complementary and al-
identified in humans, based on cell types, rate
ternative medicine.
of growth, and other factors. Because cancers
camisole n. see straitjacket. can be disfiguring and life-threatening, psycho-
camphorated tincture of opium see pare- logical counseling is often helpful for patients.
goric. —cancerous adj.
Campral n. a trade name for acamprosate. cancer phobia a persistent and irrational fear of
camptocormia n. a condition in which the cancer. Fear of developing cancer may be a
back is bent forward at a sharp angle (30–90° ). In symptom of obsessive-compulsive disorder;
some cases it may be a rare manifestation of it may also be classified as a specific phobia,
conversion disorder and may be accompa- other type. The belief that one has cancer based
nied by back pain, tremors, or both. on the misinterpretation of bodily symptoms is
classified as hypochondriasis.
campus crisis center a campus organization
created to provide support and advice for stu- Candlelighters Childhood Cancer Foun-
dents experiencing personal difficulty or trauma dation an organization that links children with
in their school, college, or university. Substance cancer and their families to support groups in
abuse, rape, depression, academic failure, and which they can share feelings and exchange in-
suicidal tendencies are typical of the problems or formation.
traumas encountered by students. A campus cri- cannabinoid n. any of a class of about 60 sub-
sis center may offer such services as counseling, a stances in the cannabis plant that includes
hotline, or an escort service for students return- those responsible for the psychoactive properties
ing to housing late at night. of the plant. The most important cannabinoid is
Canadian Psychological Association tetrahydrocannabinol.
(CPA) a professional organization representing cannabis n. any of three related plant species
psychologists in Canada, organized in 1939 and (Cannabis sativa, C. indica, or C. ruderalis) whose
incorporated in 1950. Its objectives are to lead, dried flowering or fruiting tops or leaves are
advance, and promote psychology as a science widely used as a recreational drug, known as
and profession for the benefit of humanity; to marijuana. The principal psychoactive agent in
provide leadership in psychology in Canada; to these plants, delta-9-tetrahydrocannabinol
promote the advancement, dissemination, and (THC), is concentrated in the resin, most of
application of psychological knowledge; and to which is in the plants’ flowering tops. When
develop standards and ethical principles for edu- smoked, THC is rapidly absorbed into the blood
cation, training, science, and practice in psy- and almost immediately distributed to the brain,
chology. causing the rapid onset of subjective effects that
canalization n. 1. in evolutionary genetics, the last 2–3 hours. These effects include a sense of
containment of variation of certain characters euphoria or well-being, easy laughter, perceptual
within narrow bounds so that expression of un- distortions, impairment of concentration and
derlying genetic variation is repressed. It is a short-term memory, and craving for food. Ad-
developmental mechanism that maintains a verse effects of anxiety or panic are not uncom-
constant phenotype over a range of different mon, and hallucinations may occur with high
environments in which the organism might nor- doses (see also cannabis-induced psychotic
mally occur. 2. in neurology, the hypothetical disorder; cannabis intoxication). Tolerance
process by which repeated use of a neural path- to the effects of THC develops with repeated use,
way leads to greater ease of transmission of but reports of cannabis dependence are rare.
90
cardiac neurosis
The most potent marijuana preparation is hash- served under a risk contract. Capitation is the
ish, which consists of pure resin. A less potent characteristic payment method of hmos. —cap-
preparation is sinsemilla, also called ganja; it is itated adj.
made from the plants’ flowering tops. The weak- carbamate n. any of a class of acetylcho-
est preparation is bhang. Also called hemp. linesterase inhibitors (e.g., rivastigmine)
cannabis abuse in DSM–IV–TR, a pattern of used in the treatment of dementia. Carbamates C
cannabis use manifested by recurrent signifi- can delay the progression of certain dementias,
cant adverse consequences related to its repeated slowing declines in cognitive function and in
ingestion. This diagnosis is preempted by the di- activities of daily living. They are preferred to
agnosis of cannabis dependence: If the criteria earlier generations of acetylcholinesterase inhib-
for cannabis abuse and cannabis dependence are itors because of their relatively benign side ef-
both met, only the latter diagnosis is given. See fects, relative lack of liver toxicity, and improved
also substance abuse. dosing schedule (they need to be administered
cannabis dependence in DSM–IV–TR, a clus- only once or twice a day).
ter of cognitive, behavioral, and physiological carbamazepine (CBZ) n. a drug that is related
symptoms indicating continued use of cannabis to the tricyclic antidepressants, used mainly
despite significant cannabis-related problems. as an anticonvulsant but also as a mood sta-
There is a pattern of repeated cannabis ingestion bilizer in mania. U.S. trade name (among oth-
resulting in tolerance, withdrawal symptoms ers): Tegretol.
(chiefly motor agitation) if use is suspended, and carbidopa n. see sinemet.
an uncontrollable drive to continue use. See
carbon dioxide therapy a form of inhalation
cannabis abuse. See also substance depend-
therapy, now no longer in use, that was occa-
ence.
sionally applied (in conjunction with psycho-
cannabis-induced psychotic disorder a therapy) to patients with anxiety, conversion, or
rare disorder marked by persecutory delusions psychophysiological symptoms. [first used in
associated with cannabis intoxication, some- the 1920s by Hungarian-born U.S. psychiatrist
times accompanied by marked anxiety, emo- Ladislaus Joseph Meduna (1896–1964) to induce
tional lability, depersonalization, and subsequent unconsciousness as a means of interrupting
amnesia for the episode. The disorder usually re- pathological brain circuits]
mits within a day, although it may persist for a
carbonic anhydrase inhibitor any of a
few days. Hallucinations occur rarely. Also called
group of drugs that interfere with the action of
cannabis psychosis.
the enzyme carbonic anhydrase in the body. Al-
cannabis intoxication a reversible syndrome though their primary role was originally as di-
that occurs during or shortly after the ingestion uretics, via their ability to block reabsorption of
or smoking of cannabis. It consists of clinically sodium bicarbonate from the proximal renal tu-
significant behavioral or psychological changes bule, thus improving urine excretion and elec-
(e.g., enhanced sense of well-being, intensifica- trolyte balance, their use has been supplanted by
tion of perceptions, a sense of slowed time), as less toxic diuretics. At present, acetazolamide
well as one or more signs of physiological in- (the prototype; U.S. trade name: Diamox) and
volvement (e.g., increased pulse rate, conjuncti- other carbonic anhydrase inhibitors are used pri-
vitis, dry mouth and throat). See also substance marily for the management of glaucoma and
intoxication. acute mountain sickness. The drugs are also used
cannabis psychosis see cannabis-induced as adjunctive agents in the management of epi-
psychotic disorder. lepsy. Acetazolamide inhibits epileptic seizures
cannibalism n. 1. the consumption of human and decreases the rate of cerebrospinal fluid for-
flesh. 2. a pathological urge to devour human mation.
flesh, occasionally observed in schizophrenia carbon tetrachloride a volatile solvent that,
and similar mental disturbances, such as when inhaled, can produce euphoria, disorienta-
windigo. In classical psychoanalytic theory, tion and depersonalization, and other behav-
cannibalistic impulses are associated with fixa- ioral effects similar to those produced by the
tion at the oral-biting phase of psycho- major sedatives. Continued use can lead to the
sexual development. —cannibalistic adj. rapid development of persisting dementia, as
Capgras syndrome a condition characterized well as a variety of physical problems. See also
by a delusional belief that the self or known indi- inhalant; inhalant abuse; inhalant depend-
viduals have been replaced by doubles or impos- ence; inhalant intoxication.
tors. This type of misidentification syndrome carcinoma n. see cancer.
may be associated with paranoid schizophrenia, cardiac neurosis an anxiety reaction precipi-
a neurological disorder, or a mood disorder. Also tated by a heart condition, the suspicion of hav-
called illusion of doubles. [Jean Marie Joseph ing a heart condition, or the fear of developing
Capgras (1873–1950), French psychiatrist] coronary disease. In some cases a cardiac neuro-
capitation n. a method of payment for health sis develops when the patient detects a harmless
care services in which a provider or health care heart murmur, palpitations, or a chest pain due
facility is paid a fixed amount for each person to emotional stress. In other cases it may be
91
cardiac psychology
caused or aggravated by a physician’s examina- panediols, a group originally developed as

tion (see iatrogenic illness). Cardiac anxiety anxiolytics. Carisoprodol is now used as a mus-
is a common symptom of panic disorder; it cle relaxant and is increasingly seen as an in-
may also be a focus in hypochondriasis. toxicant drug of abuse. U.S. trade name: Soma.
cardiac psychology a specialization within carnal adj. relating to the physical desires and
C health psychology that focuses solely on appetites of the body, particularly sexual ones.
physical and behavioral health and disease re- Carnal knowledge is a mainly legal term for sex-
lated to the cardiovascular system. ual intercourse.
cardiac psychosis a disorganization of carotid-sinus syndrome see aortic arch
thought processes that is associated with an syndrome.
acute state of fear and anxiety following a heart
attack. carphology n. see floccillation.
cardinal trait a basic and pervasive characteris- carryover effect the effect on the current per-
tic or personality trait that dominates an in- formance of a research participant of the experi-
dividual’s total behavior. [defined by Gordon mental conditions that preceded the current
Willard allport] conditions.
cardiomyopathy n. any disease involving the Cartesian dualism the position taken by
heart muscle, particularly when the specific French philosopher, mathematician, and scien-
cause is uncertain. tist René Descartes (1596–1650) that the world
cardiophobia n. an excessive fear of the heart comprises two distinct and incompatible classes
or, more specifically, of having or developing a of substance: res extensa, or extended substance,
heart condition. See cardiac neurosis. which extends through space; and res cogitans,
or thinking substance, which has no extension
cardiovascular disease any disease, congeni-
in space. The body (including the brain) is com-
tal or acquired, that affects the heart and blood
posed of extended and divisible substance,
vessels. Cardiovascular diseases include hyper-
whereas the mind is not. For Descartes, this
tension, congestive heart failure, myocardial
means that the mind would continue to exist
infarction, arteriosclerosis, and coro-
even if the material body did not. He accepted
nary heart disease.
that there is interaction between mind and
card-sorting test a test in which the partici- body, holding that in some activities the mind
pant is asked to sort randomly mixed cards into operates independently of bodily influences,
specific categories. Such tests may be used to de- whereas in others the body exerts an influence.
termine frontal lobe functioning, learning abil- Similarly, in some bodily activities there is influ-
ity, discriminatory powers, or clerical aptitude. ence from the mind, while in others there is not.
CARE acronym for communicated authentic- Descartes proposed that the locus for the interac-
ity, regard, empathy. tion of the mind and body is the point in the pi-
care-and-protection proceedings court in- neal gland in the brain termed the conarium.
tervention on behalf of a child when the parents However, to the question of how such incompat-
or caregivers do not adequately provide for the ible substances can interact at all, Descartes had
child’s welfare. no answer. See dualism; ghost in the ma-
chine; mind–body problem.
caregiver n. 1. a person who attends to the
needs of and provides assistance to someone else carve out to eliminate coverage for specific
who is not fully independent, such as an infant health care services (e.g., mental health or sub-
or an ill adult. 2. in health care, any individual stance abuse) from a health care plan and con-
involved in the process of identifying, prevent- tract for those services from a separate provider.
ing, or treating an illness or disability. —care- —carve-out n.
giving adj. Casanova complex a man’s desire to have a
caregiver burden the stress and other psycho- large number of lovers, leading to very active
logical symptoms experienced by family mem- pursuit of women and attempts to seduce or en-
bers and other nonprofessional caregivers in tice women into having sexual intercourse with-
response to looking after individuals with men- out any emotional relationship or commitment.
tal or physical disabilities, disorders, or diseases. The complex is named for Giovanni Jacopo Ca-
See also burnout; compassion fatigue. sanova (1725–1798), an Italian adventurer noted
carezza (karezza) n. a form of coitus in which for his sexual conquests.
the man does not reach orgasm. It is sometimes case n. 1. an instance of a disease or disorder, usu-
used as a means of birth control, but if combined ally at the level of the individual patient. In a
with meditation it is similar to the coitus borderline case, the symptoms resemble those of
reservatus technique. Carezza techniques are a disease or disorder but do not fully meet the
derived from principles of Hindu Tantrism, and criteria. See also proband. 2. a person about
in this sense were first described by U.S. gynecol- whom data are collected or who is the recipient
ogist Alice B. Stockham in 1896. Also called co- of assistance (e.g., from a health care profes-
itus prolongatus. sional or lawyer). 3. a specific instance, occur-
carisoprodol n. a drug belonging to the pro- rence, or example or a type thereof.
92
catastrophe cusp theory
case advocate see advocate. ther men or women, inactivation of these glands
case-finding n. the process of identifying indi- can also be accomplished with radiation, by ill-
viduals who need treatment for mental disorders ness, or with drugs (see chemical castration).
by administering screening tests, locating indi- castration anxiety fear of injury to or loss of
viduals who have contacted social agencies or the genitals. In the pregenital phase posited by
mental health facilities, obtaining referrals from psychoanalytic theory, the various losses and de- C
general practitioners, or via triage after a disaster. privations experienced by the infant boy may
case history a record of information relating to give rise to the fear that he will also lose his
a person’s psychological or medical condition penis. See also castration complex.
used as an aid to diagnosis and treatment. It usu- castration complex in psychoanalytic theory,
ally contains test results, interviews, professional the whole combination of the child’s uncon-
evaluations, and sociological, occupational, and scious feelings and fantasies associated with
educational data. being deprived of the phallus, which in boys
means the loss of the penis and in girls the belief
case load the amount of work required of a psy-
that it has already been removed. It derives from
chotherapist, psychiatrist, doctor, social worker,
the discovery that girls have no penis and is
or counselor during a particular period, as com-
closely tied to the oedipus complex.
puted by the number of clients assigned to him
or her and the comparative difficulty of their casualty n. 1. a person or group harmed, psycho-
cases. logically or physically, by such negative life ex-
periences as accidents, abuse, warfare, and
case management a system of managing and
disasters. 2. an individual whose psychological
coordinating the delivery of health care in order
well-being declines, rather than improves, as a
to improve the continuity and quality of care as
result of his or her experiences in a change-
well as reducing costs. Case management is usu-
promoting group.
ally a function of a hospital’s utilization re-
view department. CAT acronym for computerized axial tomogra-
phy (see computed tomography).
case manager a health care professional, usu-
ally a nurse or social worker, who works with pa- catalepsy n. a state of sustained unresponsive-
tients, providers, and health insurance plans to ness in which a fixed body posture or physical at-
coordinate the continuity and cost-effectiveness titude is maintained over a long period of time.
of services. It is seen in cases of catatonic schizophrenia,
epilepsy, and other disorders. Also called cata-
case report a collection of data relating to a per- tonic rigidity; cerea flexibilitas; flex-
son’s psychological or medical condition. ibilitas cerea; waxy flexibility. See also
case study an in-depth investigation of a single epidemic catalepsy. —cataleptic adj.
individual, family, or other social unit. Multiple catalogia n. see verbigeration.
types of data (psychological, physiological, bio-
catalytic agent in group psychotherapy, a
graphical, environmental) are assembled in
member who stimulates emotional reactions in
order to understand the subject’s background,
other members.
relationships, and behavior.
catamite n. a boy who participates in peder-
casework n. the tasks carried out by a profes- asty.
sional, usually a social worker known as a case-
worker, who provides or oversees services being catamnesis n. the medical history of a patient
delivered, including counseling or therapy. following the onset of a mental or physical disor-
Casework includes identifying and assessing the der, either after the initial examination or after
needs of the individual and his or her family and discharge from treatment (in the latter case it is
providing or coordinating and monitoring the also known as follow-up history). Compare
provision of support and services. These services anamnesis.
may include private counseling, treatment in a cataphasia n. 1. a language disorder character-
hospital or other institution, or such concrete ized by repetition of a single word. 2. see
services as arranging for public assistance, hous- verbigeration.
ing, and other aid. Also called social case- cataplexy n. a sudden loss of muscle tone that
work. may be localized, causing (for example) loss of
cassina n. a perennial evergreen shrub, Ilex grasp or head nodding, or generalized, resulting
vomitoria, that grows wild in eastern North in collapse of the entire body. It is a temporary
America, particularly Virginia and the Carolinas. condition usually precipitated by an extreme
The leaves contain caffeine and have been used emotional stimulus (e.g., an uncontrollable fit of
by Native Americans to prepare a tealike bever- laughter, overwhelming anxiety, excitement, or
age known as the “black drink” for medicinal, anger). See narcolepsy. —cataplectic adj.
ceremonial, and social purposes. Also called Catapres n. a trade name for clonidine.
yaupon; youpon. catastrophe cusp theory a theory concern-
castration n. surgical removal of the testes (see ing the interaction of cognitive anxiety and
orchidectomy); less commonly it can indicate physiological arousal. Under conditions of high
removal of the ovaries (see ovariectomy). In ei- cognitive anxiety, as physiological arousal in-
93
catastrophic illness
creases, performance will increase to a certain tonic excitement). Other common features in-
point, but past this point a catastrophic drop in clude extreme negativism (apparently motive-
performance will occur. To regain an optimal less resistance to all instructions or maintenance
level of performance, a substantial lowering of of a rigid posture against attempts to be moved)
physiological arousal is necessary. or mutism; peculiarities of voluntary move-
catastrophic illness a severe illness, acute or ment, such as posturing or stereotyped move-
C ments; and echolalia or echopraxia. The
chronic, that is likely to result in serious disabil-
ity or death. Treatment is typically prolonged, DSM–III designation was catatonic type schizo-
intense, and costly. phrenic disorder.
catastrophic reaction 1. a breakdown in the catatonic state see catatonia.
ability to cope with a threatening or traumatic catatonic stupor a state of significantly de-
situation. The individual experiences acute feel- creased reactivity to environmental stimuli and
ings of inadequacy, anxiety, frustration, and events and reduced spontaneous movement,
helplessness. 2. highly emotional behavior (ex- often as a symptom of catatonic schizophre-
treme anxiety, sudden crying, aggressive or hos- nia.
tile behavior, etc.) sometimes observed in
individuals who have suffered brain damage, in- catchment area the geographic area served by
cluding those with aphasia. The origin of this a health care program (e.g., a community mental
behavior remains unclear, although U.S. neurol- health center).
ogist D. Frank Benson (1928–1996) ascribed such cat-cry syndrome see cri du chat syndrome.
reactions to individuals’ frustration, embarrass-
ment, or agitation at their struggle to communi- catechetical method a form of instruction or
cate or perform tasks they had previously means of persuasion that uses a skillfully devised
performed with ease. Also called catastrophic series of questions, the answers to which gradu-
behavior. [first described by German-born U.S. ally lead the person being questioned to accept
psychologist Kurt Goldstein (1878–1965)] the conclusions desired by the questioner. Also
called catechetical procedure. See socratic
catastrophic stress an overwhelming reaction dialogue.
to a traumatic event that is beyond the limits of
normal life. Traumatic events, such as rape, tor- catecholamine n. any of a class of biogenic
ture, genocide, or severe war-zone experiences, amines formed by a catechol molecule and an
are filtered through cognitive and emotional amine group. Derived from tyrosine, catechol-
processes before being appraised as extreme amines include dopamine, epinephrine and
threats. norepinephrine, which are the predominant
neurotransmitters in the sympathetic nervous
catastrophize vb. to exaggerate the negative system.
consequences of events or decisions. People are
said to be catastrophizing when they think that catecholamine hypothesis the hypothesis
the worst possible outcome will occur from a that deficiencies in the catecholamine
particular action or in a particular situation or neurotransmitters norepinephrine, epinephrine,
when they feel as if they are in the midst of a ca- and dopamine at receptor sites in the brain lead
tastrophe in situations that may be serious and to a state of physiological and psychological de-
upsetting but are not necessarily disastrous. The pression, and that an excess of such neuro-
tendency to catastrophize can unnecessarily in- transmitters at these sites is responsible for the
crease levels of anxiety and lead to maladaptive production of mania. The catecholamine hy-
behavior. pothesis underlay the development of the early
tricyclic antidepressants in the late 1950s, as
catathymic crisis see isolated explosive dis- it had been known that these compounds in-
order.
hibited the reuptake of norepinephrine into
catatonia n. a state of muscular rigidity or other presynaptic neurons. Despite numerous short-
disturbance of motor behavior, such as cata- comings, the catecholamine hypothesis, and the
lepsy, extreme overactivity, or adoption of bi- related monoamine hypothesis, became the
zarre postures. It is most frequently observed in dominant hypotheses in the biological treat-
catatonic schizophrenia. Also called cata- ment of depression in the last half of the 20th
tonic state. —catatonic adj. century.
catatonic excitement periods of extreme rest- categorical data numerical values that indi-
lessness and excessive and apparently purpose- cate counts or observations in specific categories,
less motor activity, often as a symptom of for example, the number of people in a particu-
catatonic schizophrenia. lar town who are male and the number who are
catatonic rigidity see catalepsy. female. Categorical data are similar to nominal
data, and the two terms are often used inter-
catatonic schizophrenia in DSM–IV–TR, a
changeably.
relatively rare subtype of schizophrenia charac-
terized by abnormal motor activity, specifically categorical intrusion in a memory recall test,
motor immobility (see catalepsy; catatonic the recall by the participant of one or more items
stupor) or excessive motor activity (see cata- that were not presented for memorization but
94
causal latency
are from the same semantic category (e.g., tal retardation). Also called extra-small acro-
names, animals, foods) as the presented items. centric chromosome syndrome; partial
categorical scale see nominal scale. trisomy 6 syndrome; Schachenmann’s
syndrome; Schmid–Fraccaro syndrome.
categorical thought in Jean piaget’s theory
of cognitive development, abstract thinking Cattell–Horn theory of intelligence a the-
that involves the use of general concepts and ory proposing that there are two main kinds of C
classifications. It is particularly lacking in young intellectual abilities nested under general intelli-
children, who tend to think concretely (see con- gence: g-c, or crystallized intelligence (or ability),
crete thinking). See also abstract attitude. which is the sum of one’s knowledge and is mea-
sured by tests of vocabulary, general informa-
categorical variable a variable defined by
tion, etc.; and g-f, or fluid intelligence (or ability),
membership in a group, class, or category, rather
which is the set of mental processes that is used
than by rank or by scores on more continuous
in dealing with relatively novel tasks and is used
scales of measurement.
in the acquisition of g-c. In later versions of the
Category Test a nonverbal problem-solving theory, other abilities have been added, such as
task that requires abstract reasoning, concept g-v, or visual intelligence (or ability), which is
formation, and mental flexibility. The partici- the set of mental processes used in handling vi-
pant is presented with six subtests each compris- sual-spatial tasks, such as mentally rotating a
ing a different set of stimuli organized according geometric figure or visualizing what pieces of
to a specific principle and each stimulus within paper would look like were they folded. [Ray-
each set associated with a particular number. mond Bernard Cattell (1905–1998), British-born
The participant must respond by choosing a U.S. personality psychologist who originally de-
number and, using feedback about response ac- veloped the theory in the 1940s; John L. Horn
curacy, determine the principle of organization (1928–2006), U.S. psychologist who subse-
underlying the set of stimuli within a particular quently contributed to the theory beginning in
subtest. Once the principle is correctly identi- the 1960s]
fied, the participant can solve each item cor-
Cattell inventory any of several self-report in-
rectly within the subtest. A final subtest contains
ventories based on a study of personality traits
items from the previous six. The Category Test
by factor analysis. The best known of these
is part of the halstead–reitan neuropsy-
inventories is the sixteen personality factor
chological battery. Also called Halstead
questionnaire. [Raymond Cattell]
Category Test. [designed in 1947 by U.S. psy-
chologist Ward Halstead (1908–1969)] Cattell’s personality trait theory an ap-
proach to personality description based on the
cathard n. see cafard.
identification of traits through factor analysis
catharsis n. 1. in psychoanalytic theory, the dis- and their classification into surface traits and
charge of affects connected to traumatic events the 16 source traits that underlie them. [Ray-
that had previously been repressed by bringing mond Cattell]
these events back into consciousness and
caudate nucleus one of the basal ganglia, so
reexperiencing them. See also abreaction. 2.
named because it has a long extension, or tail.
more generally, the release of strong, pent-up
emotions. [from Greek, literally: “purgation, pu- causal analysis an attempt to draw dependable
rification”] —cathartic adj. inferences about cause-and-effect relationships
from data not obtained from true (randomized)
cathected adj. see cathexis.
experiments. Such analyses differ in the degree
cathectic discharge see affective dis- to which they are statistically complex and the
charge. degree to which causal inferences are, in fact,
cathexis n. in psychoanalytic theory, the invest- justified.
ment of psychic energy in an object of any causal inference the reasoned process of con-
kind, such as a wish, fantasy, person, goal, idea, cluding that one variable is the cause of another.
social group, or the self. Such objects are said to
be cathected when an individual attaches emo-
causal latency 1. the temporal separation of a
cause from its effect. Not all causes need have
tional significance (positive or negative affect)
immediate effects; indeed, there may be a
to them. See also anticathexis; decathexis;
lengthy interval between a cause and the effect it
ego cathexis; hypercathexis; object cath-
produces. Causal latency may be expected to in-
exis.
crease when there are other factors in a situation
cathinone n. see khat. that may influence the cause-and-effect relation-
cat’s-eye syndrome a rare chromosomal disor- ship. Some causes studied in psychology and the
der caused by the presence of a small additional other social sciences are remote causes, in that
section of chromosome material, possibly from they require the presence or activity of other fac-
chromosome 14, resulting in a set of birth de- tors or conditions before their effects become
fects that include an imperforate anus and a cleft manifest. Remote causes may be expected to
iris that produces a cat’s-eye appearance. Af- have large causal latencies. See delayed effect.
fected individuals show normal or near normal 2. in the statistical procedure known as path
mental development (some may have mild men- analysis, the quality of a variable that has a
95
causation
measurable statistical effect on prediction only developed it into the concept of the superego.
when other predictor variables are also included —censorship n.
in the prediction model. Although the statistical
census tract a small, generally homogeneous
relationships identified in such analyses are not,
geographic area with boundaries established to
strictly speaking, causal, the language of causal-
facilitate the collection and reporting of census
ity is commonly employed. See causal path.
C data. Community demographic data are fre-
causation n. the empirical relation between two quently used in the assessment of the area’s
events, states, or variables such that one (the characteristics and needs, including mental
cause) is held or known to bring about the other health needs. See also catchment area.
(the effect). —causal adj.
centered adj. 1. describing the state of an organ-
CBCL abbreviation for child behavior check- ism that is perfectly integrated with its environ-
list. ment. [defined by German-born U.S. neurologist
CBT abbreviation for cognitive behavior ther- Kurt Goldstein (1878–1965)] 2. denoting a state
apy. of mind characterized by having a firm grip on
CBZ abbreviation for carbamazepine. reality, knowing who one is and what one wants
out of life, and being prepared to meet most
CCRT abbreviation for core conflictual rela- eventualities in an efficient manner.
tionship theme.
CCU 1. abbreviation for continuing care unit. Center for Epidemiologic Studies De-
2. abbreviation for critical care unit (see inten- pression Scale (CES-D) a 20-item self-
sive care unit). administered rating scale used to determine an
individual’s depression quotient. The test pro-
CD abbreviation for communication deviance. vides a quantitative measure of different depres-
CDC abbreviation for centers for disease con- sive feelings and behaviors during the previous
trol and prevention. week. [developed in 1971 by Lenore Sawyer
CDI abbreviation for children’s depression in- Radloff (1935– ) while a researcher at the Na-
ventory. tional Institute of Mental Health]
CEFT abbreviation for children’s embedded Centers for Disease Control and Preven-
figures test. tion (CDC) an agency founded in 1946 (now
one of the 13 major operating components of
ceiling effect a situation in which a large pro-
the U.S. Department of Health and Human Ser-
portion of participants perform as well as, or
vices) that stands at the forefront of public
nearly as well as, possible on a task or other
health efforts to prevent and control infectious
evaluative measure, thus skewing the distribu-
and chronic diseases, injuries, workplace haz-
tion of scores and making it impossible to dis-
ards, disabilities, and environmental health
criminate differences among the many
threats. The CDC works with public health part-
individuals at that high level. For example, a test
ners, both nationally and internationally, to
whose items are too easy for those taking it
monitor health, detect and investigate health
would show a ceiling effect because most people
problems, conduct research to enhance and im-
would obtain or be close to the highest possible
plement prevention, promote healthy behaviors
score of 100. Compare floor effect.
and safe and healthful environments, and de-
Celexa n. a trade name for citalopram. velop and advocate sound public health policies.
celibacy n. 1. the state of being unmarried, es- Centers for Medicare and Medicaid Ser-
pecially as the result of a religious vow. 2. ab-
vices (CMS) a federal government agency
stinence from sexual activity. See also chastity.
within the Department of Health and Human
—celibate adj., n.
Services that is responsible for the administra-
cell body the part of a neuron (nerve cell) that tion of the medicare and medicaid programs,
contains the nucleus and most organelles. Also as well as the State Children’s Health Insurance
called perikaryon; soma. See also axon. Program. Formerly known as the Health Care Fi-
cenesthopathy n. a general feeling of illness or nancing Administration (HCFA), the CMS con-
lack of well-being that is not identified with any sists of three business offices: the Center for
particular part of the body. Beneficiary Choices, the Center for Medicare
Management, and the Center for Medicaid and
censor n. in psychoanalytic theory, the mental
State Operations.
agency, located in the preconscious, that is re-
sponsible for repression. The censor is posited central anticholinergic syndrome a syn-
to determine which of one’s wishes, thoughts, drome observed in patients receiving combina-
and ideas may enter consciousness and which tions of agents with psychopharmacological
must be kept unconscious because they violate effects and due to the additive anticholin-
one’s conscience or society’s standards. The cen- ergic effects on the central nervous system of,
sor is also posited to be responsible for the dis- among others, tricyclic antidepressants, the
tortion of wishes that occurs in dreams (see weaker phenothiazines, and antiparkinsonian
dream censorship). The idea was introduced in agents. The symptoms include anxiety, disorien-
the early writings of Sigmund freud, who later tation, short-term memory loss, visual distor-
96
cerebral cortex
tions or hallucinations, and agitation. See also For example, a centrifugal nerve carries impulses
anticholinergic syndrome. from the central nervous system to a peripheral
central conflict the intrapsychic struggle be- region of the body. Compare centripetal.
tween the healthy constructive forces of the real centripetal adj. 1. directed toward the center.
self and the obstructive, neurotic forces of the For example, a centripetal nerve carries nerve
idealized self-image. [first described by German- impulses from the periphery to the central ner- C
born U.S. psychiatrist Karen Horney (1885– vous system. Compare centrifugal. 2. in psy-
1952)] chiatry, characterizing treatment or approaches
central dyslexia any form of acquired dyslexia that focus inward on minute changes in feelings
characterized by difficulties with the pronuncia- and impulses, as in psychoanalysis.
tion and comprehension of written words. Un- cephalic index the ratio of the maximum
like peripheral dyslexia, the visual analysis breadth of the head to its maximum length,
system is intact, and the damage is to other, multiplied by 100. The average, or medium, ce-
higher level pathways and systems involved in phalic index for humans is between 75 and 81
reading (e.g., the semantic system). (mesocephalic). A measure below 75 indicates a
central executive see working memory. narrow head that is long in proportion to its
centralism n. the concept that behavior is a width (dolichocephalic); a measure above 81 in-
function of the central nervous system mediated dicates a head that is wide in proportion to its
by the brain. See centralist psychology. length (brachycephalic). Compare cranial
Compare peripheralism. index. [defined by Swedish anatomist Anders
Retzius (1796–1860)]
centralist psychology 1. a psychological ap-
proach that focuses on behavior as a function of cephalization n. 1. the evolutionary tendency
the higher brain centers, as opposed to for important structures (brain, major sense or-
peripheralist psychology (see peripheralism), gans, etc.) to develop at the anterior (front) end
which focuses on the effects of the receptors, of organisms. 2. the evolutionary tendency for
glands, and muscles on behavior. Centralist psy- the brain to increase in size. See encepha-
chology is essentially equivalent to centralism. lization; evolution of the brain.
2. more generally, the idea that mental activity cerea flexibilitas see catalepsy.
or mind occurs in or is a function of the brain cerebellar ataxia poor muscular coordination
alone. (see ataxia) due to damage in the cerebellum.
central limit theorem the statistical principle Individuals cannot integrate voluntary move-
that a linear combination of values (including ments and therefore find it difficult to stand or
the mean of those values) tends to be normally walk, feed themselves, and perform complex ac-
distributed over repeated samples as the sample tivities (e.g., playing the piano).
sizes increase, whether or not the population cerebellar cortex the gray matter, or
from which the observations are drawn is nor- unmyelinated nerve cells, covering the surface
mal in distribution. of the cerebellum.
central nervous system (CNS) the entire
cerebellum n. (pl. cerebella ) a portion of the
complex of neurons, axons, and supporting
hindbrain dorsal to the rest of the brainstem.
tissue that constitute the brain and spinal cord.
The cerebellum modulates muscular contrac-
The CNS is primarily involved in mental activi-
tions to produce smooth, accurately timed
ties and in coordinating and integrating incom-
movements; it helps maintain equilibrium by
ing sensory messages and outgoing motor
predicting body positions ahead of actual body
messages. Compare peripheral nervous sys-
movements, and it is required for some kinds of
tem.
motor conditioning.
central organizing trait see central trait.
cerebral arteriosclerosis a hardening of the
central pain pain that is caused by a disorder of arteries that supply the brain. See arterioscle-
the central nervous system, such as a brain rosis.
tumor or infection or injury of the spinal cord.
cerebral atrophy degeneration and shrinkage
central processing dysfunction impair- of the brain, usually due to aging, disease, or in-
ment in the analysis, storage, synthesis, and jury. It is marked by enlargement of the surface
symbolic use of information. Because these pro- clefts and inner cavities (ventricles) of the
cesses involve memory tasks, the dysfunction is brain. In normal aging there may be few or no
believed to be related to difficulties in learning. cognitive effects, but cerebral atrophy may be
central tendency the middle or center point of secondary to more serious disorders, such as
a distribution, estimated by a number of dif- cerebrovascular disease, encephalitis, Alzhei-
ferent statistics (e.g., mean and median). mer’s disease, or head injury. Also called brain
central trait any of a cluster of traits (e.g., com- atrophy.
passion, ambition, sociability, helpfulness) that cerebral cortex the layer of gray matter that
comprise the basic pattern of an individual’s per- covers the outside of the cerebral hemispheres
sonality. [defined by Gordon W. allport] in the brain and is associated with higher cogni-
centrifugal adj. directed away from the center. tive functions, such as language, learning, per-
97
cerebral dominance
ception, and planning. It consists mostly of liferation of new, normal cells. Although neu-
neocortex, which has six main layers of cells; rons do not proliferate after the central nervous
regions of cerebral cortex that do not have six system has reached maturity, cells of the glia do
layers are known as allocortex. Differences in continue to multiply into adulthood; in some
the cell structure of the layers led to the recogni- cases neuroglial cell growth is associated with
tion of distinct areas, called brodmann’s areas, hydrocephalus.
C many of which are known to serve different cerebral infarction the death of brain tissue
functions. due to an interruption of blood flow caused by
cerebral dominance 1. the control of lower rupture of a blood vessel, blockage of a blood
brain centers by the cerebrum or cerebral cortex. vessel by a clot, or a narrowing (stenosis) of a
2. the controlling or disproportionate influence blood vessel.
on certain aspects of behavior by one cerebral cerebral ischemia a condition in which brain
hemisphere (e.g., language is typically left- tissue is deprived of an adequate blood supply
lateralized in right-handed people). See domi- and thus lacks oxygen and nutrients. It is usually
nance; hemispheric lateralization. marked by loss of normal function of the af-
cerebral dysfunction any impairment in ce- fected area and may be accompanied by cere-
rebral processes, including disturbances of mem- bral edema. A brief interruption in blood
ory, language, attention, or executive functioning. supply—a transient ischemic attack (TIA)—
usually causes no serious damage. An inter-
cerebral edema an abnormal accumulation of
ruption lasting more than several minutes may
fluid in the intercellular spaces of brain tissues,
result in cerebral infarction. See cerebro-
which may be caused by injury, disease,
vascular accident; stroke.
cerebrovascular accident, or tumor. The condi-
tion results in swelling and a rise in intracerebral palsy (CP) a set of nonprogressive
cranial pressure; if uncorrected, this may movement and posture disorders that results
be followed by herniation of cerebral tissue from trauma to the brain occurring prenatally,
through weakened areas. It may be reversible un- during the birth process, or before the age of 5.
less the damage extends to the brainstem, where Symptoms include spasticity, uncontrolled
the effects can be fatal. The increase in intra- movements, paralysis, unsteady gait, and speech
cranial pressure may result in headaches and vi- abnormalities (see dysarthria) but may be ac-
sual disorders. Cerebral edema can also cause companied by disorders of any other brain func-
dementia that recedes when the defect is cor- tion, resulting in cognitive changes, seizures,
rected. visual defects, tactile impairment, hearing loss,
and mental retardation. CP is commonly classi-
cerebral electrotherapy (CET) the applica- fied into the following types: spastic, the most
tion of low-voltage pulses of direct electrical cur- common, resulting from damage to the motor
rent to the brain, occasionally used in the cortex, corticospinal tract, or pyramidal tract;
treatment of depression, anxiety, and insomnia. dyskinetic, resulting from damage to the basal
See electronarcosis. ganglia; ataxic, resulting from damage to the cer-
cerebral embolism the presence of a small ebellum; and mixed, in which more than one
mass of material in the blood vessels of the brain type is evident.
(see embolism), which blocks or impedes the cerebral syphilis a condition that results when
flow of blood to a part of the brain, resulting in untreated syphilis involves the cerebral cortex
an acute or chronic neurological deficit. See em- and surrounding meningeal membranes, caus-
bolic stroke; stroke. ing general paresis. The condition, which usu-
cerebral gigantism see sotos syndrome. ally develops about 10 years after the initial
cerebral hemisphere either half (left or right) infection, is marked by irritability, memory im-
of the cerebrum. The hemispheres are separated pairment, inability to concentrate, headaches,
by a deep longitudinal fissure but they are con- insomnia, and behavioral deterioration.
nected by commissural, projection, and associa- cerebral trauma any damage to the brain,
tion fibers so that each side of the brain normally which may be temporary or permanent, follow-
is linked to functions of tissues on either side of ing a blow to the head of sufficient severity to
the body. See also hemispheric lateraliza- produce a concussion, contusion, or laceration.
tion. cerebration n. any kind of conscious thinking,
cerebral hemorrhage any bleeding into the such as pondering or problem solving. —cere-
brain tissue due to a damaged blood vessel. The brate vb.
cause may be cerebrovascular disease, a ruptured cerebrocranial defect a deformity or dys-
aneurysm, a penetrating injury or blow to the function involving the cerebrum and the eight
head, or other factors. The neurological effects bones of the skull that form a protective layer
vary with the extent of the hemorrhage. Also around it. An example is the premature closing
called intracerebral hemorrhage. See hem- of the sutures of the skull, resulting in a displace-
orrhagic stroke; stroke. ment of cerebral tissues.
cerebral hyperplasia an abnormal increase in cerebrotonia n. the personality type that, ac-
the volume of brain tissue, usually due to a pro- cording to sheldon’s constitutional theory
98
change score
of personality, is associated with an ecto- review of case records to determine whether

morphic (linear, fragile) physique (see ecto- health care is necessary and whether the institu-
morph). Cerebrotonia is characterized by a tion and type of care are appropriate. 2. state
tendency toward introversion, restraint, inhibi- laws governing the right of an individual to de-
tion, love of privacy and solitude, and sensitiv- scribe himself or herself as a psychologist.
ity. —cerebrotonic adj. cervical angina see pseudoangina. C
cerebrovascular accident (CVA) a disorder Cesamet n. a trade name for nabilone.
of the brain arising from cerebrovascular CES-D abbreviation for center for epidemio-
disease, such as cerebral hemorrhage, cere- logic studies depression scale.
bral embolism, or cerebral thrombosis, result-
ing in temporary or permanent alterations in CET abbreviation for cerebral electro-
cognition, motor and sensory skills, or levels of therapy.
consciousness. This term is often used inter- CFS abbreviation for chronic fatigue syn-
changeably with stroke. Also called cerebral drome.
vascular accident. chain of behavior see behavior pattern.
cerebrovascular disease a pathological con- chakra n. in oriental philosophy, one of the
dition of the blood vessels of the brain. It may seven energy centers in the body. The chakras
manifest itself as symptoms of stroke or a tran- roughly correspond with the endocrine system.
sient ischemic attack. Also called cerebral Each chakra symbolizes different, ascending
vascular disease. See also cerebrovascular human needs and has a sound (mantra) and
accident. color associated with it. Focused awareness and
cerebrovascular insufficiency failure of the contemplation of the chakras may be practiced
cardiovascular system to supply adequate levels in yoga and in other therapeutic approaches
of oxygenated blood to the brain tissues. The and traditions.
condition usually arises when one of the four challenge 1. n. an obstacle appraised as an op-
main arteries supplying the brain, namely the portunity rather than a threat. A threat becomes
two carotid and two vertebral arteries, is inter- a challenge when the individual judges that his
rupted. It may also result from generalized arte- or her coping resources are adequate not only to
riosclerosis or the inability of the heart to overcome the stress associated with the obstacle
maintain adequate blood flow to the brain. Also but also to improve the situation in a measurable
called cerebral vascular insufficiency. way. 2. vb. to pose or face with an obstacle or
cerebrum n. the largest part of the brain, form- threat.
ing most of the forebrain and lying in front of challenged adj. describing an individual with a
and above the cerebellum. It consists of two ce- disability or handicap. The word is often con-
rebral hemispheres bridged by the corpus sidered to be euphemistic.
callosum. Each hemisphere is divided into four challenging behavior behavior that is dan-
main lobes: the frontal lobe, occipital lobe, gerous, or that interferes in participation in pre-
parietal lobe, and temporal lobe. The outer school, educational, or adult services, and often
layer of the cerebrum—the cerebral cortex— necessitates the design and use of special inter-
is intricately folded and composed of gray mat- ventions. The term is used principally in human
ter. Also called telencephalon. services in the United Kingdom and within edu-
certifiable adj. 1. describing people who, be- cational services in the United States and most
cause of mental illness, may be a danger to them- typically refers to behaviors of people with men-
selves or others and are therefore eligible to be tal retardation or related conditions.
institutionalized. See certification laws; CHAMPUS acronym for civilian health and
commitment laws. 2. having met the require- medical program of the uniformed ser-
ments to be formally recognized by the relevant vices.
licensing or sanctioning body. change agent 1. a specific causative factor or el-
certification n. 1. the formal process by which ement or an entire process that results in change,
an external agency affirms that a person has met particularly in the sense of improvement. In psy-
predetermined standards and has the requisite chotherapy research, a change agent may be a
knowledge and skills to be considered compe- component or process in therapy that results in
tent in a particular area. Certification applies to improvement in the behavior or psychological
individuals and accreditation applies to insti- adaptation of a patient or client. 2. an individual
tutions. See also credentialing. 2. the legal who instigates or implements change within an
proceedings in which appropriate mental health organization or group, such as a mental health
care professionals formally confirm that a per- professional who takes an active role in social
son has a mental disorder, which may result in policy planning, social action, and social engi-
commitment of that person. —certificated neering directed to improving community men-
adj. tal health.
certification laws 1. legislation governing the change score a score based on two or more mea-
admission of individuals to mental institutions, surements made on the same person over time.
including commitment proceedings as well as a The simplest change score is postscore minus
99
character
prescore. More complex change scores can also often pleasant and are not indicative of mental
be used to index, for example, the linearity of illness or psychological disorder. Also called
change over three, four, five, or more occasions Bonnet syndrome. [Charles Bonnet (1720–
of measurement. 1793), Swiss naturalist and philosopher]
character n. 1. the totality of an individual’s at- chart 1. n. a graphic representation of data. 2. vb.
C tributes and personality traits, particularly to create such a representation.
his or her characteristic moral, social, and reli- chastity n. the state of abstaining from illicit sex-
gious attitudes. Character is often used synony- ual intercourse or—by extension—from all sex-
mously with personality. 2. see character ual activity. In religious usage it also includes the
type. concept of not having sexual urges or impure
character analysis 1. in psychoanalysis, the thoughts. See also celibacy. —chaste adj.
treatment of a character disorder. 2. see chat n. see khat.
characterology.
chatterbox effect the conversational behavior
character development the gradual develop- of many people with hydrocephalus and mental
ment of moral concepts, conscience, religious retardation or with spina bifida. The person may
values or views, and social attitudes as an essen- appear quite fluent and sociable in conversa-
tial aspect of personality development. tions but does not communicate in a meaningful
character disorder formerly, in psychoanaly- manner, may tend to fabricate information as
sis, an alternative name for personality disor- long as it seems interesting to the listener, and
der. may be unable later to recall what was discussed.
characteristic n. 1. a quality of a person, espe- Also called cocktail-party syndrome.
cially any of the enduring qualities that define CHD abbreviation for coronary heart disease.
an individual’s nature or personality in relation
cheilophagia (chilophagia) n. the repeated
to others. 2. any distinguishing feature of an or-
biting of one’s own lips.
ganism, object, place, process, condition, or
event. chemical antagonism see antagonist.
characterization n. a description of psychochemical castration the administration of
logical aspects of an individual, including ascrip- antiandrogens for the purposes of managing
tions of personality traits, characteristics, or advanced prostate cancer or, more controver-
motives. —characterize vb. sially, to reduce sexual drive in repeat sex offend-
character neurosis in psychoanalysis, a for- ers. Research has shown that a minority of sex
mer name, used interchangeably with neurotic offenders will offend again after chemical castra-
character, for personality disorder. tion, indicating that sex drive is not the only
cause of sexual offenses.
characterology n. 1. formerly, the branch of
psychology concerned with character and per- chemical dependence see substance de-
sonality. Also called character analysis. 2. a pendence.
pseudoscience in which character is “read” by chemoreceptor trigger zone (CTZ) a cluster
external signs, such as hair color or facial type. of cells in the medulla oblongata that is sensi-
character strength a positive trait, such as tive to certain toxic chemicals and reacts by
kindness, teamwork, or hope, that is morally val- causing vomiting. The trigger zone is particu-
ued in its own right and contributes to the fulfill- larly sensitive to narcotics and responds by pro-
ment of the self and others. Also called human ducing dizziness, nausea, and vomiting, the
strength. See positive psychology. precise effects depending on the agent and the
dosage. See also area postrema.
character structure the organization of the
traits and attributes that make up a person’s chemotherapy n. the use of chemical agents
character. to treat diseases, particularly cancer, in which
case it is contrasted with radiation therapy.
character traits in trait conceptions of person-
ality functioning, dispositional tendencies hav- —chemotherapeutic adj. —chemothera-
ing to do with values, motives, and the pist n.
regulation of behavior in accord with moral and chi (qi) n. in oriental philosophy, life-force en-
ethical standards. ergy (from Chinese, “energy”). Blockages in chi
character type 1. see personality type. 2. in are believed to create illness. The equivalent
psychoanalytic theory, a personality type de- Hindu concept is prana (Sanskrit, literally:
fined by the kinds of defense mechanism used “breath of life”). See also acupuncture.
(e.g., a phobic character) or fixation at a par- chibih n. see susto.
ticular stage in psychosexual development Chicago school a school of psychology that
(e.g., an oral personality). emerged at the University of Chicago in the early
Charles Bonnet syndrome complex visual 20th century, associated with psychologists
hallucinations without delusions or the loss of John dewey, James R. angell, and Harvey Carr
insightful cognition, typically seen in older (1873–1954). Their approach, called function-
adults who have severe visual impairment. Such alism, was related to the act psychology of
hallucinations are usually nonthreatening and Franz Brentano (1838–1917); it was an attempt
100
childhood disintegrative disorder
to modify the subject matter of psychology by parents’ capacity to address children’s needs,
introducing the Darwinian idea that mental ac- and providing the court with a recommendation
tivities subserve an adaptive biological action regarding child custody arrangements. See
function that should be the focus of psychology. primary caretaker standard.
child abuse harm to a child caused by a parent child find in the U.S. educational system, an or-
or other caregiver. The harm may be physical (vi- ganized screening and identification program, C
olence), sexual (violation or exploitation), psy- directed by each state’s Department of Educa-
chological (causing emotional distress), or tion, that identifies preschool children in need
neglect (failure to provide needed care). See also of particular services and evaluates their readi-
battered-child syndrome. ness for school entry as well as their risk for de-
child advocacy any organized and structured velopmental disabilities.
interventions on behalf of children by profes- child-focused family a family in which the
sionals or institutions, often in relation to such children’s needs are paramount, sometimes to a
issues as special parenting needs, child abuse, point where they dominate the family con-
and adoption or foster care. stellation and the parents’ needs become sec-
child analysis the application of psychoana- ondary. Also called child-centered family.
lytic principles (considerably modified from child guidance a mental health approach for
those of classical psychoanalysis) to the children that focuses not only on treatment but
treatment of children. In his first and most fa- also on the prevention of possible future disor-
mous case, Sigmund freud analyzed 5-year-old ders by offering instruction, information, and
little hans by having the child answer ques- therapeutic aid to the child and his or her family.
tions through his father, but Freud never directly Child guidance services and treatment are typi-
analyzed a child patient. Pioneers in the field are cally provided by specialized child-guidance clin-
Melanie klein, who developed the psychoana- ics. The child-guidance movement emerged in
lytic play technique to achieve a deep analy- the early 20th century and was at its strongest
sis of the child’s unconscious, and Anna freud, from the 1940s to 1970s.
whose method was more pedagogical and en- childhood n. 1. the period between the end of
couraged ego development. See also play infancy (about 2 years of age) and the onset of
therapy. puberty, marking the beginning of adoles-
Child Behavior Checklist (CBCL) a stan- cence (10–12 years of age). This period is some-
dardized instrument used to assess the behav- times divided into (a) early childhood, from 2
ioral problems and competencies of children years through the preschool age of 5 or 6 years;
between the ages of 4 and 18 years (a separate (b) middle childhood, from 6 to 8–10 years of
version is available for assessing the behavior of age; and (c) late childhood or preadolescence,
children ages 2 to 3). The CBCL is administered which is identified as the 2-year period before
to parents, who describe their children’s behav- the onset of puberty. 2. the period between 3 or
ior by assigning a rating to each of the more than 4 years of age and about 7 years of age. In this
100 items on the checklist. The items assessed context, childhood represents the period after
range from “internalizing behaviors” (e.g., fear- weaning and before children can fend for them-
ful, shy, anxious, inhibited) to “externalizing selves. [defined by U.S. anthropologist Barry
behaviors” (e.g., aggressive, antisocial, under- Bogin (1950– )]
controlled). [developed in 1983 by U.S. psychol- childhood amnesia the inability to recall
ogists Thomas M. Achenbach (1940– ) and events from early childhood (see early mem-
Craig S. Edelbrock (1951– )] ory). Childhood amnesia has been attributed to
child care 1. the daytime care of children by a the facts that (a) cognitive abilities necessary for
nursery or childminder while parents are at encoding events for the long term have not yet
work. 2. the full-time residential care of children been fully developed and (b) parts of the brain
who have no other home or whose home life is responsible for remembering personal events
seriously troubled. have not yet matured. Also called infantile
child care facilities facilities licensed to pro- amnesia.
vide regular out-of-home care to children during childhood autism see autistic disorder.
the working day. Child care facilities may be pri- childhood depression a major depressive
vately run but may also be associated with firms, episode that occurs in childhood. Defining
churches, or social agencies. Such a facility is symptoms may differ from those of major de-
often referred to as a day care center. pressive episodes in adults in that irritable mood
child custody the care, protection, and supervi- is more characteristic than depressed mood, and
sion of a child. In certain legal proceedings, such failure to make expected weight gains often re-
as divorce or separation, the court may grant cus- places an actual weight loss.
tody to one or both parents following a child childhood disintegrative disorder in
custody evaluation. DSM–IV–TR, a pervasive developmental dis-
child custody evaluation a procedure, often order characterized by a significant loss of two
conducted by clinical psychologists, that in- or more of the following: previously acquired
volves evaluating parenting behavior, analyzing language skills, social skills or adaptive behavior,
101
childhood disorder
bowel or bladder control, play, or motor skills. may be treated concurrently in group or family
This regression in functioning follows a period therapy.
of normal development and occurs between the children in need of supervision (CHINS)
ages of 2 and 10. Impairments in social interac- children who commit offenses that may lead the
tion and communication are also evident. court to act in service to them when they cannot
C childhood disorder any social, emotional, be- be adequately controlled by parents or guard-
havioral, or educational disorder of childhood. ians. The child will typically appear before the
court and receive some form of sanction. The
childhood fears fears occurring at different crimes that lead to a CHINS classification are
stages of childhood, such as fear of strangers,
“status offenses,” such as truancy, running away
which usually develops around 8 months of age,
from home, and misbehavior at school.
and fear of heights, which emerges after the
child learns to crawl. The content of fear changes Children’s Depression Inventory (CDI) a
for children from 2 to 6 years of age, with fears of self-report questionnaire, based on the beck de-
darkness, animals, doctors, ghosts, monsters, pression inventory, designed to assess the se-
and storms being common occurrences that usu- verity of depression in children aged between 7
ally pass in a few months or years without treat- and 17 years. Intended primarily as a research
ment. tool, the CDI comprises 27 items that each con-
sist of three statements reflecting different levels
childhood neurosis in Freudian theory, the of severity of a particular symptom. For each
development of psychological symptoms in item, the participant chooses the statement
childhood in response to efforts of defense that best describes himself or herself during the
against conflict. previous two weeks. [originally published in
childhood psychosis a psychotic disorder 1977 by U.S. clinical psychologist Maria Kovacs
with onset in childhood: In DSM–IV–TR, the de- (1944– )]
fining features of psychotic disorders are essen- Children’s Embedded Figures Test (CEFT)
tially equivalent across all age groups. a version of the embedded figures test of cog-
Historically, the term has been used much more nitive style that is designed for children aged 5 to
widely to denote any of a variety of disorders or 12 years. Participants are required to detect a
mental conditions of children that result in se- simple shape within 25 increasingly complex
vere functional impairment, encompassing, for figures or colored backgrounds. [developed in
example, mental retardation and pervasive de- 1971 by U.S. clinical psychologist Stephen A.
velopmental disorders. Karp (1928– ) and Norma Konstadt]
childhood schizophrenia schizophrenia Children’s Manifest Anxiety Scale
with onset prior to age 12: In DSM–IV–TR, the (CMAS) a 53-item modification of the taylor
defining features of schizophrenia are essentially manifest anxiety scale that is appropriate for
equivalent across all age groups. Historically, the children. Originally developed in 1956 by U.S.
term has been used more widely to denote psychologists Alfred Castaneda (1923– ), Boyd
schizophrenic behavior that appears early in life, R. McCandless (1915–1975), and David S.
encompassing pervasive developmental dis- Palermo (1929–2011), the CMAS was subse-
orders and autistic disorder in particular. quently revised in 1978 by U.S. educational psy-
child molestation child sexual abuse: any chologists Cecil R. Reynolds (1952– ) and Bert
sexual behavior toward a child by an adult. See O. Richmond (1929– ). This Revised Children’s
also emotional incest; ritual abuse. Manifest Anxiety Scale (RCMAS) comprises 37
yes–no items measuring the nature and level of
child neglect the denial of attention, care, or af- anxiety symptoms in children and adolescents
fection considered essential for the normal de- aged between 6 and 19 years.
velopment of a child’s physical, emotional, and
intellectual qualities, usually due to indifference,
Children’s Personality Questionnaire
(CPQ) a 140-item self-report inventory for chil-
disregard, or impairment of the child’s care-
dren aged 8 to 12 years that is based on
givers. See also parental rejection.
cattell’s personality trait theory. It as-
child pornography pornographic material sesses 14 dimensions of personality (e.g., shy
featuring children. This may include written sto- versus bold, self-assured versus apprehensive,
ries, pictures, or videos of naked children or of sober versus enthusiastic) conceptualized as use-
children engaging in sexual activity. Child por- ful in evaluating, understanding, and predicting
nography is illegal in the United States, and pro- personal adjustment, social development, and
duction or circulation of such materials is academic performance. [originally developed in
usually vigorously prosecuted. 1959 by U.S. educator Rutherford Burchard Por-
child psychotherapy psychotherapy for chil- ter (1909–2002) and British-born U.S. personal-
dren up to the age at which they reach puberty. ity psychologist Raymond Bernard Cattell
The focus may be on emotions, cognitions, or (1905–1998)]
behavior. The level of parental involvement is child support a legally enforceable require-
typically dependent upon the age of the child, ment that parents meet the economic and edu-
type of problem, or approach used. The child cational needs of their children. This includes
102
cholinergic drug
providing the financial means to meet these ing it a lengthy half-life and a consequent
needs. long-acting anxiolytic effect. Its use in the man-
child visitation in the context of divorce or sit- agement of anxiety and insomnia has been
uations in which children have been legally largely supplanted by benzodiazepines with less
placed in the care of another (e.g., foster care), complicated metabolism and more predictable
the permission granted by the court allowing a half-lives, but it remains in common use to pro-
tect against the effects of alcohol withdrawal. It C
noncustodial parent some time to visit the child,
provided this contact remains in the best inter- is available in oral and injectable form. Because
ests of the child. Also called visitation rights. of erratic absorption, intramuscular administra-
tion is not advised. U.S. trade name: Librium.
chilophagia see cheilophagia.
chloride channel see ion channel.
chimeric stimulation a procedure, used by
Roger sperry in the split-brain technique (see chlorpromazine (CPZ) n. the first synthesized
commissurotomy), for studying the functions antipsychotic agent, introduced into clinical
of the two cerebral hemispheres of the brain. In a use in Europe in 1952 and in Canada and the
typical experiment participants are shown an United States in 1954. It was initially used to re-
image of a chimeric face, consisting of the left duce presurgical anxiety and deepen conscious
half of one person’s face joined to the right half sedation during surgical procedures; its anti-
of another person’s face. In participants with a psychotic effects were discovered seren-
severed corpus callosum (i.e., a split brain), one dipitously. This low-potency phenothiazine
hemisphere perceives only one face, while the provided a degree of behavioral control and
other hemisphere perceives the other, suggest- management of positive psychotic symptoms
ing that there are two separate spheres of con- previously unavailable and ushered in the mod-
scious awareness located in the two ern era of psychopharmacological treatment.
hemispheres. See also right-hemisphere con- However, although effective in managing the
sciousness. acute symptoms of schizophrenia, acute mania,
and other psychoses, chlorpromazine caused
chiropractic n. an alternative health care sys-
a number of unwanted adverse effects, includ-
tem concerned with the relationship between
ing neuromuscular rigidity and other extra-
the structure of the body (particularly the spine)
pyramidal symptoms, sedation, orthostatic
and disease processes. Treatment comprises
hypotension, cognitive slowing, and long-term
noninvasive drug-free methods, primarily ma-
association with tardive dyskinesia. Although
nipulations and adjustments to the body, theo-
chlorpromazine has been largely supplanted by
rized to restore proper nerve functioning and to
newer antipsychotic agents, it is still used as a
promote health. See also complementary and
referent for dose equivalency of other anti-
alternative medicine. —chiropractor n.
psychotics. It has also been used in lower doses
chi-square distribution ( 2 distribution) to treat nausea, vomiting, and intractable hic-
the distribution of the sum of a set of independ- cups. U.S. trade name: Thorazine.
ent squared normal random deviates. If p inde-
chlorprothixene n. a low-potency antipsy-
pendent variables are involved, the distribution
chotic of the thioxanthene class, similar in its
is said to have p degrees of freedom. The chi-
effects to other thioxanthenes. U.S. trade names:
square test is based upon it.
Taractan; Taractin.
chi-square test a measure of how well a theo-
choice n. a decision-making problem in which
retical probability distribution fits a set of data. If
a person has to indicate a preference for one of
values x1, x2, … xp are observed o1, o2, … op times
a set of alternatives. See also binary choice.
and are expected by theory to occur e1, e2, … ep
2 —choose vb.
times, then chi-square is calculated as (o1 – e1) /e1
2
+ (o2 – e2) /e2 + … Tables of chi-square for differ- choice behavior the selection of one of many
ent degrees of freedom can be used to indicate available options or behavioral alternatives.
the probability that the theory is correct. Also choleric type a type of temperament character-
called chi-square procedure. ized by irritability and quick temper, as de-
chloral hydrate a short-acting depressant of scribed by Roman physician Galen (129–199 ce).
the central nervous system, first synthesized in cholesterol n. a steroid derivative abundant in
1832 and formerly widely used clinically, chiefly animal tissues, found especially in foods rich in
as a hypnotic. It is occasionally still used to in- animal fats. Cholesterol is a constituent of
duce sleep, but its use is limited by its potential plasma membranes, the precursor of other ste-
toxicity. U.S. trade name: Aquachloral. See also roids (e.g., the sex hormones), and a component
knockout drops. of plasma lipoproteins, especially low-density
chlordiazepoxide n. the first commercially lipoproteins (LDLs), which are believed to play
available benzodiazepine anxiolytic. De- an important role in forming atherosclerotic
veloped in 1957 and in clinical use in the early plaques (see atherosclerosis).
1960s, it became one of the most heavily pre- cholinergic drug any pharmacological agent
scribed medications ever developed. It is charac- that stimulates activity in the parasympa-
terized by extensive metabolism in the liver and thetic nervous system because it potentiates
possesses a number of metabolic products, giv- the activity of acetylcholine or has effects
103
cholinesterase
similar to this neurotransmitter. Cholinergic age intelligence. The trait is transmitted by an

drugs include such alkaloids as physostigmine autosomal dominant gene (see acrocephalo-
and pilocarpine; bethanechol; and syndactyly). Also called acrocephalosyndac-
anticholinesterases (cholinesterase inhibi- tyly Type III; Saethre–Chotzen syndrome.
tors; e.g., edrophonium, neostigmine, and [F. Chotzen, German physician]
pyridostigmine); they are used for such pur- chrematisophilia n. sexual arousal obtained
C poses as treating myasthenia gravis, glaucoma, by paying for sex, as opposed to having sexual
and urinary retention. Also called parasympa- relations with a willing partner who is not a
thetic drug; parasympathomimetic drug. prostitute.
cholinesterase (ChE) n. an enzyme that splits chromosomal aberration 1. an abnormal
acetylcholine into choline and acetic acid, change in the structure of a chromosome. 2. a
thus inactivating the neurotransmitter after its congenital defect that can be attributed to an ab-
release at a synaptic junction. Cholinesterase oc- normal chromosome. See autosomal aberra-
curs in two forms: acetylcholinesterase (AChE), tion; sex-chromosomal aberration.
found in nerve tissue and red blood cells;
and butyrylcholinesterase (BuChE, or pseudo- chromosome n. a usually invisible strand or fil-
cholinesterase [PChE]), found in blood plasma ament composed of nucleic acid (mainly dna in
and other tissues. Drugs that block the ability of humans) and proteins that carries the genetic, or
this enzyme to degrade acetylcholine are called hereditary, traits of an individual. Located in the
cholinesterase inhibitors (ChEIs, or acetyl- cell nucleus, chromosomes are visible, through a
cholinesterase inhibitors [AChEIs], or anti- microscope, only during cell division. The nor-
cholinesterases). Some ChEIs are used clinically mal human complement of chromosomes totals
as nootropics to slow the progression of de- 46, or 23 pairs (44 autosomes and 2 sex chro-
mentia in Alzheimer’s disease; there is specula- mosomes), which contain more than 30,000
tion that agents acting on both forms of the genes (see genome). Each parent contributes
enzyme may be beneficial in reducing the forma- one chromosome to each pair, so a child receives
tion of the plaques and neurofibrillary tan- half its chromosomes from its mother and half
gles associated with the disease. from its father. —chromosomal adj.
chorea n. irregular and involuntary jerky move- chromosome 4, deletion of short arm a
ments of the limbs and facial muscles. Chorea is chromosomal disorder involving absence of a
associated with various disorders, including portion of chromosome 4, resulting in micro-
huntington’s disease and Sydenham’s chorea cephaly (small head), visual defects, severe men-
(formerly known as Saint Vitus’s dance), which tal retardation, and indifference to painful
occurs as a complication of a streptococcal stimuli. Until 1965 the condition was considered
infection (e.g., rheumatic fever). —choreal adj. a variation of cri du chat syndrome, involving
—choreic adj. chromosome 5, although the cat-cry effect was
rarely noted.
choreomania n. an uncontrollable urge to
dance, especially in a frenzied, convulsive man- chromosome 5, deletion of short arm see
ner. Major outbreaks of choreomania occurred cri du chat syndrome.
in the European dance epidemics of the Middle chromosome 18, deletion of long arm a
Ages. Also called dancing madness; dancing chromosomal disorder characterized by micro-
mania. cephaly (small head), deafness, and mental retar-
chorion n. the outermost of the membranes that dation associated with the absence of part of the
surround and protect the developing embryo. long arm of chromosome 18. Reduced muscle
In most mammals (including humans) a section tone and nystagmus (involuntary eye move-
of it forms the embryonic part of the placenta. ments) are other neurological effects observed in
—chorionic adj. affected individuals.
chorionic villus sampling (CVS) a method chromosome abnormality an abnormality
of diagnosing diseases and genetic and chromo- that is evidenced by either an abnormal number
somal abnormalities in a fetus. Samples of cells of chromosomes or some alteration in the struc-
of the chorionic villi, the microscopic projec- ture of one or more chromosomes.
tions in the protective membrane surrounding chromosome disorder any disorder caused by
the fetus, are obtained for analysis of bacteria, a defect in the structure or number of one or
metabolites, or DNA. Unlike amniocentesis, more chromosomes. Such disorders can result
this procedure can be carried out in the first tri- from autosomal aberrations or sex-
mester of pregnancy. chromosomal aberrations.
Chotzen’s syndrome an inherited condition chromosome-13 trisomy a chromosomal
in which an abnormally shaped head due to pre- syndrome involving an extra chromosome 13,
mature closing of one or more of the cranial su- resulting in the birth of an infant with a variety
tures, usually involving the coronal suture, is of defects, including mental retardation; cleft lip
accompanied by webbing of the fingers and toes. and palate; polydactyly (extra fingers or toes);
Mental retardation may be associated with the cerebral anomalies; and ocular abnormalities
disorder, but affected children often have aver- such as missing or very small eyes, cataracts, and
104
chronic schizophrenia
defects in the iris. Also called D trisomy; chronic mental illness a mental illness that
Patau’s syndrome; trisomy 13; trisomy continues for a prolonged period of time.
13–15. chronic mood disorder a mood disorder,
chronic adj. denoting conditions or symptoms such as dysthymic disorder or cyclothymic
that persist or progress over a long period of time disorder, in which symptoms rarely remit.
and are resistant to cure. Compare acute. chronic motor or vocal tic disorder in C
chronic adjustment disorder see adjust- DSM–IV–TR, a tic disorder characterized by
ment disorder. motor or vocal tics (but not both) for a period of
more than 1 year, during which any period with-
chronic alcoholism habitual, long-term de-
out tics lasts for no more than 3 months. The dis-
pendence on alcohol (see alcohol depend-
order has an onset before the age of 18. Compare
ence). See also gamma alcoholism.
tourette’s disorder.
chronically accessible constructs mental chronic myofascial pain (CMP) a
contents (e.g., ideas or categories) that are fre- musculoskeletal disorder characterized by
quently used and therefore come to mind partic- pain and stiffness that is restricted to certain lo-
ularly readily. cations on the body, called “trigger points.” It
chronically suicidal describing an individual is nonprogressive, nondegenerative, and non-
with a history of multiple suicide attempts or ep- inflammatory. Chronic myofascial pain is some-
isodes that include serious thoughts about or times referred to as myofascial pain syndrome
plans for committing suicide. Such a history (MPS), especially in older literature.
often occurs in individuals with borderline chronic obstructive pulmonary disease
personality disorder. (COPD) a group of lung diseases, most com-
chronic anxiety a persistent, pervasive state of monly chronic bronchitis and emphysema, that
apprehension that may be associated with as- are characterized by limited airflow with varying
pects of a number of anxiety disorders. These in- degrees of lung-tissue damage and alveolar (air-
clude uncontrollable worries in generalized sac) enlargement. Marked by coughing, wheez-
anxiety disorder, fear of a panic attack in ing, and shortness of breath, COPD is caused by
panic disorder, and obsessions in obsessive- cigarette smoking, exposure to other irritants
compulsive disorder. and pollutants, lung infections, or genetic fac-
chronic brain disorder any disorder caused tors. Individuals with COPD frequently experi-
by or associated with brain damage and produc- ence depression, anxiety, and problems with
ing permanent impairment in one or more areas sexual function; they also sometimes have cog-
of brain function (cognitive, motor, sensory, and nitive and neuropsychological difficulties that
emotional). Such disorders may arise from may be associated with chronic deficiencies of
trauma, stroke, infection, degenerative diseases, oxygen to the brain. In addition to medical treat-
or many other conditions. In older literature, ments, behavioral interventions (e.g., those that
these disorders are also referred to as chronic promote smoking cessation and exercise), psy-
brain syndrome. chotherapy, and treatment with psychoactive
drugs can benefit patients with this condition.
chronic care long-term care and treatment of Also called chronic obstructive lung dis-
patients with long-standing health care prob- ease.
lems.
chronic pain pain that may have been caused
chronic fatigue syndrome (CFS) an illness by actual tissue damage, disease, or emotional
characterized by often disabling fatigue, de- trauma but continues to occur despite all medi-
crease in physical activity, and flulike symp- cal and pharmacological efforts at treatment.
toms, such as muscle weakness, swelling of the Cognitive factors and beliefs influence the
lymph nodes, headache, sore throat, and some- course of rehabilitation and the subjective expe-
times depression. The condition is typically not rience of pain and may lead to maladaptive
diagnosed until symptoms have been ongoing avoidance behaviors and family problems if left
for several months and it can last for years. The unattended.
cause is unknown, although certain viral infec-
chronic posttraumatic stress disorder a
tions can set off the illness.
form of posttraumatic stress disorder that
chronic illness illness that persists for a long is diagnosed when the symptoms persist over a
period. Chronic illnesses include many major period of more than 2 years, regardless of when
diseases and conditions, such as heart disease, they first appeared.
cancer, diabetes, and arthritis. Disease manage- chronic psychosis 1. a delusional or hallucina-
ment is important when dealing with chronic tory state that persists indefinitely. 2. a former
illness; this includes ensuring adherence to treat- name for chronic schizophrenia. 3. histori-
ment and maintaining quality of life. cally, any irreversible disorder of cognition,
chronicity n. 1. the state of being chronic. 2. mood or affect, and behavior.
see social breakdown syndrome. chronic schizophrenia schizophrenia of any
chronic mania a manic state that persists in- type—paranoid, disorganized, catatonic, or un-
definitely. differentiated—in which the symptoms persist
105
chronic tic disorder
for an extended period and are generally resis- callosal sulcus. It is a component of the limbic
tant to treatment. It is contrasted with acute system. Also called callosal gyrus; cingulate
schizophrenic episodes, in which the symp- cortex; gyrus cinguli.
toms are florid (blatant) but transient. cingulotomy n. a procedure used in the treat-
chronic tic disorder any tic disorder that ment of chronic pain in which electrodes are
C lasts for more than a year. See chronic motor used to destroy portions of the cingulum bundle.
or vocal tic disorder; tourette’s disorder. It is also, albeit rarely, used in the treatment of
chronobiology n. the branch of biology con- some chronic mental disorders (e.g., obsessive-
cerned with biological rhythms, such as the compulsive disorder) that have not re-
sleep–wake cycle. sponded to other, nonsurgical forms of treat-
ment. Also called cingulumotomy.
chronological age (CA) the amount of time
elapsed since an individual’s birth, typically ex- circadian dysrhythmia a disruption of the
pressed in terms of months and years. Also called normal cycles of wakefulness and sleep. See cir-
calendar age; life age. cadian rhythm sleep disorder.
chronotaraxis n. a condition of time confusion circadian rhythm any variation in physiologi-
cal or behavioral activity that repeats at approxi-
in which the individual tends to underestimate
mately 24-hour intervals, such as the sleep–
or overestimate the passage of time or is con-
wake cycle. Also called diurnal rhythm. See
fused about the time of day or day of the week.
also biological rhythm.
chronotaxis n. see dischronation.
circadian rhythm sleep disorder in DSM–
chronotherapy n. a treatment for circadian IV–TR, a sleep disorder that is due to a mismatch
rhythm sleep disorders that systematically between the sleep–wake schedule required by a
moves bedtime progressively later by intervals person’s environment and his or her circadian
(phase delays) until it approaches the desired sleep–wake pattern, resulting in excessive sleepi-
bedtime. ness or insomnia. In the delayed sleep-phase
chunking n. 1. the process by which the mind type, sleep onset and awakening times are later
sorts information into small, easily digestible than is socially typical or appropriate and the
units (chunks) that can be retained in short- person is unable to fall asleep and wake up at a
term memory. As a result of this recoding, one desired earlier time. In the jet-lag type, which af-
item in memory (e.g., a keyword or key idea) can fects people who repeatedly travel across two or
stand for multiple other items (e.g., a short list of more time zones, sleepiness and alertness occur
associated points). The capacity of short-term at times inappropriate to the local time. In the
memory is believed to be constant for the num- shift-work type, sleep disruption is produced by
ber of individual units it can store (see seven recurrent changes in work shifts; it is character-
plus or minus two), but the units themselves ized by insomnia during the major sleep period
can range from simple chunks (e.g., individual or excessive sleepiness during the major wake
letters or numbers) to complex chunks (e.g., period. This disorder was formerly called sleep–
words or phrases). The exact number of chunks wake schedule disorder. See dyssomnia. See
remembered can depend on the size of each also disorders of the sleep–wake cycle
chunk or the subunits contained within each schedule.
chunk. 2. the associated principle that effective circle of support a group of people who pro-
communication between humans depends on vide support for an individual. For a person with
sorting information into units that do not ex- a developmental disability, the circle often in-
ceed the mind’s capacity to chunk them (the cludes family members, friends, acquaintances,
chunking limit). This has implications for the coworkers, and sometimes service providers or
content and layout of written documents, dia- coordinators, who meet on a regular basis and
grams and visual aids, websites, and so on. For help the individual accomplish personal goals.
example, any list of more than nine bullet points These goals are selected based on extensive and
should normally be subdivided into two or more recurrent review of the person’s past and current
shorter lists. [coined by U.S. cognitive psycholo- preferences and interests; they are addressed one
gist George Armitage Miller (1920– ) in 1956] stage at a time.
cigarette smoking a common form of sub- circuit resistance training a series of differ-
stance abuse. See nicotine; nicotine dependent exercises set out in a specific order, with a
ence; tobacco. specific time or number of repetitions for each
Cinderella syndrome behavior in childhood exercise. The type and order of exercises will be
based on the child’s belief of being a set according to their use as rehabilitation—
“Cinderella,” or a victim of parental rejection, health-related exercise for individuals with spi-
neglect, or abuse. nal cord injuries, diabetes, obesity, and other
conditions—or as fitness training for athletes.
cingulate gyrus a long strip of cerebral cor-
tex on the medial surface of each cerebral hemi- circular behavior any action that stimulates a
sphere. The cingulate gyrus arches over and similar action in others, such as yawning or
generally outlines the location of the corpus laughing. Also called circular response.
callosum, from which it is separated by the circular questioning a technique used in
106
classical
some methods of family therapy to yield infor- of normal liver function. In most cases, it is a
mation about the dynamics and relationships in consequence of alcohol abuse, although it may
a family. For example, one family member may also be due to congenital defects involving meta-
be asked to answer a question about who in the bolic deficiencies, exposure to toxic chemicals,
family is most depressed; subsequent family or infections (e.g., hepatitis). —cirrhotic adj.
members each respond to the same question. CISD abbreviation for critical-incident stress
This method of questioning everyone in the “cir- C
debriefing.
cle” is intended to elicit the various perspectives
cissa n. a craving for unusual foods or
within the group.
nonnutritive substances while pregnant. See also
circumlocution n. 1. a mode of speaking char- pica.
acterized by difficulty or inability in finding the citalopram n. an antidepressant of the ssri
right words to identify or explain an object that class. It exerts its action by blocking the
has been perceived and recognized. It involves presynaptic serotonin transporter, preventing
the use of a variety of words or phrases that indi- reabsorption of serotonin into the presynaptic
rectly communicate the individual’s meaning. neuron and thereby increasing levels of available
Circumlocution can be a manifestation of serotonin in the synaptic cleft without in-
anomia caused by damage to the left posterior creasing overall levels of serotonin in the brain.
temporal lobe of the brain, but in some cases it is U.S. trade name: Celexa.
an indication of disorganized thought processes,
cittosis n. an abnormal desire for unusual foods
as in schizophrenia. See circumstantiality. 2.
or nonnutritive substances. See cissa; pica.
a style of speaking used consciously by healthy
individuals to convey meaning indirectly, so civil commitment a legal procedure that per-
that the meaning is inferred by the listener. mits a person who is not charged with criminal
conduct to be certified as mentally ill and to be
circumplex model of personality and institutionalized involuntarily.
emotion a type of model for determining the
degree of similarity between personality traits Civilian Health and Medical Program of
and emotions by depicting in a circular form the the Uniformed Services (CHAMPUS) the
relations and interactions between those traits medical insurer that since 1967 has provided
and emotions. Elements adjacent to one another and paid for health care to U.S. military retirees
on the circle are highly similar (positively corre- and families and surviving family members of
lated); the similarity (and correlation) between deceased military sponsors. Many new benefits
elements declines as the distance between them have been added since the program was first
on the circle increases. Certain elements may be established. The current program is called
completely unrelated to each other (a correla- TRICARE.
tion of 0). Elements opposite each other on the CJD abbreviation for creutzfeldt–jakob dis-
circle are highly dissimilar (negatively corre- ease.
lated) and represent dimensional extremes (e.g., CL abbreviation for comparison level.
agreeableness versus contrariness, joy versus sor- claims review an evaluation of the appropri-
row, pessimism versus optimism). ateness of a claim for payment for a medical or
circumscribed belief a narrowly defined de- mental health service rendered. It will consider
lusional belief held by some people with para- whether the claimant is eligible for reimburse-
noia or brain damage who otherwise seem to ment, whether the charges are consistent with
function entirely normally. For example, such customary fees or published institutional rates,
people may believe they are being persecuted by and whether the service was necessary.
the CIA, be convinced that they are Jesus, or sus- CLAlt abbreviation for comparison level for
pect that the interviewer has hidden hostility to- alternatives.
ward them. The delusional belief system is clang association an association of words by
generally highly consistent and resistant to dissimilarity of sound rather than meaning. Clang
proof and appears to function separately from association occurs as a pathological disturbance
other beliefs held by the same person. in manic states and schizophrenia. Also called
circumstantiality n. circuitous, indirect clanging.
speech in which the individual digresses to give clarification n. a therapist’s formulation, in
unnecessary and often irrelevant details before clearer terms and without indicating approval or
arriving at the main point. An extreme form, disapproval, of a client’s statement or expression
arising from disorganized associative processes, of feelings. Clarification goes further than re-
may occur in schizophrenia, obsessional disor- statement and reflection of feeling but stops
ders, and certain types of dementia. Circum- short of interpretation.
stantiality differs from tangentiality in that classical adj. denoting a style, mode of opera-
the main point is never lost but rather accompa- tion, or function that was typical or standard at
nied by a large amount of nonessential informa- some time in the past. In psychology, it was ap-
tion. plied to pavlovian conditioning to contrast it
cirrhosis n. a chronic liver disease marked by with newly recognized operant conditioning
widespread formation of fibrous tissue and loss when the distinction between the two forms of
107
classical conditioning
learning was pointed out by B. F. skinner in classifying disorders founded on the assumption
1938. that there are clear-cut differences between dis-
classical conditioning see pavlovian con- orders.
ditioning. classification n. in clinical psychology and psy-
classical depression a major depressive epi- chiatry, the grouping of mental disorders on the
C sode characterized by intense sadness, difficulty basis of their characteristics or symptoms. See
in concentrating, psychomotor retardation, also dsm–iv–tr; international classifica-
decreased appetite, insomnia, and weight loss, as tion of diseases; nosology. —classify vb.
well as psychotic features (i.e., delusions or hal- classification table a table (usually two-
lucinations). It is often thought to be proto- dimensional) in which the number of cases in a
typical of depressive disorders. sample are arranged on the basis of their joint
classical paranoia as conceptualized in the membership in the row and column classes of
19th century by German physician Karl Ludwig the table.
Kahlbaum (1828–1899) and later refined by Ger- classroom-behavior modification an in-
man psychiatrist Emil Kraepelin (1856–1926), a structor’s use of basic learning techniques, such
rare disorder characterized by elaborate, fixed, as conditioning, to alter the behavior of the stu-
and systematic delusions, usually of a dents within a learning environment. Spe-
persecutory, grandiose, or jealous character, that cifically, classroom behavior modification may
develop insidiously, cannot be accounted for by utilize such methods as adjusting classroom seat-
any psychiatric disorder, and exist in the context ing, providing a flexible time deadline for assign-
of preserved logical and orderly thinking. The ments, or altering the lesson requirements.
basic definition of delusional disorder in Direct intervention, however, is the most effec-
DSM–IV–TR retains much of the original concept tive modification procedure, using cognitive-
of Kahlbaum and Kraepelin. behavioral techniques to address inappropriate
classical psychoanalysis 1. psychoanalytic classroom behavior. Such procedures are most
theory in which major emphasis is placed on the useful for students with learning disabilities, at-
libido, the stages of psychosexual develop- tention-deficit/hyperactivity disorder, and other
ment, and the id instincts or drives. The special needs.
prototypical theory of this kind is that of claustrophobia n. a persistent and irrational
Sigmund freud. Also called classical theory; fear of enclosed places (e.g., elevators, closets,
drive theory. 2. psychoanalytic treatment that tunnels) or of being confined (e.g., in an airplane
adheres to Sigmund Freud’s basic procedures, or the backseat of a car). The focus of fear is typi-
using dream interpretation, free association, and cally on panic symptoms triggered in these situa-
analysis of resistance, and to his basic aim of tions, such as feelings of being unable to breathe,
developing insight into the patient’s uncon- choking, sweating, and fears of losing control or
scious life as a way to restructure personality. going crazy. —claustrophobic adj.
Also called orthodox psychoanalysis.
clavus n. a sharp sensation as if a nail were being
classical test theory (CTT) a body of psycho- driven into the head.
metric theory of measurement that partitions
observed scores into two components—true clay therapy a form of therapy in which chil-
scores and error scores—and estimates error dren manipulate clay, often used in physical re-
variance by calculating internal consistency habilitation, in stimulating individuals with
reliability, retest reliability, and alternate- mental retardation, and in the assessment and
forms reliability. Among the key benefits of treatment of various disorders. The clay can be a
CTT—the principal framework for test develop- metaphor for feelings, yet at the same time it
ment prior to the 1970s—are that it is relatively serves as a tangible item that is visible, change-
simple to execute and that it can be applied to a able, and under the child’s control. A child can
broad range of measurement situations. Among look at the clay, focus on it, manipulate it,
its major limitations are that examinee charac- squeeze it, and pound it, which can help reduce
teristics cannot be separated from test character- anxiety, enable the acting out of hostile emo-
istics and that the measurement statistics tions, and provide opportunities for gratifica-
derived from it are fundamentally concerned tion, achievement, and acceptance.
with how people perform on a given test as op- clearance (CL) n. the rate of elimination of a
posed to any single item on that test. These in- drug from the body in relation to its concentra-
herent limitations of CTT prompted the tion in a body fluid, as expressed by the equation
development of item response theory and CL = rate of elimination/C, where C is the con-
other models that are not subject to these limita- centration of the drug in the body fluid. Clear-
tions, that more accurately detect bias, and that ance is additive, that is, drugs are eliminated by
offer enhanced reliability assessment and in- various mechanisms (renal, hepatic, etc.) at dif-
creased precision in ability measurement. fering rates; thus, total clearance is the sum of
classical theory see classical psychoanaly- clearance from each individual organ system.
sis. clear sensorium see sensorium.
classic categorical approach a method for Clérambault’s syndrome a form of erotic
108
clinical counseling
paranoia in which a person has erotic delu- client rights the rights of patients or clients to
sions that someone else, who is typically older be fully informed of the benefits or risks of treat-
and of higher social status, is in love with him or ment procedures and to make informed deci-
her. The person continues to hold this belief de- sions to accept or reject treatment.
spite having little contact with the other person client satisfaction the extent to which a per-
and no reciprocation of feelings. The condition son seeking mental health services is content
is more common in females than in males. Also C
with the results.
called de Clérambault’s syndrome. [first de-
scribed in 1922 by Gaëtan Gatian de Cléram- client self-monitoring see self-monitoring.
bault (1872–1934), French physician] client–treatment matching the selection of
client n. a person receiving treatment or services, therapies and psychotherapists most appropriate
especially in the context of counseling or social for the clients’ needs and characteristics (e.g.,
work. See patient–client issue. ethnicity, gender, personality traits). Client–
treatment matching is assumed to enhance ther-
client abuse harm to clients caused by thera- apeutic outcomes.
pists and counselors who exploit their clients’
vulnerability and their own position of influ- climacteric n. the biological stage of life in
ence and trust to engage in inappropriate, un- which reproductive capacity declines and finally
professional behavior. Client abuse, which ceases. In women this period, which results from
sometimes takes the form of sexual involvement changes in the levels of estrogens and progester-
with a client, is usually grounds for legal and one and is known as menopause (popularly,
professional action against the practitioner. See change of life), occurs between 45 and 55 years
also professional ethics; professional stan- of age and lasts 2–3 years. During this time, men-
dards. strual flow gradually decreases and finally ceases
altogether, and various physical and potentially
client-centered therapy a form of psycho- psychological changes occur, typically manifest
therapy developed by Carl rogers in the early as hot flashes, night sweats, and emotional
1940s. According to Rogers, an orderly process of lability, joint pains, and depression may occur in
client self-discovery and actualization occurs in varying combinations and degrees. Some men
response to the therapist’s consistent empathic undergo a similar period about 10 years later
understanding of, acceptance of, and respect for than is typical for women (see male climac-
the client’s frame of reference. The therapist teric).
sets the stage for personality growth by reflecting
and clarifying the ideas of the client, who is able climax n. see orgasm.
to see himself or herself more clearly and come clinging behavior a form of attachment be-
into closer touch with his or her real self. As ther- havior in which a child of 6 months or older
apy progresses, the client resolves conflicts, reor- clings to the primary caregiver and becomes
ganizes values and approaches to life, and learns acutely distressed when left alone. Clinging be-
how to interpret his or her thoughts and feel- havior reaches a maximum in the 2nd and 3rd
ings, consequently changing behavior that he or years and then slowly subsides.
she considers problematic. It was originally clinic n. 1. a health care facility for the diagnosis
known as nondirective counseling or non- and treatment of emergency and ambulatory pa-
directive therapy, although this term is now tients. 2. a brief instructional program or session
used more broadly to denote any approach to with diagnostic, therapeutic, or remedial pur-
psychotherapy in which the therapist estab- pose in the areas of mental or physical health or
lishes an encouraging atmosphere but avoids education.
giving advice, offering interpretations, or engag-
ing in other actions to actively direct the thera-
clinical adj. 1. of or relating to the diagnosis and
treatment of psychological, medical, or other
peutic process. Also called client-centered
disorders. Originally involving only direct obser-
psychotherapy; person-centered psycho-
vation of patients, clinical methods have now
therapy; Rogerian therapy.
broadened to take into account biological and
client characteristics aspects of a client that statistical factors in treating patients and diag-
define his or her physical and personality attrib- nosing disorders. 2. relating to or occurring in a
utes as well as the problems and symptoms that clinic.
the client brings into therapy for resolution and
healing. clinical assessment the systematic evaluation
and measurement of psychological, biological,
client education interventions aimed at giving and social factors in a person presenting with a
clients information intended to change their possible psychological disorder. See also dy-
cognitions, beliefs, affect, and behaviors. This namic assessment.
educational process can take place in formal
groups (psychoeducational groups) or as a rou- clinical counseling counseling that addresses
tine part of initiating psychotherapy. a client’s personal or emotional difficulties. The
counseling encompasses general goals for the cli-
client obligations see contract. ent, for example, greater self-acceptance, better
client–patient issue see patient–client reality orientation, improved decision-making
issue. ability, and greater effectiveness in interpersonal
109
clinical diagnosis
relationships. The counselor’s responsibilities clinical judgment research empirical stud-

include gathering and interpretating data, iden- ies of the factors influencing the judgments
tifying the client’s major problems, and formu- mental health practitioners make with regard to
lating and (sometimes) implementing a treat- assessment, treatment, predictions (e.g., danger-
ment plan. ousness, suicidality), and prognosis in therapeu-
clinical diagnosis the process of identifying tic and legal settings. Factors researched include
C individual differences of the practitioner (e.g.,
and determining the nature of a mental disorder
through the study of the symptom pattern, values, gender, sexual orientation), social con-
review of medical records, investigation of back- texts, and complex cognitive thought processes
ground factors, and, where indicated, adminis- involved in judgment.
tration of psychological tests. clinical marker an observable sign indicative
clinical efficacy the effectiveness of clinical of disorder or predictive of an upcoming event of
interventions based on the evidence of con- special interest. See also biochemical marker;
trolled studies. Such studies typically include biological marker.
random assignment to control groups and treat- clinical method 1. the process by which a clin-
ment manuals that guide therapist actions. ical psychologist, psychiatrist, or other mental
clinical evidence information about clients or health or medical professional arrives at a con-
patients that is relevant to clinical diagnosis and clusion, judgment, or diagnosis about a client or
therapy, obtained either directly, through ques- patient in a clinical situation. 2. the process of
tioning (see clinical interview), or indirectly, collecting data in a natural situation (e.g., home,
through observation of their behavior in a clini- office, school) rather than in the formal setting
cal setting, their case histories, and the like. of a laboratory.
clinical health psychology a specialty field clinical neuropsychology an applied spe-
in health psychology that applies bio- cialty in neuropsychology that comprises
psychosocial theory, research, and practice prin- neuropsychological assessment and rehabilita-
ciples to promote physical health and to help tion, which are critical in cases of neuropsy-
resolve the immediate problems of patients with chological injury that results in a range of
medical conditions and related family difficul- impairments that disrupt an individual’s abili-
ties. Biofeedback, relaxation training, hypno- ties to function.
therapy, and coping skills are among the many clinical practice guidelines systematically
methods used by clinical health psychologists, developed statements to assist providers, as well
who are also active in health policy and in devel- as clients or patients, in making decisions about
oping and implementing models of preventive appropriate medical or mental health care for
intervention. specific clinical conditions.
clinical interview a type of directed conversa- clinical prediction the process of examining
tion initially used with children but now applied such factors as signs, symptoms, and case history
in a variety of contexts, including human factors to determine the clinical diagnosis and likely
research and diagnostic evaluation and treat- progress of patients. Clinical prediction can be
ment planning of patients by mental health contrasted with statistical prediction, in which
professionals. In a clinical interview, the investi- formal statistical methods combine numerical
gator may utilize certain standard material but information for the same purposes. See clinical
essentially determines which questions to ask judgment.
based on the responses given by the participant clinical psychology the branch of psychology
to previous ones. This technique is largely spon- that specializes in the research, assessment, diag-
taneous and enables the interviewer to adapt nosis, evaluation, prevention, and treatment of
questions to the patient’s understanding and ask emotional and behavioral disorders. The clinical
additional questions to clarify ambiguities and psychologist is a doctorate-level professional
enhance understanding. who has received training in research methods
clinical investigation 1. examination of an and techniques for the diagnosis and treatment
individual by means of interviews, testing, be- of various psychological disorders (see also psy-
havioral observation, or document analysis. 2. chologist). Clinical psychologists work pri-
an in-depth analysis of an individual’s life expe- marily in health and mental health clinics, in
riences and personal history. research, or in group and independent practices.
clinical judgment analysis, evaluation, or pre- They also serve as consultants to other profes-
diction of disordered behavior, symptoms, or sionals in the medical, legal, social-work, and
other aspects of psychological functioning. It in- community-relations fields. Clinical psycholo-
cludes assessing the appropriateness of particu- gists comprise approximately one third of the
lar treatments and the degree or likelihood of psychologists working in the United States and
clinical improvement. These conclusions are de- are governed by the code of practice of the Amer-
rived from the expert knowledge of mental ican Psychological Association.
health professionals, as opposed to conclusions clinical psychopharmacology a branch of
drawn from actuarial tables or statistical meth- pharmacology concerned with how drugs affect
ods. the brain and behavior and specifically with the
110
clonus
clinical evaluation and management of drugs depart of the clitoris, usually as an ethnic or reli-
veloped for the treatment of mental disorders. gious rite. It is a highly controversial practice
See also psychopharmacotherapy. and the most common form of female genital
clinical risk assessment a clinician-based mutilation.
prediction of the likelihood that an individual clitoris n. a small body of erectile tissue situated
will pose a threat to others or engage in a certain anterior to the vaginal opening. It is homolo- C
behavior (e.g., violence) within a given period. gous to the penis but usually much smaller.
Unlike actuarial risk assessment, a specific —clitoral adj.
formula or weighting system using empirically cloaca n. the common cavity, occurring in early
derived predictors is not applied. Instead, clini- mammalian embryos, into which the intestinal,
cians make predictions of dangerousness or vio- urinary, and reproductive canals open. The
lent behavior based primarily on their own proximity of these functions and the pleasure in-
experience, reasoning, and judgment; their ob- volved in them are a major factor in Sigmund
servations, examination, and psychological test- freud’s psychosexual theory. [Latin, literally:
ing of the client; and information obtained from “sewer”, “drain”] —cloacal adj.
client life histories.
cloacal theory a theory, sometimes held by
clinical social work a field devoted to provid- young children, that combines the vagina and
ing individual, family, and group treatment the anus into a single orifice and includes the be-
from a psychosocial perspective in such areas as lief that birth takes place through the anus and is
health, mental health, family and child welfare, a form of defecation. See primal fantasy.
and correction. Clinical social work additionally
involves client-centered advocacy that assists cli- clomipramine n. a tricyclic antidepressant
ents with information, referral, and in dealing drug used for the treatment of obsessive-
with local, state, and federal agencies. compulsive disorder (OCD) as well as depression
and panic disorder. Clomipramine is a more po-
clinical sociology a multidisciplinary, prac- tent inhibitor of serotonin reuptake than other
tice-oriented specialization in the field of sociol- tricyclic antidepressants, and its active metabo-
ogy that seeks to effect social change through lite inhibits norepinephrine reuptake; it thus is
analysis, applied sociological theory, and prob- classified as a mixed serotonin–norepinephrine
lem-focused intervention. reuptake inhibitor. Because of its tricyclic struc-
clinical sport psychology a specialty within ture, it has the same adverse side effects and tox-
clinical psychology focused on individuals in- icity as other tricyclic antidepressants, and it has
volved in sport. Clinical sport psychologists help been largely supplanted by the ssris, one of
athletes with performance enhancement and which—fluvoxamine—is also used for the
consistency and with clinical issues (e.g., depres- treatment of OCD. U.S. trade name: Anafranil.
sion, eating disorders). clonazepam n. a highly potent benzodiaz-
clinical study see clinical trial. epine originally developed to treat absence sei-
clinical trial a research study designed to com- zures but now used for the treatment of panic
pare a new treatment or drug with an existing disorder and other anxiety disorders and as a
standard of care or other control condition (see mood stabilizer. Because it has a slow onset of
control group). Trials are generally designed action, long half-life, and slow rate of clear-
to answer scientific questions and to find better ance, it needs to be taken less frequently (twice a
ways to treat individuals who have a specific dis- day) than some other benzodiazepines. U.S.
ease or disorder. Also called clinical study. trade name: Klonopin.
clinical type an individual whose pattern of clonidine n. a drug used for the treatment of hy-
symptoms or behaviors is consistent with a rec- pertension. It functions by direct stimulation of
ognizable disorder of clinical psychology and alpha-adrenergic receptors in the brainstem
psychiatry. to restrict the flow of impulses in peripheral
sympathetic nerves supplying the arteries, thus
clinical utility the extent to which clinical in-
causing them to relax (widen); most of the other
terventions can be applied successfully and cost-
commonly prescribed antihypertensive drugs
effectively in real clinical settings. It is one of a
act as beta blockers or as diuretics. Clonidine has
proposed set of guidelines for evaluating clinical
been used as an adjunctive agent in the manage-
interventions.
ment of alcohol and opioid withdrawal, as a
clinical validation the act of acquiring evi- nonstimulant treatment for attention-
dence to support the accuracy of a theory by deficit/hyperactivity disorder, and in the man-
studying multiple cases with specific procedures agement of clozapine-induced sialorrhea (i.e.,
for diagnosis or treatment. drooling). It has also been tried in patients with
clinician n. a medical or mental health care pro- bipolar disorder resistant to other drug treat-
fessional who is directly involved in the care and ments, but with limited effectiveness. U.S. trade
treatment of patients, as distinguished from one name (among others): Catapres.
working in other areas, such as research or ad- clonus n. a type of involuntary movement
ministration. caused by a rapid succession of alternate muscu-
clitoridectomy n. the surgical removal of all or lar contractions and relaxations. Although some
111
Clopixol
forms of clonus, such as hiccups, are considered cloverleaf skull see kleeblattschädel syn-
normal, most such movements are abnormal; for drome.
example, clonus occurs as part of a tonic– clozapine n. an atypical antipsychotic agent
clonic seizure. More severe forms are associ- of the dibenzodiazepine class: the first of the
ated with spinal cord damage, poisoning (e.g., atypical antipsychotics to be used clinically and
from strychnine), or an infection (e.g., syphilis). released into the U.S. market in 1990. Although
C
Clopixol n. a trade name for zuclopenthixol. regarded by some as the most effective of all
clorazepate n. a long-acting benzodiazepine antipsychotic drugs, clozapine has problematic
used in the treatment of anxiety, alcohol with- side effects that have limited its use. Among oth-
drawal, and partial seizures. U.S. trade name ers, these adverse effects may include weight
(among others): Tranxene. gain, sedation, and—importantly—agranulo-
cytosis, which may occur in 1–2% of patients
closed-ended question a question that pro- treated with the drug. Use of clozapine therefore
vides respondents with alternative answers from requires frequent monitoring of white blood cell
which to select their response. Also called fixed- counts in patients and is generally reserved for
alternative question; multiple-choice patients who have responded suboptimally to
question. Compare open-ended question. other antipsychotic agents. U.S. trade name:
closed group a counseling or therapy group Clozaril.
consisting of only those members who consti- club drugs substances used by teenagers and
tuted the original group. New members may not young adults at bars, dance clubs, or all-night
join during the course of therapy. Compare parties known as “raves.” Such substances in-
open group. clude mdma (Ecstasy); ghb and flunitrazepam
closed head injury a head injury, such as a (see also date-rape drug); ketamine; metham-
concussion, in which the head strikes against an phetamine; and lsd. Chronic abuse can have
object but the skull is not broken open or severe physiological or psychological repercus-
pierced. Compare open head injury. sions (or both) and, when combined with the in-
closed marriage a marriage that changes little take of alcohol, might also prove fatal.
over the years and that involves relatively little clumsy child syndrome an outdated and pe-
change in the individual partners. A closed mar- jorative name for developmental dyspraxia
riage relies on the legal bond between the parties or developmental coordination disorder.
to enforce permanence and sexual exclusivity. cluster analysis a method of data analysis in
Also called static marriage. Compare open which individuals (cases) are grouped together
marriage. into clusters based on their strong similarity
closedmindedness n. see dogmatism. with regard to specific attributes.
closet homosexual a gay man or lesbian who cluster evaluation 1. a type of program evalu-
does not reveal his or her sexual orientation to ation, either a formative evaluation or a
others, particularly to family members, parents, summative evaluation, carried out at several
or employers. Compare coming out. sites. Each site has the same evaluation objec-
tives, which are assessed in a coordinated effort
closing n. ending a session in psychotherapy or by different evaluators in a continuous process.
counseling. Approaches to closing vary among
Information so obtained is then shared to enable
therapists: Some allow the client to initiate the
common program outcomes to be assessed
end of the session; others initiate it themselves.
and to identify elements that contributed to the
closure n. 1. the act, achievement, or sense of failures or successes of the program. 2. a strategy
completing or resolving something. In psycho- for accumulating information in evaluation re-
therapy, for example, a client achieves closure search that involves combining and reconciling
with the recognition that he or she has reached a studies with somewhat different conclusions.
resolution to a particular psychological issue or This approach suggests criteria for determining
relationship problem. 2. one of the gestalt when data from dissimilar studies can be pooled.
principles of organization. It states that peo- 3. an approach in which individual evaluators in
ple tend to perceive incomplete forms (e.g., im- separate projects collaborate with an overarch-
ages, sounds) as complete, synthesizing the ing evaluator.
missing units so as to perceive the image or cluster headache a headache, typically limited
sound as a whole—in effect closing the gap be- to the area around one eye, that lasts between 15
tween the incomplete and complete forms. Also min and 3 hr and occurs in bouts, or “clusters,”
called law of closure; principle of closure. every day (sometimes twice or more a day or
See also goodness of configuration; every other day) for a period of up to 3 months,
prägnanz. followed by a headache-free period of months or
clouded sensorium see sensorium. years.
clouding of consciousness a mental state in- clustering n. 1. the tendency for items to be
volving a reduced awareness of the environ- consistently grouped together in the course of
ment, inability to concentrate, and confusion. recall. This grouping typically occurs for related
Also called mental fog. items. It is readily apparent in memory tasks in
112
cocaine dependence
which items from the same category, such as ani- accumbens, limbic, and frontal cortex) by
mals, are recalled together. 2. in statistics, the potentiating dopaminergic neurotransmission.
process by which a cluster analysis is con- caffeine and nicotine are CNS stimulants with
ducted. —cluster n., vb. different mechanisms of action at adenosine re-
cluster sampling a survey sampling method in ceptors and nicotinic receptors, respectively.
which the complete population is first subdi- In non-Western cultures, betel nut, coca
leaves, guarana, khat, and numerous other C
vided into groups, or clusters, and random sam-
ples are then drawn from certain clusters. A substances are used as stimulants. Some stimu-
common example would be sampling voters in a lants are used clinically in mental health, and in
large jurisdiction (e.g., a state) by identifying psychiatric contexts are often referred to as
clusters on the basis of close geographical prox- psychostimulants. These drugs include the am-
imity (e.g., counties) and then drawing samples phetamines and related or similarly acting com-
from the county clusters (e.g., towns and cities). pounds (e.g., methylphenidate, pemoline,
modafinil), used for the treatment of attention-
cluster suicides a statistically high occurrence
deficit/hyperactivity disorder, narcolepsy, de-
of suicides within a circumscribed geographic
pression, and organic brain syndromes and as
area, social group, or time period. Such clusters
appetite suppressants. Caffeine and ephedrine
typically occur among adolescents who imitate
are ingredients of over-the-counter “alertness”
the suicide of a high-status peer or among dis-
medications.
persed individuals, all exposed to the same or
similar media coverage, who imitate the suicide coaching n. specialized instruction and training
of a widely admired role model. Compare mass provided to enable individuals to acquire or en-
suicide. hance particular skills, as in life coaching, or
cluttering n. rapid speech that is confused, jum- to improve performance, as in athletic coaching
bled, and imprecise, often occurring during a or academic coaching.
manic episode. coca n. a shrub, Erythroxylum coca, that is indige-
CMAS abbreviation for children’s manifest nous to Peru, Bolivia, and other South American
anxiety scale. countries and cultivated in India, Sri Lanka, and
Indonesia. The leaves have been used for centu-
CME abbreviation for continuing medical edu-
ries as the source of cocaine.
cation.
CMHC abbreviation for community mental cocaine n. a drug, obtained from leaves of the
health center. coca shrub, that stimulates the central nervous
system (see cns stimulant), with the effects of
CMI abbreviation for cornell medical index. reducing fatigue and increasing well-being.
CMP abbreviation for chronic myofascial These are followed by a period of depression as
pain. the initial effects diminish. The drug acts by
CMS abbreviation for centers for medicare blocking the reuptake of the neurotransmitters
and medicaid services. dopamine, serotonin, and norepinephrine.
CNS abbreviation for central nervous system. The psychoactive properties of the coca plant
were recognized by the Peruvian Incas before
CNS abnormality any defect in structure or 4000 bce, and in the 1880s the possible thera-
function of the tissues of the brain and spinal
peutic uses of cocaine were investigated.
cord, that is, the central nervous system (CNS).
Sigmund freud observed that the drug func-
CNS depressant any of a group of drugs that, at tioned as a topical anesthetic. See also crack;
low doses, depress the inhibitory centers of the freebase.
brain. At somewhat higher doses, they depress
other neural functions, slow reaction times, and
cocaine abuse in DSM–IV–TR, a pattern of co-
caine use manifested by recurrent significant ad-
lower respiration and heart rate. At still higher
verse consequences related to the repeated
doses, they can induce unconsciousness, coma,
ingestion of the substance. This diagnosis is pre-
and death. Examples of CNS depressants are al-
empted by the diagnosis of cocaine depend-
cohol, barbiturates, benzodiazepines, in-
ence: If the criteria for cocaine abuse and
halants, and meprobamate. See also seda-
cocaine dependence are both met, only the latter
tive, hypnotic, and anxiolytic drugs.
diagnosis is given. See also substance abuse.
CNS stimulant any of a group of drugs that, at
low to moderate doses, heighten wakefulness Cocaine Anonymous a voluntary organiza-
and alertness, diminish fatigue, and provoke tion of men and women who seek to recover
feelings of energy and well-being. At higher from cocaine addiction by using a twelve-step
doses, the more powerful stimulants can pro- program. See also self-help group.
duce agitation, panic excitement, hallucina- cocaine dependence in DSM–IV–TR, a cluster
tions, and paranoia. In general, stimulants exert of cognitive, behavioral, and physiological
their effects by enhancing catecholamine symptoms indicating continued use of cocaine
neurotransmission and increasing activity in the despite significant cocaine-related problems.
sympathetic nervous system. cocaine and There is a pattern of repeated cocaine ingestion
the amphetamines are examples of stimulants resulting in tolerance, withdrawal symptoms if
thought to activate the reward system (nucleus use is suspended, and an uncontrollable drive to
113
cocaine intoxication
continue use. See also cocaine abuse; sub- relationship among multiple selves, or mental
stance dependence. processes, that are simultaneously available but
cocaine intoxication a reversible syndrome separated by a “diaphanous veil” from everyday
due to the recent ingestion of cocaine. It in- awareness. [defined by William james] 2. in con-
cludes clinically significant behavioral or psy- temporary philosophy, the unity of conscious-
chological changes (e.g., agitation, aggressive ness. —coconscious adj.
C
behavior, elation, grandiosity, impaired judg- cocounseling n. the counseling of peers by each
ment, talkativeness, hypervigilance), as well as other, as opposed to one-way professionally led
one or more physiological signs (e.g., rapid counseling.
heartbeat, elevated blood pressure, perspiration codeine n. an opiate derived from morphine,
or chills, nausea and vomiting). Large doses, es- with which it shares many properties—it is a po-
pecially when taken intravenously, may produce tent analgesic (used alone or in combination
confusion, incoherence, apprehension, tran- with other analgesics, e.g., aspirin) and it in-
sient paranoid ideas, increased sexual interest, duces euphoria. However, its addiction potential
and perceptual disturbances (e.g., a sensation of is substantially less than that of heroin. See
insects crawling on the skin). An hour or so after opioid analgesic.
these effects subside, the user may experience
tremulousness, anxiety, irritability, fatigue, and code of ethics a set of standards and principles
depression. See also substance intoxication. of professional conduct, such as the Ethical Prin-
ciples of Psychologists and Code of Conduct of the
cocaine intoxication delirium a reversible American Psychological Association. See ethics;
syndrome that develops over a short period of standards of practice.
time (usually hours to days) following the heavy
ingestion of cocaine. It includes disturbance of codependency n. 1. the state of being mutually
consciousness (e.g., reduced ability to focus, sus- reliant, for example, a relationship between two
tain, or shift attention), accompanied by individuals who are emotionally dependent on
changes in cognition (e.g., memory deficit, dis- one another. 2. a dysfunctional relationship pat-
orientation, or language disturbance) in excess tern in which an individual is psychologically
of those usually associated with cocaine intox- dependent on (or controlled by) a person who
ication. See also substance intoxication de- has a pathological addiction (e.g., alcohol, gam-
lirium. bling). —codependent adj.
cocaine withdrawal a characteristic with- Co-Dependents Anonymous a self-help
drawal syndrome that develops after cessation of group for individuals who seek to improve
(or reduction in) prolonged, heavy consumption problematic codependent relationships with
of cocaine. The essential characteristic is de- others (see codependency) by using a twelve-
pressed mood, sometimes severe, and there may step program.
also be fatigue, disturbed sleep, increased appe- coefficient n. 1. a number that functions as a
tite, vivid and unpleasant dreams, or psycho- measure of some property. For example, the
motor retardation or agitation, or all of these correlation coefficient is a measure of the
features. Marked withdrawal symptoms (see degree of linear relatedness. 2. in algebra, a scalar
crash) often follow an episode of intense, high- that multiplies a variable in an equation. For ex-
dose use. See also substance withdrawal. ample, in the equation y = bx, the scalar quantity
Cockayne’s syndrome a hereditary disorder b is said to be a coefficient.
involving dwarfism, microcephaly (small head), coercive behavior behavior designed to force
mental retardation, visual disorders, hypersensi- others to do one’s bidding, often masked as filial
tivity to sunlight, and progressive neurological devotion or as marital or parental concern and
deterioration. Early psychomotor development sometimes expressed in undisguised form (e.g.,
is slow, and most affected individuals show an “If you don’t do what I say, I’ll kill myself”).
IQ of less than 50. Affected individuals eventu- coexistence hypothesis a theoretical explana-
ally become blind and deaf and typically do not tion of the misinformation effect stating that
live past the age of 20. Also called Cockayne– when misleading information is introduced after
Neill dwarfism. [reported in 1936 by Edward a witnessed event, it exists in competition with
Alfred Cockayne (1880–1956), British physician, the original memory of the event. The false in-
and in about 1950 by Catherine A. Neill (1922– formation is more accessible due to the recency
2006), British-born U.S. pediatrician] effect and is more likely to be retrieved upon
cocktail-party syndrome see chatterbox questioning, leading to erroneous reporting of
effect. the event. Compare alteration hypothesis.
cocoa n. a product derived from the cacao plant cofacilitator n. a therapist or student in train-
(Theobroma cacao) by roasting and grinding the ing who assists in leading a therapy group. The
beans (seeds) and removing the oils. The phar- cofacilitator may act as an observer or as one
macologically active ingredients are theo- who balances the approach of the other group
bromine (typically about 1–3% of dry weight) leader.
and caffeine. coffee n. a product derived from evergreen trees
coconsciousness n. 1. in early psychology, the of the genus Coffea, which grow wild or are culti-
114
cognitive complexity
vated in tropical regions worldwide, including cognitive behavioral couples therapy

Brazil, Columbia, and Ethiopia. Of more than couples therapy that uses behavioral couples
100 species of Coffea, two are commercially im- therapy techniques yet also focuses on the re-
portant sources of coffee beans (seeds), used in ciprocal influence of the partners’ idiosyncratic
beverages. They are C. arabica and C. robusta, patterns of ideas about each other and about
whose beans contain significant concentrations couples in general. Interfering ideas are made
(about 1% and 2%, respectively) of the stimulant conscious and explicit, and then modified to im- C
caffeine. prove the couple’s relationship using techniques
Cogentin n. a trade name for benztropine. modified from cognitive behavior therapy.
Compare integrative behavioral couples
Cognex n. a trade name for tacrine.
therapy.
cognition n. 1. all forms of knowing and aware-
cognitive behavioral group therapy a
ness, such as perceiving, conceiving, remember-
type of group psychotherapy that uses tech-
ing, reasoning, judging, imagining, and problem
niques and methods of cognitive behavior
solving. Along with affect and conation, it is one
therapy, such as modeling, restructuring
of the three traditionally identified components
thoughts, relaxation training, and communica-
of mind. 2. an individual percept, idea, memory,
tion skills training, to achieve behaviorally de-
or the like. —cognitional adj. —cognitive adj.
fined goals. Groups can include clients with
cognitive–affective crossfire a state of con- diverse issues or can be limited to clients with
flict between a person’s cognitive responses to specific problems (e.g., agoraphobia, anger). See
feedback about the self and his or her affective also beck therapy.
responses. In particular, an individual’s
cognitive behavior modification see cog-
thoughts (cognitions) may favor information
nitive behavior therapy.
that confirms his or her existing self-concept
(see consistency motive), whereas the same cognitive behavior theory any theory deriv-
individual’s emotional reactions (affects) may ing from general behavioral theory that consid-
favor pleasant or positive views of the self (see ers cognitive or thought processes as significant
self-enhancement motive). mediators of behavioral change. A central fea-
ture in the theoretical formulations of the pro-
cognitive–affective personality system a
cess is that the human organism responds
theoretical conception of personality structure
primarily to cognitive representations of its envi-
in which personality is viewed as a complex
ronments rather than to the environments
system that features a large number of highly
themselves. The theory has led to popular thera-
interconnected cognitions and emotional ten-
peutic procedures that incorporate cognitive be-
dencies. [developed by U.S. personality psy-
havior techniques to effect changes in self-image
chologists Walter Mischel (1930– ) and Yuichi
as well as behaviors.
Shoda]
cognitive behavior therapy (CBT) a form of
cognitive aids external representations that
psychotherapy that integrates theories of cogni-
support various mental processes. Examples are
tion and learning with treatment techniques de-
reminders, checklists, and other prompts pro-
rived from cognitive therapy and behavior
vided to prevent forgetting of critical tasks.
therapy. CBT assumes that cognitive, emo-
cognitive-analytic therapy a time-limited tional, and behavioral variables are functionally
integrative, collaborative psychotherapy that interrelated. Treatment is aimed at identifying
emphasizes schemas and integrates principles and modifying the client’s maladaptive thought
and techniques from psychodynamic psycho- processes and problematic behaviors through
therapy and cognitive behavior therapy. cognitive restructuring and behavioral
cognitive anxiety the level of worry and ap- techniques to achieve change. Also called cog-
prehension an individual experiences in a partic- nitive behavior modification; cognitive
ular situation. behavioral therapy.
cognitive appraisal theory the theory that cognitive click a moment in psychotherapy in
cognitive evaluation is involved in the genera- which it becomes suddenly clear to the client
tion of each and every emotion (see appraisal). that his or her thinking is incorrect and therefore
This concept is more appropriately expressed that he or she must change his or her attitudes
in the cognitive–motivational–relational and beliefs.
theory, as the latter recognizes that cognition is cognitive closure 1. the state in which an indi-
only one of three simultaneously operating pro- vidual recognizes that he or she has achieved un-
cesses that contribute to the generation of any derstanding of something. 2. the final stage in
emotion. See also core relational themes. figuratively seeing the total picture and how all
[proposed by U.S. psychologist Richard S. Laza- pieces of it fit together.
rus (1922–2002)]
cognitive complexity the state or quality of a
cognitive arousal theory of emotion see thought process that involves numerous con-
schachter–singer theory. structs, with many interrelationships among
cognitive balance theory see balance the- them. Such processing is often experienced as
ory. difficult or effortful.
115
cognitive conditioning
cognitive conditioning a process in which a ual’s chronological age and formal educational
stimulus is repeatedly paired with an imagined experience.
or anticipated response or behavior. Cognitive cognitive derailment the often abrupt shift-
conditioning has been used as a therapeutic ing of thoughts or associations so that they do
technique, in which case the stimulus is typi- not follow one another in a logical sequence.
cally aversive. For example, the client imagines Cognitive derailment is a symptom of schizo-
C that he or she is smoking a cigarette and gives phrenia; the term is essentially equivalent to
himself or herself a pinch; the procedure is re- thought derailment. See derailment. See
peated until the thought produces the effect of also cognitive slippage.
discouraging the behavior. See also cognitive
cognitive development the growth and mat-
rehearsal.
uration of thinking processes of all kinds, includ-
cognitive consistency theory any of a broad ing perceiving, concept formation, remember-
class of theories postulating that attitude change ing, problem solving, imagining, and reasoning.
is a result of the desire to maintain consistency
cognitive developmental theory any the-
among elements of a cognitive system. See also
ory that attempts to explain the mechanisms un-
balance theory; cognitive dissonance the-
derlying the growth and maturation of thinking
ory; congruity theory.
processes. Explanations may be in terms of
cognitive consonance in cognitive disso- stages of development in which the changes in
nance theory, a situation in which two cogni- thinking are relatively abrupt and discontinu-
tive elements are consistent with one another, ous, or the changes may be viewed as occurring
that is, one cognitive element follows from or is gradually and continuously over time.
implied by the other.
cognitive discrimination the ability to make
cognitive control the set of processes that or- distinctions between concepts and to distin-
ganize, plan, and schedule mental operations. guish between examples and nonexamples of a
See also control processes; executive. particular concept.
cognitive coping strategy any coping cognitive disorder any disorder that involves
strategy in which mental activity is used to impairment of the executive functions, such
counter the problem or situation. Examples in- as organization, regulation, and perception.
clude thinking out the cause of the problem, These fundamental abilities can affect perfor-
working out how others might handle it, divert- mance in many cognitive areas, including speed,
ing one’s attention to something less stressful or reasoning, planning, judgment, decision mak-
anxiety-provoking (e.g., remembering happy ing, emotional engagement, perseveration, im-
times, solving mathematical problems), and pulse control, temper control, awareness,
meditation or prayer. attention, language, learning, memory, and tim-
cognitive decline reduction in one or more ing.
cognitive abilities, such as memory, awareness, cognitive dissonance an unpleasant psycho-
judgment, and mental acuity, across the adult logical state resulting from inconsistency be-
life span. The presence and degree of decline var- tween two or more elements in a cognitive
ies with the cognitive ability being measured: system. It is presumed to involve a state of
Fluid abilities often show greater declines than heightened arousal and to have characteristics
crystallized abilities (see cattell–horn theory similar to physiological drives (e.g., hunger).
of intelligence). Cognitive decline is a part of Thus, cognitive dissonance creates a motiva-
normal healthy aging, but a severe decline could tional drive in an individual to reduce the disso-
be symptomatic of disease: It is the primary nance (see dissonance reduction). See also
symptom of disease-induced dementia (e.g., alz- cognitive consonance. [first described by
heimer’s disease). Leon festinger]
cognitive deconstruction a mental state cognitive dissonance theory a theory pro-
characterized by lack of emotion, the absence of posing that people have a fundamental motiva-
any sense of future, a concentration on the here- tion to maintain consistency among elements in
and-now, and focus on concrete sensation rather their cognitive systems. When inconsistency oc-
than abstract thought. People may cultivate this curs, people experience an unpleasant psycho-
state to escape from emotional distress or trou- logical state that motivates them to reduce the
blesome thoughts. dissonance in a variety of ways (see dissonance
cognitive defect any impairment in percep- reduction). See also cognitive consonance;
tual, learning, memory, linguistic, or thinking new-look theory of cognitive dissonance;
abilities. Multiple significant cognitive defects self-consistency perspective of cognitive
are characteristic of dementia. dissonance theory. [first proposed by Leon
cognitive deficit performance on intellectual festinger]
and other mentally based tasks (e.g., those in- cognitive distortion faulty or inaccurate
volving memory), as measured by individually thinking, perception, or belief. An example is
administered standardized assessments (verbal overgeneralization. Cognitive distortion is a
and nonverbal cognitive measures), that is subnormal psychological process that can occur in
stantially below that expected given the individ- all people to a greater or lesser extent.
116
cognitive plan
cognitive dysfunction any disruption in developed cognitive maps that contain spatial
mental activities associated with thinking, information enabling them to orient themselves
knowing, and remembering. and find their way in the real world; symbolism
cognitive electrophysiology see electro- and meaning are also contained in such maps.
encephalography. See also mental map. [introduced by Edward
Chace tolman]
cognitive enhancers see nootropic. C
cognitive faculty a specific aspect or domain cognitive mediation the processing that is
of mental function, such as language, object rec- presumed to occur in the mind between arrival
ognition, or face perception. of a stimulus and initiation of the response.
cognitive flooding a method used in psycho- cognitive model a theoretical view of thought
therapy, mainly to treat phobias, in which the and mental operations, which provides explana-
client is encouraged to focus on negative or tions for observed phenomena and makes pre-
aversive mental images to generate emotional dictions about an unknown future. People are
states similar to those experienced when faced continually creating and accessing internal rep-
with a feared object or situation. The simulated resentations (models) of what they are experi-
fear is then seen to be manageable and associ- encing in the world for the purposes of
ated with images that will reduce the original perception, comprehension, and behavior selec-
fear. See also implosive therapy. tion (action).
cognitive generalization 1. the ability to cognitive–motivational–relational the-
apply knowledge, concepts, or cognitive skills ory an extension of the cognitive appraisal
acquired in one context or domain to problems theory that puts equal emphasis on three pro-
in another. See generalization. 2. a general cesses involved in the generation of an emotion:
principle of human cognition, such as associa- (a) appraisal (the cognitive process), (b) the cen-
tion or categorization, that applies across cogni- tral role of the individual’s strivings, intentions,
tive faculties or domains. and goals (the motivational process), and (c) the
cognitive hypothesis testing problem- relevance of external events to these strivings
solving behavior in which the individual derives (the relational process). [proposed by U.S. psy-
a set of rules (hypotheses) that are then sampled chologist Richard S. Lazarus (1922–2002)]
and tested until the one rule is discovered that cognitive neuropsychology the study of the
consistently results in correct solutions to the structure and function of the brain as it relates to
problem. perception, reasoning, remembering, and all
cognitive interview a structured technique other forms of knowing and awareness. Cogni-
developed for enhancing eyewitness recollection tive neuropsychology focuses on examining the
in criminal investigation. It relies on principles effects of brain damage on thought processes—
of cognition and memory retrieval, such as re- typically through the use of in-depth single-
porting everything (however seemingly irrele- case experimental design—so as to construct
vant), recalling events in different order, and models of normal cognitive functioning.
changing perspectives. See also aided recall. cognitive neuroscience a branch of neuro-
cognitive learning the acquisition and reten- science and biological psychology that fo-
tion of a mental representation of information cuses on the neural mechanisms of cognition.
and the use of this representation as the basis for Although overlapping with the study of the
behavior. mind in cognitive psychology, cognitive
cognitive learning theory any theory postu- neuroscience, with its grounding in such areas as
lating that learning requires central constructs experimental psychology, neurobiology, phys-
and new ways of perceiving events. An example ics, and mathematics, specifically examines how
is the purposive behaviorism of Edward C. mental processes occur in the brain, but the two
tolman. Cognitive theory is usually contrasted perspectives continually exert significant influ-
with behavioral learning theories, which suggest ence on each other.
that behaviors or responses are acquired through cognitive operations the mental manipula-
experience. tion of mental representations. See also sym-
cognitive load the relative demand imposed by bolic process; thinking.
a particular task, in terms of mental resources re- cognitive overload the situation in which the
quired. Also called mental load; mental demands placed on a person by mental work
workload. See also cognitive overload. (the cognitive load) are greater than the per-
cognitive map a mental understanding of an son’s mental abilities can cope with. See also
environment, formed through trial and error as sensory overload; stimulus overload.
well as observation. The concept is based on the
assumption that an individual seeks and collects
cognitive penetrability the capacity of a
mental process to be influenced by an individ-
contextual clues, such as environmental rela-
ual’s knowledge, beliefs, or goals. Reflex behav-
tionships, rather than acting as a passive recep-
ior is said to be cognitively impenetrable.
tor of information needed to achieve a goal.
Human beings and other animals have well- cognitive plan in problem solving, a mental
117
cognitive process
outline of the steps to be undertaken to solve a ential use of numerous sophisticated cognitive
problem or complete a task. strategies to process information, solve prob-
cognitive process any of the mental functions lems, and perform tasks. In other words, individ-
assumed to be involved in the acquisition, stor- uals with high cognitive reserve have developed
age, interpretation, manipulation, transforma- a variety of efficient neural networks and neural
tion, and use of knowledge. These processes pathways to cope with brain pathology such
C that they can sustain a greater degree of underly-
encompass such areas as attention, perception,
learning, and problem solving and are coming neurological damage than individuals with
monly understood through several basic theo- low cognitive reserve before becoming symp-
ries, including the serial processing approach, tomatic. The size of this hypothesized supply of
the parallel processing approach, and a com- mental abilities and mechanisms, and thus the
bination theory, which assumes that cognitive degree of protection against dementia and other
processes are both serial and parallel, depending neurological disorders it conveys, is believed to
on the demands of the task. This term is often depend on the intellectual challenges a person
used synonymously with mental process. experiences throughout life: more mental stimu-
lation creates more reserve. Possible mechanisms
cognitive processing therapy (CPT) a treat- by which this might occur include: (a) Knowl-
ment approach, based on information pro- edge can enhance memory in the form of richer
cessing theory, that deals with the client’s and more elaborate encoding and more effective
conceptualizations of the self, others, and retrieval cues facilitated by a superior organiza-
events. It is often used in the treatment of tional structuring of information; (b) knowledge
posttraumatic stress disorder resulting from sex- can result in easier access to relevant informa-
ual assault to facilitate the expression of affect tion and better organized representations of the
and the appropriate accommodation of the trau- problem, resulting in enhanced problem solving
matic event with more general cognitive skills; (c) knowledge of past consequences of var-
schemas regarding one’s self and the world. ious alternatives can provide an effortless means
cognitive psychology the branch of psychol- of making accurate predictions regarding future
ogy that explores the operation of mental pro- consequences; (d) knowledge can enable reli-
cesses related to perceiving, attending, thinking, ance on previously compiled efficient algo-
language, and memory, mainly through infer- rithms, rather than on slow and controlled
ences from behavior. The cognitive approach, processes; and (e) knowledge of prior solutions
which developed in the 1940s and 1950s, di- to familiar problems can reduce online process-
verged sharply from contemporary behavior- ing requirements. Commonly used indirect mea-
ism in (a) emphasizing unseen knowledge sures of cognitive reserve include number of
processes instead of directly observable behav- years of education, literacy level, vocabulary
iors and (b) arguing that the relationship be- knowledge, occupational complexity, estimated
tween stimulus and response was complex and premorbid intelligence, and frequency and
mediated rather than simple and direct. Its con- range of participation in mentally stimulating
centration on the higher mental processes also leisure activities (e.g., reading, writing, doing
contrasted with the focus on the instincts and crossword puzzles, playing board or card games,
other unconscious forces typical of psychoanaly- playing music) or complex mental activities gen-
sis. More recently, cognitive psychology has erally. It is important to distinguish cognitive re-
been influenced by approaches to information serve from the closely related brain reserve,
processing and information theory developed which posits that brain-based anatomical differ-
in computer science and artificial intelligence. ences among people convey differential abilities
See also cognitive science. to tolerate neuronal damage or loss before de-
cognitive rehabilitation specific rehabili- veloping cognitive impairment. Despite the
tation interventions designed to address prob- different emphases of the two terms, many re-
lems in mental processing that are associated searchers use them interchangeably.
with chronic illness, brain injury, or trauma, cognitive response an evaluative response to
such as stroke. Rehabilitation may include re- attitude-relevant information. Cognitive re-
learning specific mental abilities, strengthening sponses include inferences generated about the
unaffected abilities, or substituting new abilities information, assessments of its validity, and
to compensate for lost ones. other evaluative reactions that may or may not
cognitive rehearsal a therapeutic technique be cognitive in nature (e.g., emotional re-
in which a client imagines those situations that sponses). Positive cognitive responses are associ-
tend to produce anxiety or self-defeating behav- ated with the formation or bolstering of positive
ior and then repeats positive coping statements attitudes; negative cognitive responses are asso-
or mentally rehearses more appropriate behav- ciated with the formation or bolstering of nega-
ior. tive attitudes. See also elaboration.
cognitive reserve a capacity of the adult brain cognitive restructuring a technique used in
to sustain the effects of disease or injury without cognitive therapy and cognitive behavior
manifesting clinical symptoms of dysfunction therapy to help the client identify his or her
that stems from the active acquisition and differ- self-defeating beliefs or cognitive distortions, re-
118
cognitive vulnerability
fute them, and then modify them so that they bal encoding. Other dimensions along which
are adaptive and reasonable. cognitive styles vary include reflectivity–
cognitive science an interdisciplinary ap- impulsivity and abstract attitude versus
proach to understanding the mind and mental concrete attitude. Also called learning
processes that combines aspects of cognitive psy- style; thinking style. Many use the term
chology, the philosophy of mind, epistemology, learning style interchangeably with cognitive
style, whereas others use the former more specif- C
neuroscience, anthropology, psycholinguistics,
and computer science. ically to mean a person’s characteristic cogni-
tive, affective, and psychological behaviors that
cognitive self-guidance system the use of influence his or her preferred instructional
private, self-directed speech to guide problem- methods and interactions with the learning en-
solving behavior. [proposed by Lev vygotsky] vironment. See also theory of mental self-
cognitive self-management the use of self- government.
talk, imagery, or both to direct one’s behavior in
cognitive system a set of cognitions that are
demanding or stressful situations.
organized into a meaningful complex with im-
cognitive set the predetermined way an indi- plied or stated relationships between them. See
vidual construes a situation, which is based on a also complex of ideas.
group of concepts, related to the self and other
things, that determines a person’s view of the cognitive task a task requiring mental pro-
world and influences his or her ability to negoti- cesses related to such activities as perceiving,
ate living. attending, problem solving, thinking, or remem-
bering.
cognitive sign principle the belief that,
through learning, stimuli come to signal out- cognitive theory any theory of mind that fo-
comes or events in the environment. Edward C. cuses on mental activities, such as perceiving, at-
tolman offered cognitive sign learning as an al- tending, thinking, remembering, evaluating,
ternative to the ideas of other behavioral theo- planning, language, and creativity, especially
rists, such as Clark L. hull, who postulated that one that suggests a model for the various pro-
stimuli become directly associated with re- cesses involved.
sponses. cognitive therapy (CT) a form of psychother-
cognitive slippage a mild form of discon- apy based on the concept that emotional and be-
nected thought processes or loosening of as- havioral problems in an individual are, at least in
sociations. Cognitive slippage may be seen in part, the result of maladaptive or faulty ways of
patients with a range of physical and mental dis- thinking and distorted attitudes toward oneself
orders; it is a common characteristic of individu- and others. The objective of the therapy is to
als with schizophrenia. [coined by Paul Everett identify these faulty cognitions and replace
meehl] them with more adaptive ones, a process known
cognitive specificity hypothesis the belief as cognitive restructuring. The therapist
that specific feeling states, such as depression takes the role of an active guide who attempts to
and anxiety, are linked to particular kinds of au- make the client aware of these distorted thinking
tomatic thoughts. [proposed by U.S. psychiatrist patterns and who helps the client correct and re-
Aaron T. Beck (1921– )] vise his or her perceptions and attitudes by citing
evidence to the contrary or by eliciting it from
cognitive stage in some theories of cognitive the client. See also cognitive behavior ther-
development, especially that of Jean piaget, a apy. [developed by U.S. psychiatrist Aaron T.
plane of cognition that is characterized by a par- Beck (1921– )]
ticular, qualitatively different level of thinking
than preceding or later stages. cognitive triad a set of three beliefs thought to
characterize major depressive episodes. These
cognitive structure 1. a mental framework, are negative beliefs about the self, the world, and
pattern, or schema that maintains and orga-
the future. Also called negative triad.
nizes a body of information relating to a particu-
lar topic. When a need arises for the cognitive cognitive unconscious unreportable mental
structure, as in a college test, the individual is processes, collectively. There are many sources
thought to engage in a memory search in which of evidence for a cognitive unconscious, includ-
the stored cognitive structure is retrieved and ap- ing regularities of behavior due to habit or
plied to the present requirements. 2. a unified automaticity, inferred grammatical rules, the
structure of facts, beliefs, and attitudes about the details of sensorimotor control, and implicit
world or society. See cognitive map; concep- knowledge after brain damage (see tacit
tual system; frame of reference. knowledge). It is often contrasted with the psy-
choanalytically derived notion of the dynamic
cognitive style a person’s characteristic mode
unconscious, which involves material that is
of perceiving, thinking, remembering, and prob-
kept out of consciousness to avoid anxiety,
lem solving. Cognitive styles might differ in pre-
shame, or guilt.
ferred elements or activities, such as group work
versus working individually, more structured cognitive vulnerability a set of beliefs or atti-
versus less defined activities, or visual versus ver- tudes thought to make a person vulnerable to de-
119
cognitivism
pression. Examples include perfectionism, the penis is inserted between the pressed thighs
dependence, and sociotropy. of the female. Also called coition; inter-
cognitivism n. adherence to the principles of course; sexual intercourse. See also anal in-
cognitive psychology, especially as opposed tercourse; carezza. —coital adj.
to those of behaviorism. coitus analis see anal intercourse.
C cognizance need the drive to acquire knowl- coitus a tergo see coitus.
edge through questions, exploration, and study. coitus in ano see anal intercourse.
[proposed by U.S. psychologist Henry Alexander
Murray (1893–1988)]
coitus inter femora see coitus.
cohabitation n. the state or condition of living coitus interruptus the withdrawal of the
penis during intercourse, prior to orgasm, with
together as sexual and domestic partners with-
orgasm occurring external to the vagina. This is
out being married. See common-law mar-
done mainly to reduce the likelihood of concep-
riage; domestic partnership; same-sex mar-
tion but is not very effective, as some semen is
riage. —cohabit vb. —cohabitee n.
often released prior to orgasm.
coherence n. meaningful interconnections be-
tween distinct psychological entities. For exam- coitus intra mammas coitus in which the
ple, a system of independent beliefs that is penis is inserted between the breasts of the fe-
logically consistent from one belief to another male.
would be described as coherent. coitus prolongatus see carezza.
cohesion n. the unity or solidarity of a group, as coitus reservatus sexual intercourse in which
indicated by the strength of the bonds that link the man suppresses the ejaculation of semen.
group members to the group as a whole, the Coitus reservatus has been practiced for genera-
sense of belongingness and community within tions in eastern Asia, by the application of
the group, the feelings of attraction for specific opium paste to the glans penis to reduce its sen-
group members and the group itself experienced sitivity. In the Oneida community (a 19th-
by individuals, and the degree to which mem- century Methodist commune in the northeast-
bers coordinate their efforts to achieve goals. Ac- ern United States), young men were encouraged
cording to Leon festinger, cohesion reflects the to practice coitus reservatus with menopausal
degree to which group members are attracted to women until they were able to achieve a state of
the group, which in turn depends on their liking male continence. See also carezza.
for each other or the group’s prestige or activi- coke n. slang for cocaine.
ties. The higher the cohesion, the stronger the cola nut see kola nut.
members’ motivation to adhere to the group’s
standards. Group cohesion is frequently consid- cold cognition a mental process or activity that
ered essential to effective group therapy. Also does not involve feelings or emotions. For in-
called cohesiveness; group cohesion. —co- stance, reading a list of nonsense syllables or fac-
hesive adj. toids (brief pieces of invented or inaccurate
information) typically involves cold cognition.
cohort n. a group of people who have experi-
enced a significant life event (e.g., marriage) dur- cold emotion a reaction to some stimulants
ing the same period of time. The term usually (e.g., epinephrine) that entails the physiological
refers to a birth cohort, or generation. responses of emotional arousal without an iden-
tifiable affective root.
cohort sampling a sampling method in
which one or more cohorts are selected for ob- coldness n. a psychological characteristic featur-
servation. ing a relative absence of empathy toward and
emotional support of others.
coil n. see intrauterine device.
cold turkey the abrupt cessation of the use of
coital anorgasmia failure of a woman to reach drugs, particularly opiates, without cushioning
orgasm during penile–vaginal intercourse. the impact by the use of methadone or tranquil-
Studies show that roughly half of women do not izers. The name refers specifically to the chills
have coital orgasms in the absence of concurrent and gooseflesh experienced during opioid
clitoral stimulation. Sex therapists do not con- withdrawal.
sider this a dysfunction; if the woman can have
orgasm with her partner in other ways, and en- coleadership n. leadership by two equal thera-
joys intercourse, there is no requirement that pists or counselors, often used in group ther-
both happen simultaneously. apy.
coital position any of various postures that colera n. see bilis.
may be assumed by sexual partners during inter- colitis n. inflammation of the colon, the main
course. part of the large intestine. Colitis may be caused
coitus n. an act of sexual union, usually the inser- or aggravated by emotional disturbances, such as
tion of the penis into the vagina followed by depression or anxiety.
ejaculation. Variations include coitus a tergo, in collaborative care 1. collaboration between
which the penis is inserted from the rear; and co- two or more disciplines or practitioners to assess
itus inter femora (interfemoral sex), in which a client’s problem or problems, develop a treat-
120
collusion
ment plan, and monitor progress. 2. collabora- tagion) rather than conventional, individualis-
tion across agencies to coordinate services to a tic disorders. Also called group hysteria; mass
particular client or client group. hysteria.
collaborative empiricism an approach to collective method any method that relies on
psychotherapy in which the therapist and client groups rather than single individuals to solve
work together as equal partners in addressing is- problems, perform tasks, make decisions, and so C
sues and fostering change through mutual un- on. In psychological treatment, for example, the
derstanding, communication, and respect. The collective method is seen in the use of group
therapist views the client as a peer who is capable therapy, encounter groups, and the like.
of objective analyses and conclusions.
collective neurosis an archaic name for any
collaborative family health care a form of fairly mild and transient disorder (e.g., hysteria,
interdisciplinary practice that asserts that health an obsession or phobia, anxiety) exhibited by an
events occur simultaneously on biological, entire group of people rather than by a single in-
psychological, and social levels and that offers dividual. Compare collective psychosis. See
treatment incorporating individual, family, collective hysteria.
community, and cultural influences. Collabora-
tive clinicians share decision making and re- collective psychosis an archaic name for any
sponsibility with patients and their families and grossly distorted reaction (e.g., hallucination,
integrate clinical expertise from relevant disci- depression, delusion) exhibited by an entire
plines to provide patients with comprehensive group of people rather than by a single individ-
and coordinated care. ual. Compare collective neurosis. See col-
collaborative filtering 1. in therapeutic and lective hysteria.
social interactions, the cooperative screening collective self the part of the self (or self-
out of unproductive information and ideas dur- concept) that derives from one’s relationships
ing a discussion. 2. any process of acquiring with other people and memberships in groups or
from other people the information needed to categories, ranging from family to nationality or
make a choice or decision, whether by asking race. The collective self is distinguished from the
them individually (word of mouth) or by polling public self and the private self. Also called so-
them in large numbers. cial identity. See also social self.
collaborative therapy 1. any form of therapy collective suicide see mass suicide.
employing collaborative empiricism. 2.
couples therapy conducted by two therapists, collective unconscious the part of the un-
each seeing one partner but conferring from conscious that, according to Carl jung, is com-
time to time. Also called collaborative mar- mon to all humankind and contains the
riage therapy; collaborative marital ther- inherited accumulation of primitive human ex-
apy. periences in the form of ideas and images called
archetypes. It is the deepest and least accessible
collective experience in group psychother- part of the unconscious mind. See also personal
apy, the common body of emotional experience unconscious; racial memory.
that develops out of the individual members’
identification with each other’s problems and collectivism n. 1. the tendency to view oneself
mutual support and empathy. [first described by as a member of a larger (family or social) group,
20th-century Russian-born U.S. psychotherapist rather than as an isolated, independent being. 2.
Samuel Richard Slavson] a social or cultural tradition, ideology, or per-
collective formation 1. generally, the initial sonal outlook that emphasizes the unity of the
constitution of a social aggregate or group, par- group or community rather than each person’s
ticularly when a group forms naturally as indi- individuality. Asian, African, and South Ameri-
viduals interact with one another frequently. 2. can societies tend to put more value on col-
in the psychoanalytic theory of Sigmund freud, lectivism than do Western societies, in so far as
the human tendency to form and interact in they stress cooperation, communalism, con-
groups, as when a multiplicity of individuals structive interdependence, and conformity to
take the same object as the ego-ideal. cultural roles and mores. Compare individual-
ism. —collectivist adj.
collective hypnotization the act of hypno-
tizing a group of people at the same time. Also collegial model any collaborative approach
called group hypnosis. that encourages equal participation by all
interactants while minimizing status differ-
collective hysteria the spontaneous outbreak
ences. In research, for example, this approach
of atypical thoughts, feelings, or actions in a
enjoins researchers to involve participants fully
group or social aggregate. Manifestations may
in the research process; in therapeutic settings
include psychogenic illness, collective halluci-
the model requires therapists to treat clients as
nations, and bizarre actions. Instances of epi-
equals.
demic manias and panics, such as listeners’
reactions to the Orson Welles broadcast based collusion n. in psychotherapy, the process in
on H. G. Wells’s War of the Worlds in 1938, have which a therapist consciously or unconsciously
been attributed to contagious hysteria (see con- participates with a client or third party to avoid
121
collusional marriage
an issue that needs to be addressed. —col- and are comfortable with their sexual orienta-
lusional adj. tion. Also called coming out of the closet.
collusional marriage a marriage in which commissure n. a structure that forms a bridge or
one partner instigates or engages in inordinate, junction between two anatomical areas, particu-
deficient, irregular, or illegal conduct, and the larly the two cerebral hemispheres or the halves
C other covertly endorses it or covers it up, while of the spinal cord. Examples include the two key
ostensibly being in the role of passive victim or landmarks in brain mapping: the anterior
martyr. See also marital skew. commissure, a bundle of myelinated fibers that
joins the temporal lobes and contains fibers of
coma n. a profound state of unconsciousness the olfactory tract; and the posterior commis-
characterized by little or no response to stimuli, sure, a bundle of myelinated fibers that connects
absence of reflexes, and suspension of voluntary regions in the midbrain and diencephalon. See
activity. Common causes include severe brain also corpus callosum; gray commissure;
injury, intracranial tumor, encephalitis, cerebral white commissure. —commissural adj.
hemorrhage or embolism, diabetes, and drug or
alcohol intoxication. Also called comatose commissurotomy n. surgical transection or
state. See also glasgow coma scale. severing of a commissure, especially surgical
separation of the cerebral hemispheres of the
coma therapy a treatment for schizophrenia, brain by severing the corpus callosum (called
developed in the 1930s but rarely used after callosectomy, callosotomy, or corpuscallosot-
1960, in which hypoglycemia was induced by omy) and often the anterior commissure. This
intramuscular injection of insulin to produce a procedure is used clinically to treat severe epi-
temporary coma. Inductions might last for 15 to lepsy and has been used experimentally in ani-
60 min, and a full course of coma treatment typi- mals to study the functions of each hemisphere.
cally involved numerous coma inductions over a Because commissurotomy allows each hemi-
given period. Also called insulin-coma ther- sphere to function relatively independently,
apy; insulin-shock therapy. considerable information has been obtained
combat stress reactions (CSR) psychological about hemispheric lateralization in humans
reactions to traumatic events in military opera- and animals. Research in this area was pioneered
tions, which can range from mild to severe and by Roger sperry, who—by directing stimuli to
are normal reactions to the abnormal events. In one or the other hemisphere—provided compel-
World War I such reactions were known as shell ling evidence that the two hemispheres have dif-
shock, whereas in World War II the terms battle ferent roles (see also chimeric stimulation).
fatigue, combat fatigue, combat hysteria, and Also called split-brain procedure; split-
combat neurosis were widely used. In DSM–IV– brain technique.
TR they are categorized as posttraumatic commitment n. confinement to a mental insti-
stress disorders. See also stress casualty. tution by court order following certification by
combat stress reduction measures designed appropriate psychiatric or other mental health
to develop skills to reduce combat stress reac- authorities. The process may be voluntary but is
tions. Stress reduction entails remediation pro- generally involuntary. See certification laws.
cedures, regulatory techniques, and preventive See also civil commitment; criminal commit-
strategies (psychological coping techniques). ment; observation commitment; temporary
commitment; voluntary admission.
combination therapy the application of two
commitment laws legislation governing the
or more distinct therapeutic approaches by the
holding of a patient in a mental hospital invol-
same therapist to a client’s presenting problem.
untarily upon certification. See certification
It is distinct from adjunctive therapy, which
laws.
involves multiple practitioners.
commitment therapy see acceptance and
combined therapy 1. psychotherapy in which commitment therapy.
the client is engaged in two or more treatments
with the same or different therapists. For exam- common factors in psychotherapy, variables
ple, couples therapy may include group ther- that are common to various therapies with indi-
apy with several other couples in addition to viduals, such as therapeutic alliance and
individual therapy or conjoint therapy for length of treatment, as opposed to factors that
each couple. 2. treatment using a combination are unique to a particular therapy, such as the
of psychotherapy and medication. See also ad- use of interpretation. therapeutic factors are
junctive therapy; adjuvant therapy. similar, but typically apply to therapies with
groups.
combined treatment see combined ther- common-law marriage a relationship be-
apy.
tween an unmarried but long-term cohabiting
coming out revealing that one is gay, lesbian, couple that is considered legally equivalent to
bisexual, or transgender. Such a declaration can marriage. Most states in the United States do not
sometimes lead to problems with the individ- recognize common-law marriages, although
ual’s family, employers, or friends and can there- cohabitees may be regarded as equivalent to
fore be a difficult step, even for those who accept married partners for some purposes.
122
community-centered approach
common trait in the personality theory of vention that teaches individuals to express
Gordon W. allport, any of a number of endur- themselves clearly and directly and to listen in
ing characteristics that describe or determine an an active and empathic way, using such tech-
individual’s behavior across a variety of situa- niques as feedback and modeling, in group, fam-
tions and that are common to many people and ily, or work contexts. Training sessions typically
similarly expressed. Common traits, such as as- focus on a specific theme (e.g., active listening,
sertiveness, thus serve as a basis for comparison problem solving, or conflict resolution) after C
of one person to another and are distinct from which homework is assigned. Initially developed
personal dispositions. for couples and families, the training is now used
communal relationship a relationship in with such populations as people with develop-
which interaction is governed primarily by con- mental impairment and with teams in industry
sideration of the other’s needs and wishes. This settings.
contrasts with an exchange relationship, in communion principle a theory that the first
which the people involved are concerned requisite of individual and group psychotherapy
mainly with receiving as much as they give. See is a sense of unity and mutuality between client
also social exchange theory. [discussed by and therapist, thus enabling both parties to feel
U.S. social psychologists Margaret Clark and that they are engaged in a common enterprise to
Judson Mills] bring about improvement for the client.
communicated authenticity, regard, communities for people with mental re-
empathy (CARE) qualities of a psychothera- tardation service settings that consist of clus-
pist regarded by some theorists as necessary for ters of houses in which adults with mental
therapy to be effective and, ultimately, success- retardation who can function somewhat inde-
ful. CARE is considered essential to client- pendently participate in work and daily routines
centered therapy. with people without disabilities. With the help
communication n. the transmission of infor- of staff members, these adults manage the
mation, which may be by verbal (oral or written) houses independently—planning meals, pur-
or nonverbal means (see nonverbal communi- chasing and preparing food, and participating in
cation). Humans communicate to relate and household maintenance chores—and enjoy lei-
exchange ideas, knowledge, feelings, and experi- sure activities with their peers. In many in-
ences and for many other interpersonal and so- stances staff live in the community as well.
cial purposes. Communication is studied by
community action group a group of citizens
cognitive and experimental psychologists, and
organized to campaign against specific problems
communication disorders are treated by
within the local community, such as inadequate
mental and behavioral health therapists and by
delivery of health services, homelessness, or
speech and language therapists.
crime.
communication apprehension anxiety re-
lated to initiating or maintaining conversation community care in psychiatry, psychology,
with others. This is a common feature of social and rehabilitation, comprehensive community-
phobia. See also public-speaking anxiety. based services and supports for people with de-
velopmental or physical disabilities. These facili-
communication deviance (CD) lack of clar- ties or services include halfway houses, group
ity in communication, making it hard to follow homes, sheltered workshops and supported
and difficult for the listener to share a common work arrangements, supervised and supportive
focus of attention and meaning with the residences for people with multiple disabilities
speaker. Communication deviance is thought to or mental retardation, special education or inte-
be a long-term trait within families that may en- grated education programs for children and
gender inefficient patterns of thinking and in- young people, in-home treatment and family
formation processing. It is also thought to be support, personal-care or home-care assistance,
associated with schizophrenia and other psycho- case management or service coordination, coop-
logical disorders. erative living, and hospital-based or free-
communication disorder any of a group of standing clinics.
disorders characterized by difficulties with
community-centered approach a con-
speech and language. In DSM–IV–TR communi-
certed, coordinated approach to such problems
cation disorders include expressive language
as mental disorder, delinquency, and substance
disorder, mixed receptive-expressive lan-
abuse on the part of agencies and facilities in the
guage disorder, phonological disorder,
local community or catchment area. The com-
stuttering, and communication disorder
munity-centered approach holds that since
not otherwise specified.
these problems developed in the community, ef-
communication disorder not otherwise forts at prevention and treatment should be
specified in DSM–IV–TR, a communication community-based rather than being the prov-
disorder that does not meet the diagnostic crite- ince primarily of state institutions or federal
ria for any of the specific disorders of this cate- agencies. See community mental health cen-
gory. An example is a voice disorder. ter; community mental health program;
communication skills training an inter- community services.
123
community inclusion
community inclusion the practice of accept- community mental health training train-
ing and encouraging the presence and participa- ing for mental health professionals in order to fa-
tion of people with disabilities, in particular cilitate programs and services offered to the
developmental disabilities, in the full range of community.
social, educational, work, and community activ- community needs assessment see needs as-
ities.
C sessment.
community integration the practice of as- Community Notification Act see megan’s
sisting people with disabilities, especially devel- law.
opmental disabilities, to participate in com- community prevention and interven-
munity activities. Those with such disabilities tion organized efforts by professionals, indige-
are encouraged to attend community functions, nous nonprofessionals, and others to implement
engage in social interactions with peers and preventive programs as well as systems for inter-
community members without disabilities, and vention in dealing constructively with problems
join formal and informal community groups. in the community, such as substance abuse,
community mental health activities under- homelessness, child abuse, juvenile delin-
taken in the community, rather than in institu- quency, cigarette smoking, and a high suicide
tional settings, to promote mental health. The rate. These efforts are typically most effective
community approach focuses primarily on the where the residents are themselves involved in
total population of a single catchment area and dealing with such problems through existing
involves overall planning and demographic community groups, such as neighborhood coun-
analyses. It emphasizes preventive services as cils, block committees, service groups, social and
distinguished from therapeutic services (e.g., by fraternal organizations, and community educa-
identifying sources of stress within the commu- tional and self-help programs.
nity) and seeks to provide a continuous, compre- community psychology the branch of psy-
hensive system of services designed to meet all chology concerned with person–environment
mental health-related needs in the community. interactions and the way society affects individ-
Mental health is approached indirectly through ual and community functioning. Community
consultation and education, with emphasis on psychology focuses on social issues, social insti-
such strategies as brief psychotherapy and tutions, and other settings that influence indi-
crisis intervention and on using such workers viduals, groups, and organizations. Community
as paraprofessionals and indigenous mental researchers examine the ways that individuals
health workers. interact with each other, social groups (e.g.,
community mental health center clubs, churches, schools, families), and the larger
(CMHC) a community-based facility or group of culture and environment. Research findings and
facilities providing a full range of prevention, methods are applied with regard to poverty, sub-
treatment, and rehabilitation services, some- stance abuse, violence, school failure, and many
times organized as a practical alternative to the other social issues. See community-centered
largely custodial care given in mental hospitals. approach; community services.
Typical services are full diagnostic evaluation; community residence a residential setting,
outpatient individual and group psychotherapy; usually serving 3 to 15 people and located in a
emergency inpatient treatment; specialized clin- regular house, with live-in or shift staffing. Com-
ics for people with substance abuse and for dis- munity residences, some of which provide clini-
turbed children and families; aftercare (foster cal services in addition to supervision, personal
homes, halfway houses, home visiting); voca- assistance, and training in everyday living skills,
tional, educational, and social rehabilitation represent the most common out-of-home resi-
programs for current and former patients; con- dential setting for people with mental retarda-
sultation to physicians, members of the clergy, tion or developmental disabilities.
courts, schools, health departments, and welfare
community services the complex of commu-
agencies; and training for all types of mental
nity-based services and facilities designed to
health personnel. Also called comprehensive
maintain health and welfare, including mental
mental health center.
health clinics, public health and adoption ser-
community mental health program an vices, family services, vocational training facili-
integrated program designed to meet the overall ties, rehabilitation centers, and living facilities
mental health needs of a particular community, (e.g., halfway houses, home care, and foster-
including inpatient, outpatient, and emergency family care). Also called community mental
treatment; special facilities for treating children health services. See community care; com-
and patients with alcohol and drug dependence; munity-centered approach.
and educational, counseling, rehabilitation, re- community social worker a social worker
search, and training programs. See community- who maintains liaison between local, state, and
centered approach; community mental federal government officials and the public on
health center. matters affecting the physical and psychological
community mental health services see health of the community. For example, commu-
community services. nity social workers may try to raise the social
124
compensatory reflex
consciousness of the community regarding rec- ity and ambivalence. See also isolation. —com-
reational facilities, adequate housing, local em- partmentalize vb.
ployment problems, and environmental compassion n. a strong feeling of sympathy
obstacles to the mobility of people with physical with another person’s feelings of sorrow or dis-
impairment. tress, usually involving a desire to help or com-
community speech and hearing center fort that person. —compassionate adj. C
see speech, language, and hearing center. Compassionate Friends a voluntary organiza-
comorbidity n. the simultaneous presence in tion that offers support, friendship, and under-
an individual of two or more mental or physical standing to parents and siblings grieving the
illnesses, diseases, or disorders. —comorbid death of a child. See self-help group.
adj. compassion fatigue the burnout and stress-
companionate love a type of love character- related symptoms experienced by caregivers and
ized by strong feelings of intimacy and affection other helping professionals in reaction to work-
for another person but not accompanied by ing with traumatized people over an extended
strong passion or emotional arousal in the period of time. See also posttraumatic stress
other’s presence. In these respects, compan- disorder. [defined by U.S. psychologist Charles
ionate love is distinguished from passionate R. Figley (1944– )]
love. From the perspective of Robert J. Stern- Compazine n. a trade name for prochlor-
berg’s triangular theory of love, the rela- perazine.
tionship is high in intimacy and commitment.
compensation n. 1. substitution or develop-
comparable groups two or more representa- ment of strength or capability in one area to off-
tive samples drawn from the same population
set real or imagined lack or deficiency in
for the purpose of observation or experiment.
another. This may be referred to as overcompen-
comparison level (CL) in social exchange sation when the substitute behavior exceeds
theory, the standard by which an individual what might actually be necessary in terms of
evaluates the quality of any social relationship in level of compensation for the lack or deficiency.
which he or she is currently engaged. The CL de- Compensation may be a conscious or uncon-
rives from the average of all outcomes experi- scious process. In his classical psychoanalytic
enced by the individual in previous similar theory, Sigmund freud described compensation
relationships or observed by the individual in as a defense mechanism that protects the indi-
similar relationships of others. In most cases, in- vidual against the conscious realization of such
dividuals whose prior relationships yielded posi- lacks or deficiencies. The idea of compensation is
tive rewards with few costs will have higher CLs central to Alfred adler’s theory of personality,
than those who experienced fewer rewards and which sees all human striving as a response to
more costs in prior relationships. If the reward- feelings of inferiority (see also inferiority com-
to-cost ratio of the current relationship falls plex). However, many psychologists emphasize
below the CL, the individual will experience dis- the positive aspects of compensation in mitigat-
satisfaction. [proposed in 1959 by U.S. social ing the effects of a weakness or deficiency (see
psychologists Harold H. Kelley (1921–2003) and compensatory mechanism). For example, it
John W. Thibaut (1917–1986)] can be regarded as an important component of
comparison level for alternatives (CLAlt) successful aging because it reduces the negative
in social exchange theory, a standard used effects of cognitive and physical decline associ-
by individuals making decisions about whether ated with the aging process. 2. in Jean piaget’s
to remain in a relationship. According to this theory of cognitive development, a mental pro-
theory, such decisions are based on a compari- cess in which one realizes that for any operation
son of the outcomes (reward-to-cost ratios) of there exists another operation that compensates
the current relationship with the possible out- for the effects of the first, that is, a change in one
comes of available alternative relationships. If dimension can compensate for changes in an-
the latter is higher, the relationship will become other. Also called reciprocity. —compensate
unstable and may not last. [proposed in 1959 by vb. —compensatory adj.
U.S. social psychologists John Thibaut (1917– compensatory mechanism a cognitive pro-
1986) and Harold H. Kelley (1921–2003)] cess that is used to offset a cognitive weakness.
comparison stimulus (Co) one of a number For example, someone who is weaker in spatial
of stimuli to be compared with a standard stimu- abilities than in verbal abilities might use com-
lus. pensatory mechanisms to attempt to solve spa-
compartmentalization n. a defense mecha- tial problems, such as mentally rotating a
nism in which thoughts and feelings that seem geometric figure by using verbal processes. The
to conflict or to be incompatible are isolated underlying theory is that intelligence partly con-
from each other in separate and apparently sists of finding ways to compensate for the skills
impermeable psychic compartments. In the clas- that one has lost over time or in which one was
sical psychoanalytic tradition, compartmen- not adept in the first place. See also compensa-
talization produces fragmentation of the ego, tion.
which ideally should be able to tolerate ambigu- compensatory reflex a response that is oppo-
125
compensatory self-enhancement
site to, and therefore compensates for, another cine (CAM) a group of therapies and health care
response. For example, a compensatory response systems that fall outside the realm of con-
to the suppression of pain by opioid drugs would ventional Western medical practice. These in-
be an increase in pain sensitivity, that is, with clude but are not limited to acupuncture,
extended use, more of the drug is needed to chiropractic, meditation, aromatherapy,
achieve the same effect. homeopathy, naturopathy, touch therapy,
C reflexology, reiki, and the use of certain di-
compensatory self-enhancement a strat-
egy for self-presentation or boosting self-esteem etary supplements. Complementary medicine is
in which people respond to bad feedback in used as an adjunct to conventional treatment;
one sphere by focusing on or emphasizing their alternative medicine stands alone and replaces
positive traits in an unrelated sphere. The posi- conventional treatment.
tive traits seem to offset the unwelcome impli- completion test a type of test in which the par-
cations of the bad feedback. Also called self- ticipant is usually required to supply a missing
affirmation. phrase, word, or letter in a written text. In non-
competence n. 1. the ability to exert control verbal completion tests, a missing number, sym-
over one’s life, to cope with specific problems ef- bol, or representation must be supplied.
fectively, and to make changes to one’s behavior complex n. a group or system of related ideas or
and one’s environment, as opposed to the mere impulses that have a common emotional tone
ability to adjust or adapt to circumstances as and exert a strong but usually unconscious influ-
they are. Affirming, strengthening, or achieving ence on the individual’s attitudes and behavior.
a client’s competence is often a basic goal in psy- The term, introduced by Carl jung to denote the
chotherapy. 2. one’s developed repertoire of contents of the personal unconscious, has
skills, especially as it is applied to a task or set of taken on an almost purely pathological connota-
tasks. A distinction is sometimes made between tion in popular usage, which does not neces-
competence and performance, which is the ex- sarily reflect usage in psychology. Primary ex-
tent to which competence is realized in one’s ac- amples from classical psychoanalysis and its
tual work on a problem or set of problems. 3. in offshoots are Jung’s power complex, Sigmund
law, the capacity to comprehend the nature of a freud’s castration complex and oedipus
transaction and to assume legal responsibility complex, and Alfred adler’s inferiority com-
for one’s actions. See competency to stand plex.
trial; incompetence. —competent adj.
complex behavior an activity that requires
competence motivation the drive to interact many decisions and actions in rapid order or si-
effectively with the environment and develop multaneously. Dancing in a ballet is an example
personal skill and capability in solving problems of a complex behavior.
and performing tasks, such mastery being rein-
Complex Figure Test a nonverbal memory
forced by a sense of control and positive self-
test for a complex design. The individual is first
esteem.
asked to copy a complex design without being
competency evaluation evaluation of the de- forewarned about a later memory test. This is fol-
fendant by a psychologist to determine his or lowed by immediate and delayed recall trials in
her competency to stand trial. which the individual is asked to reproduce the
competency to stand trial the capacity to be complex figure from memory. A comparison of
tried in court as determined by a person’s ability, performance on the copy and recall trials allows
at the time of trial, to understand and appreciate the examiner to estimate the contribution of
the criminal proceedings against him or her, to visuospatial and visuomotor processes, task
consult with an attorney with a reasonable de- strategy, and memory abilities to the individ-
gree of understanding, and to make and express ual’s performance. The Children’s Complex Fig-
choices among available options. It is a compo- ure Test is a version of this test for children. Also
nent of adjudicative competence. See dusky called Rey Complex Figure Test (RCFT);
standard. See also incompetency plea. Rey–Osterrieth Complex Figure Test.
competing response training a technique complexity hypothesis a hypothesis that
in behavior therapy that involves two sequen- conscious events result from neural systems in
tial stages: (a) identification of habit occurrence, the dynamic core that have high levels of com-
including antecedents and warning signs; and plexity, a mathematical quantity defined as a
(b) creation and practice, in session and through joint function of neuronal integration and dif-
homework, of a competing (i.e., alternative) re- ferentiation. [proposed by Italian–U.S. psycholo-
sponse to the problem behavior. The competing gist Giulio Tononi (1960– ) and U.S. neuro-
response should be physically incompatible scientist Gerald M. Edelman (1929– )]
with the behavioral habit, inconspicuous, and complex motives simultaneous, multiple de-
easy to practice. This technique is typically used sires to achieve one or more goals. For example,
with habit disorders and is also used in anger desires may be compatible and oriented toward
management training. See also alternative the same goal (e.g., working hard due to a desire
behavior completion. for success as well as a desire for money) or in-
complementary and alternative medi- compatible and oriented toward opposing goals
126
compromise formation
(e.g., desiring to achieve success through work gram evaluation that examines the separate ele-
while simultaneously desiring to relax by not ments comprising a human service delivery
working). system or intervention program. The unit of
complex of ideas a set of related ideas closely analysis in the evaluation shifts from the pro-
associated with emotions, memories, and other gram level to components or links between com-
psychic factors so that when one of the ideas is ponents and subsequent program outcomes.
C
recalled, other aspects of the complex are re- component instinct in psychoanalytic the-
called with it. See also cognitive system. ory, a fundamental element of the sexual in-
complex partial seizure a partial seizure stinct that has a specific source in one part of
that is characterized by complex psychological the body (e.g., the oral instinct) and a particular
symptoms, repetitive motor activities, and spe- aim (e.g., instinct to master). The component in-
cific sensory experiences. During the seizure the stincts are posited to function independently
individual is in an impaired or altered, often during the early stages of psychosexual devel-
trancelike, state of consciousness, typically ac- opment and later to fuse together during the
companied by false memories (e.g. déjà vu), genital stage, which begins at puberty. Also
and may experience such emotions as fear, anxi- called partial instinct; part instinct.
ety, or (less commonly) sadness or pleasure. Ste- composite figure in psychoanalytic theory, a
reotyped motor behavior includes grimacing, person or object in a dream whose image is cre-
sucking, chewing, and swallowing, and there ated from the features or qualities of two or more
may also be visual or olfactory hallucinations. individuals or objects (actual or existing in fan-
Complex partial seizures are most commonly as- tasy or imagination) by the process of conden-
sociated with abnormal discharges from neurons sation.
in the temporal lobe and were formerly called
compos mentis in law, mentally competent,
temporal lobe seizures. Also called psycho-
that is, neither mentally deficient nor legally in-
motor seizure.
sane. See competence. Compare non compos
compliance n. 1. submission to the demands, mentis.
wishes, or suggestions of others. See also con-
comprehension n. the act or capability of un-
formity. 2. in pharmacotherapy, see adher-
derstanding something, especially the meaning
ence. 3. a change in a person’s behavior in
of a communication. Compare apprehension.
response to a direct request. A variety of tech-
—comprehend vb.
niques have been developed to enhance compli-
ance with requests. Although some techniques comprehensive assessment service a team
may enhance compliance by producing at- of professionals, often affiliated with a health
titude change, behavioral change is the pri- care system or hospital, who perform multiple
mary goal of these techniques. —compliant assessments of patients. The team’s purposes are
adj. —comply vb. to identify specific health conditions and behav-
ioral factors affecting an individual’s growth and
compliant character a submissive personal-
development and to enhance the value of the in-
ity whose prime motive is to seek affection from
dividual’s referral to subsequent specialized edu-
others. German-born U.S. psychoanalyst Karen
cational or developmental services.
D. Horney (1885–1952) defined the develop-
ment of such a character as one of three basic comprehensive functional assessment an
neurotic trends used as a defense against assessment that is broad in scope, often imple-
basic anxiety. Compare aggressive charac- mented by an interdisciplinary team, and most
ter; detached character. frequently focuses on a person with mental
complicated grief a response to death (or, retardation or a related condition. It typically in-
sometimes, to other significant loss or trauma) corporates findings regarding specific develop-
that deviates significantly from normal expecta- mental strengths and individual preferences,
tions. Three different types of complicated grief specific functional and adaptive social skills that
are posited: chronic grief, which is more intense, the individual needs to learn, the nature of any
prolonged, or both; delayed grief; and absent presenting disabilities and their causes, and the
grief. The most often observed form of compli- need for a wide range of services.
cated grief is the pattern in which the immediate comprehensive mental health center see
response to the loss is exceptionally devastating community mental health center.
and in which the passage of time does not mod- compression n. in neurology, pressure on the
erate the emotional pain or restore competent brain, spinal cord, or a nerve. Compression in-
functioning. The concept of complicated grief side the skull raises intracranial pressure and
was intended to replace the earlier terms abnor- may be caused by, for example, edema, hydro-
mal grief and pathological grief. cephalus, or a tumor. Symptoms include motor
complication n. an additional disease, disorder, disorders and disturbances of sensation, mem-
or condition that occurs or develops during the ory, or consciousness.
course of another disease or disorder or during a compromise formation in psychoanalytic
medical procedure. See also comorbidity. theory, the conscious form of a repressed wish or
component evaluation an approach in pro- idea that has been modified or disguised, as in a
127
compulsion
dream or symptom, so as to be unrecognizable. obsessive-compulsive personality disorder.

Thus it represents a compromise between the de- See compulsion.
mands of the ego’s defenses and the unconscious compulsive orderliness overconcern with ev-
wish. eryday arrangements, such as a clean desk or
compulsion n. a type of behavior (e.g., hand dust-free house, with unbearable anxiety if there
C washing, checking) or a mental act (e.g., count- is any variation. See obsessive-compulsive dis-
ing, praying) engaged in to reduce anxiety or disorder; obsessive-compulsive personality
tress. Typically the individual feels driven or disorder.
compelled to perform the compulsion to reduce compulsive personality see compulsive
the distress associated with an obsession or to character.
prevent a dreaded event or situation. For exam-
compulsive personality disorder see ob-
ple, individuals with an obsession about con-
sessive-compulsive personality disorder.
tamination may wash their hands until their
skin is cracked and bleeding. Compulsions may compulsive repetition the irresistible drive to
also take the form of rigid or stereotyped acts perform needless acts, such as checking and re-
based on idiosyncratic rules that do not have a checking a door to see whether it has been
rational basis (e.g., having to perform a task in a locked. See compulsion; obsessive-compulsive
certain ritualized way). Compulsions do not pro- disorder.
vide pleasure or gratification and are dispro- compulsive stealing see kleptomania.
portionate or irrelevant to the feared situation compunction n. distress or guilt associated with
they are used to neutralize. See counter- wrongdoing or with an anticipated action or re-
compulsion; obsessive-compulsive disor- sult.
der. —compulsive adj.
computed tomography (CT) a radiographic
compulsion to repeat see repetition com- technique for quickly producing detailed, three-
pulsion. dimensional images of the brain or other soft tis-
compulsive character a personality pattern sues. An X-ray beam is passed through the tissue
characterized by rigid, perfectionistic standards, from many different locations, and the different
an exaggerated sense of duty, and meticulous, patterns of radiation absorption are analyzed
obsessive attention to order and detail. Individ- and synthesized by a computer. Because a CT
uals of this type are usually humorless, parsimo- scan produces many slice-by-slice pictures of the
nious, stubborn, inhibited, rigid, and unable to head, chest, or abdomen, it is possible to locate
relax. Also called compulsive personality. abnormalities, such as lesions or tumors, with-
out exploratory surgery. Also called computer-
compulsive disorder any disorder in which
assisted tomography; computerized axial
the individual feels forced to perform acts that
tomography (CAT); computerized tomog-
are against his or her wishes or better judgment.
raphy. See also magnetic resonance imag-
The act may be associated with an experience of
ing.
pleasure or gratification (e.g., compulsive gam-
bling, drinking, or drug taking) or with the re- computer addiction see internet addic-
duction of anxiety or distress (e.g., rituals in tion.
obsessive-compulsive disorder). See inter- computer anxiety strong apprehension about
mittent explosive disorder; kleptomania; computers and computer use that is dispropor-
paraphilia; pathological gambling; pyro- tionate to the actual threat posed by these ma-
mania; substance abuse; trichotillomania. chines. The anxiety may be related to fear of the
See also impulse-control disorder. unknown or fear of the possible outcome of try-
compulsive drinker an individual who has an ing to use a computer (e.g., failure, frustration,
uncontrollable urge to drink excessively: an al- embarrassment, or disappointment). If the anxi-
coholic. See alcohol dependence. ety is sufficient to cause significant distress and
impairment, it may be classified as a specific
compulsive eating an irresistible drive to over- phobia, situational type. Also called computer
eat, in some cases as a reaction to frustration or
phobia.
disappointment. See also binge-eating disor-
der; bulimia nervosa; food addiction. computer-assisted diagnosis see comput-
erized diagnosis.
compulsive exerciser an individual who feels
it is necessary to participate in moderate to high- computerized assessment the process of
level physical activity on a regular basis. using a computer to obtain and evaluate psycho-
logical information about a person. The com-
compulsive gambling see pathological puter presents questions or tasks and then makes
gambling. diagnoses and prognoses based on a comparison
compulsive laughter persistent, inappropri- of the participant’s responses or performance to
ate, and apparently uncontrollable laughter of databases of previously acquired information on
which the individual may be unaware. See also many other individuals. Also called automated
inappropriate affect. assessment.
compulsiveness n. a behavior pattern associ- computerized diagnosis the use of computer
ated with obsessive-compulsive disorder or programs for cataloging, storing, comparing,
128
concordance
and evaluating psychological and medical data concentration difficulty a common symp-
as an aid to clinical diagnosis. In view of the tom of a major depressive episode in which
many possible variables involved in a particular the ability to concentrate and think clearly is di-
type of disorder, computerized diagnosis makes minished.
use of information based on thousands of similar concentrative meditation a type of medita-
or related sets of signs and symptoms of previous tion that focuses on a single stimulus (e.g.,
patients, as well as information on diagnoses C
breathing); a specific image (e.g., a yantra); a
and effective treatments stored in databases. specific sound, syllable, word, or phrase (see
Also called computer-assisted diagnosis. See mantra); or a specific thought. It is the opposite
problem-oriented record. of insight in that thoughts unrelated to the
computerized therapy the use of a specially stimulus do not enter the consciousness. See also
programmed computer to provide therapy, transcendental meditation. Compare mind-
under the auspices of a trained therapist. Com- fulness meditation.
puters have been used for assessment, history concept formation the process by which a
taking, diagnosis, patient education, and inter- person abstracts a common idea or concept from
vention. Computer therapy software operates particular examples, such as learning what dogs
through a series of if–then statements, which de- are by experience of various different dogs. Also
termine how the computer responds to explicit called concept acquisition. See also abstrac-
input by the individual. tion.
computer phobia see computer anxiety. concept-formation test any test used in
computer simulation in cognitive psychol- studying the process of concept formation and
ogy, a technique in which a model of cognitive in assessing the level of concept acquisition
processes is implemented as a computer pro- achieved by a specific individual.
gram. This is generally to investigate specific the- conceptual disorder a disturbance in the
ories of cognitive processing rather than to thinking process or in the ability to formulate
explore the more general issues that are the prov- abstract ideas from generalized concepts.
ince of artificial intelligence.
conceptual disorganization irrelevant, ram-
Comrey Personality Scales (CPS) an inven- bling, or incoherent verbalizations, frequently
tory of individual differences in eight personal- including neologisms and stereotyped expres-
ity traits constructed primarily through factor sions. It is one of the major signs of disorganized
analysis and yielding scores on eight scales: thought processes. See also schizophrenic
trust versus defensiveness, orderliness versus thinking.
lack of compulsion, social conformity versus re-
belliousness, activity versus lack of energy, emo- conceptualization n. the process of forming
tional stability versus neuroticism, extraversion concepts or ideas, particularly those of an ab-
versus introversion, masculinity versus feminin- stract nature, out of experience or learned mate-
ity, and empathy versus egocentrism. Designed rial using thought processes and verbalization.
for individuals aged 16 years and over, it consists See also abstract conceptualization; ab-
of 180 statements to which participants respond straction; concept formation. —concep-
using a 7-point likert scale format, ranging tualize vb.
from “never” to “always” or from “definitely conceptual system the organization of a per-
not” to “definitely.” [developed in 1970 by An- son’s cognitive abilities, emotional awareness,
drew Laurence Comrey (1923– ), U.S. psychol- experience, and philosophical or religious orien-
ogist] tation into a system for understanding events,
conation n. the proactive (as opposed to habit- data, or experience. See also cognitive struc-
ual) part of motivation that connects knowl- ture; frame of reference.
edge, affect, drives, desires, and instincts to conceptual tempo the pace that is typical of a
behavior. Along with cognition and affect, co- person’s approach to cognitive tasks, for exam-
nation is one of the three traditionally identified ple, a hasty rather than a deliberate approach to
components of mind. The behavioral basis of at- observing, thinking, and responding. Concep-
titudes is sometimes referred to as the conative tual tempo is an aspect of cognitive style. See
component. See also bases of an attitude. also reflectivity–impulsivity.
conative adj. characterized by volition or self- Concerta n. a trade name for methyl-
activation toward a goal. phenidate.
concentration-camp syndrome a variant concordance n. 1. the state or condition of
form of posttraumatic stress disorder suf- being in harmony or agreement. Affective con-
fered by survivors of concentration camps. Per- cordance is said to exist, for instance, when fa-
sistent stress symptoms in concentration-camp cial gestures mirror internal states of feeling,
victims consist of severe anxiety, defenses such as frowning when perplexed or annoyed,
against anxiety, an obsessive ruminative state, or, in another context, when two or more indi-
psychosomatic reactions, depression, and survi- viduals related through some condition or activ-
vor guilt produced by remaining alive while so ity experience the same or similar emotional
many others died. reactions. 2. in twin studies, the presence of a
129
concordance rate
given trait or disorder in both members of the a standardized test, at the same point in time.
pair. Evidence for genetic factors in the produc- See also content validity; criterion valid-
tion of the trait or disorder comes from the com- ity.
parison of concordance rates between identical concussion n. see brain concussion.
and fraternal twins. Compare discordance.
condensation n. the fusion of several mean-
C concordance rate the percentage of pairs of ings, concepts, or emotions into one image or
twins or other blood relatives who exhibit a par- symbol. Condensation is particularly common
ticular trait or disorder. Also called concor- in dreams, in which, for example, one person
dance ratio. See also twin study. may exhibit the characteristics of several or one
concrete attitude a cognitive style that is behavior may represent several feelings or reac-
directed to specific objects and immediate stim- tions.
uli. A person who exhibits a concrete attitude conditional discharge the release of a patient
tends not to make abstract comparisons and will from a psychiatric facility with imposition of
not usually respond to abstract qualities, con- certain conditions and limitations (such as peri-
cepts, or categories. Compare abstract atti- odically reporting to a supervisor or taking medi-
tude. [defined by German-born U.S. neurologist cations), during which time the patient is still
Kurt Goldstein (1878–1965)] under commitment.
concrete intelligence the ability to under- conditional positive regard an attitude of
stand and manipulate objects. It is often con- acceptance and esteem expressed by others on a
trasted with abstract intelligence and conditional basis, that is, depending on the ac-
social intelligence. ceptability of the individual’s behavior and the
concrete thinking thinking focused on imme- other’s personal standards. In his theory of per-
diate experiences and specific objects or events. sonality, Carl rogers proposed that while the
It is characteristic of young children and may need for positive regard is universal, conditional
also be seen in people with schizophrenia and regard works against sound psychological devel-
people who have suffered a brain injury, espe- opment and adjustment in the recipient. Com-
cially frontal-lobe damage. Compare abstract pare unconditional positive regard.
thinking. conditional probability the probability that
concretism n. in the analytic psychology of an event will occur given that another event is
Carl jung, a type of thought or feeling that is de- known to have occurred.
pendent on immediate physical sensation and conditioned adj. relating to or describing be-
displays little or no capacity for abstraction. In havior whose occurrence, form of display, or
some traditional societies, such thinking may both is a result of experience. The two main
manifest itself in fetishism and belief in magic. classes of experience resulting in conditioned be-
In the modern world, it may display itself as an havior are operant conditioning and pav-
inability to think beyond the obvious material lovian conditioning.
facts of a situation. conditioned emotional response (CER)
concretization n. 1. inability to think ab- any negative emotional response, typically fear
stractly in which there is an overemphasis on de- or anxiety, that becomes associated with a neu-
tails and immediate experience. It occurs in such tral stimulus as a result of pavlovian condi-
conditions as dementia and schizophrenia. 2. in tioning.
general usage, the process of being specific or of conditioned reinforcement see secondary
giving an example of a concept or relationship. reinforcement.
concurrent review an analysis of admissions conditioned response (CR) in pavlovian
to a psychiatric hospital or clinic carried out conditioning, the learned or acquired re-
while care is being provided. It comprises certifi- sponse to a conditioned stimulus. Also called
cation of the necessity for admission (see admis- conditioned reflex.
sion certification) and assessment of the need conditioned stimulus (CS) a neutral stimulus
for care to be continued (see continued-stay that is repeatedly associated with an uncondi-
review). tioned stimulus until it acquires the ability to
concurrent therapy 1. the use of two treat- elicit a response that it previously did not. In
ments at the same time. 2. in couples therapy many (but not all) cases, the response elicited by
and family therapy, the simultaneous treat- the conditioned stimulus is similar to that elic-
ment of spouses or other family members in in- ited by the unconditioned stimulus. A light, for
dividual or group therapy, either by the same example, by being repeatedly paired with food
therapist or different therapists. See also com- (the unconditioned stimulus), eventually comes
bined therapy. to elicit the same response as food (i.e., saliva-
concurrent validity the extent of correspon- tion) when presented alone. Also called condi-
dence between two measurements at about the tional stimulus.
same point in time: specifically, the assessment conditioning n. the process by which certain
of one test’s validity by comparison of its results kinds of experience make particular actions
with a separate but related measurement, such as more or less likely. See instrumental condi-
130
confirmation bias
tioning; operant conditioning; pavlovian terval) used for estimating the value of a popula-
conditioning. tion parameter from data obtained in a sample,
conditioning therapy see behavior ther- with a preset, fixed probability that the interval
apy. will include the true value of the population pa-
rameter being estimated. Most research is done
conditions not attributable to a mental on samples, but it is done in order to draw infer-
disorder in DSM–III and earlier editions, a re- ences about the entire relevant population. C
sidual category of conditions that in DSM–IV–TR Compare point estimate.
is labeled other conditions that may be a
focus of clinical attention. confidence level the probability that a confi-
dence interval contains the true value of an
conditions of worth the state in which an in- experimental variable under investigation. It is
dividual considers love and respect to be condi- expressed as a percentage that indicates the sta-
tional on meeting the approval of others. This tistical likelihood that the value of the variable
belief derives from the child’s sense of being obtained using a sample is an accurate reflection
worthy of love on the basis of parental approval: of the actual value in the entire population. For
As the individual matures, he or she may con- example, a survey of 100 individuals in a small
tinue to feel worthy of affection and respect only town of 1,000 people might indicate that 20% of
when expressing desirable behaviors. [proposed respondents intend to enroll in a distance learn-
by Carl rogers] ing class within the next month. If the confi-
condom n. a sheath, usually made of latex rub- dence level for this research is 95%, this
ber, placed over the erect penis to prevent preg- indicates that if the entire town were surveyed
nancy and to avoid sexually transmitted then the results obtained would be within 5% of
diseases. the value obtained with the sample (i.e., any-
conduct n. the behavior of an individual, either where between 16 and 24% of respondents
generally or on a specific occasion, usually as it would enroll in a class). In other words, the re-
conforms to or violates social norms. searcher is 95% certain that his or her results for
the sample are accurate for the entire population
conduct disorder in DSM–IV–TR, a persistent and thus would be obtained were the research to
pattern of behavior that involves violating the be repeated with additional samples.
basic rights of others and ignoring age-
appropriate social standards. Specific behaviors
confidence limits the upper and lower end
points of a confidence interval; that is, the
include lying, theft, arson, running away from
values between which the value of the parameter
home, aggression, truancy, burglary, cruelty to
is anticipated with a known probability to be.
animals, and fighting. This disorder is distin-
guished from oppositional defiant disorder confidentiality n. a principle of professional
by the increased severity of the behaviors and ethics requiring providers of mental health care
their occurrence independently of an event oc- or medical care to limit the disclosure of a pa-
casioning opposition. attention-deficit/hy- tient’s identity, his or her condition or treat-
peractivity disorder frequently coexists with ment, and any data entrusted to professionals
or is misdiagnosed as conduct disorder. during assessment, diagnosis, and treatment.
Similar protection is given to research partici-
confabulation n. the falsification of memory
pants and survey respondents against unautho-
in which gaps in recall are filled by fabrications
rized access to information they reveal in
that the individual accepts as fact. It is not typi-
confidence. See informed consent; tarasoff
cally considered to be a conscious attempt to de-
decision. —confidential adj.
ceive others. Confabulation occurs most
frequently in korsakoff’s syndrome and to a configuration n. 1. an arrangement of ele-
lesser extent in other conditions associated with ments or components in a particular pattern or
organically derived amnesia. In forensic con- figure. See goodness of configuration. 2. the
texts, eyewitnesses may resort to confabulation usual English translation of gestalt. —config-
if they feel pressured to recall more information urational adj.
than they can remember. —confabulate vb. configurational analysis an integrative
confederate n. 1. in an experimental situation, psychodynamic model for case formulation,
an aide of the experimenter who poses as a par- psychotherapy, and outcome evaluation.
ticipant but whose behavior is rehearsed prior to Maladaptive states of mind in the context of the
the experiment. The real participants are some- client’s problems, topics of concern, defenses,
times referred to as naive participants. See also identity, and relationships are the focus of as-
active deception. 2. in parapsychology, an in- sessment and therapy. [developed by 21st-
dividual who assists a supposed psychic by co- century U.S. psychiatrist Mardi Horowitz]
vertly providing him or her with information confirmation n. the fulfillment of an expec-
about a client’s concerns, preferences, back- tancy that reinforces the behavior that led to the
ground, or situation, thus creating or strength- fulfillment.
ening the illusion of the psychic’s paranormal confirmation bias the tendency to gather evi-
abilities. dence that confirms preexisting expectations,
confidence interval a range of values (an in- typically by emphasizing or pursuing supporting
131
confirmatory data analysis
evidence while dismissing or failing to seek con- confound n. in an experiment using a facto-
tradictory evidence. rial design, a variable that is conceptually dis-
confirmatory data analysis statistical data tinct but empirically inseparable from one or
analysis designed to address one or more specific more other variables. Confounding makes it im-
research questions. Compare exploratory possible to differentiate that variable’s effects in
isolation from its effects in conjunction with
C data analysis.
other variables. These indistinguishable effects
confirmatory factor analysis one of a set of are themselves called aliases.
procedures used in factor analysis to demon-
strate that a group of variables possess a theoreti- confrontation n. 1. an argument or hostile dis-
cally expected factor structure. In other words, agreement. 2. the act of directly facing, or being
confirmatory factor analysis provides formal sta- encouraged or required to face, a difficult situa-
tistical tests of a priori hypotheses about the spe- tion, realization, discrepancy, or contradiction
cific underlying (latent) variables thought to involving information, beliefs, attitudes, or be-
explain the data obtained on a set of observed havior. Confrontational techniques may be used
(manifest) variables. Unlike exploratory factor therapeutically, for example, to reveal and invite
analysis, in which all measured variables relate self-examination of inconsistencies in a client’s
to all latent factors, confirmatory factor analysis reported and actual behavior, but they have a
imposes explicit restrictions so that the mea- potential for disruptive as well as constructive ef-
sured variables relate with some (or usually just fects. 3. in individual psychology, a state-
one) latent factors but do not relate with others. ment or question calculated to motivate the
client to make a decision or face the reality of a
conflict n. the occurrence of mutually antago- situation. —confrontational adj.
nistic or opposing forces, including events, be-
haviors, desires, attitudes, and emotions. This confrontational methods methods in-
general term has more specific meanings within tended to change behavior in which individuals
different areas of psychology. For example, in are aggressively forced to confront their failures
psychoanalytic theory it refers to the opposition and weaknesses. Such methods are used, for ex-
between incompatible instinctual impulses or ample, in residential drug programs staffed by
between incompatible aspects of the mental ex-addicts. Similar but less aggressive methods
structure (i.e., the id, ego, and superego) that are used in encounter groups as a means of in-
may be a source of neurosis if it results in the creasing awareness and modifying behavior. Re-
use of defense mechanisms other than sublima- search has not supported the efficacy of
tion. In interpersonal relations conflict denotes confrontational approaches, and many patients
the disagreement, discord, and friction that respond negatively.
occur when the actions or beliefs of one or more confusion n. a disturbance of consciousness
individuals are unacceptable to and resisted by characterized by bewilderment, inability to
others. think clearly or act decisively, and disorienta-
tion for time, place, and person. Also called
conflict-free sphere in ego psychology, an
mental confusion.
area of the ego that develops and functions with-
out giving rise to internal conflict. Functions or- confusional psychosis a form of cycloid
dinarily controlled by the conflict-free sphere psychosis in which disturbances of cognitive
include speech, motility, and other autonomous processes are prominent and accompanied by a
ego functions. Also called conflict-free area. labile (highly changeable) emotional state char-
acterized alternately by manifest anxiety, with
conflict of interest a situation in which indi-
the individual often misidentifying other peo-
viduals or groups are drawn to the pursuit of
ple, and by mutism and greatly decreased move-
goals or outcomes that are incompatible with
ment. The latter differs from catatonic stupor
the goals they are supposed to be pursuing. For
in that self-care and spontaneity are preserved
example, psychologists who are employed by a
and negativism is absent. [defined by German
health agency may find that their obligation to
psychiatrist Karl Leonhard (1904–1988)]
help their clients is incompatible with the
agency’s requirement to minimize treatment confusional state a state of impaired mental
costs. See also double-agentry. functioning in which awareness is retained but
with loss of cognitive coherence and orientation
conformity n. the adjustment of one’s opin- to time, place, and sometimes identity. It may be
ions, judgments, or actions so that they match accompanied by rambling or incoherent speech,
either (a) the opinions, judgments, or actions of visual hallucinations, and psychomotor dis-
other people or (b) the normative standards of a turbances. It can arise from a wide variety of
social group or situation. Conformity includes causes, including brain lesions, trauma, toxicity,
the temporary compliance of individuals, who medications, neurotransmitter imbalances, sleep
agree publicly with the group but do not accept disturbances, Alzheimer’s disease, sedation, or
its position as their own, as well as the conver- fever.
sion of individuals, who fully adopt the group
position. Compare anticonformity; noncon- congenital adj. denoting a condition or disorder
formity. See also majority influence; peer that is present at birth. Also called connate.
pressure. congenital acromicria see down syndrome.
132
Conners’ Rating Scales
congenital anomaly see congenital defect. son receiving a persuasive communication has a
congenital defect any abnormality present at negative attitude to the content of the message
birth, regardless of the cause. It may be caused by but a positive attitude to the source of the mes-
faulty fetal development (e.g., spina bifida, cleft sage, or vice versa, then he or she will be moti-
palate), hereditary factors (e.g., Huntington’s vated to revise both of these attitudes in some
disease), chromosomal aberration (e.g., Down degree in order to restore congruity. Congruity
theory differs from balance theory in that it takes C
syndrome), maternal conditions affecting the
developing fetus (e.g., fetal alcohol syndrome), into account gradations of evaluation of ele-
metabolic defects (e.g., phenylketonuria), or in- ments and therefore makes more precise predic-
jury to the brain before or during birth (e.g., tions regarding the magnitude of change
some cases of cerebral palsy). A congenital defect required to restore congruity among elements.
may not be apparent until several years after [first proposed by U.S. psychologists Charles
birth (for example, an allergy or a metabolic dis- osgood and Percy Tannenbaum (1927–2009)]
order) or even until after the individual has conjoint marital therapy see conjoint
reached adulthood (e.g., Huntington’s disease). therapy.
Also called birth defect; congenital anom-
aly. conjoint therapy therapy in which the part-
ners in a relationship or members of a family are
congenital hypothyroidism a condition of treated together in joint sessions by one or more
motor and mental retardation associated with a therapists, instead of being treated separately.
deficiency of thyroid hormone. More than a The technique is commonly applied in resolving
dozen causes, mostly hereditary metabolic de- marital disputes, when it is also known as con-
fects, have been identified with the disorder. The joint marital therapy. Also called conjoint
prognosis varies with the degree of thyroid defi- counseling. See also couples therapy; family
ciency during fetal and early infant life, but early therapy.
and adequate thyroid-hormone therapy gener-
ally reverses signs and symptoms. conjunctive motivation the drive to achieve
true and lasting (rather than temporary or sub-
congenital rubella syndrome a complex of
stitute) satisfaction. Compare disjunctive mo-
congenital defects in infants whose mothers
tivation. [defined by U.S. psychiatrist Harry
were infected by the rubella virus early in preg-
Stack Sullivan (1892–1949)]
nancy. The defects may include deaf-mutism,
cataracts, heart disease, cerebral palsy, connate adj. see congenital.
microcephaly (small head), and mental retarda-
Conners’ Comprehensive Behavior Rat-
tion. Neurological abnormalities occur in about
ing Scales (Conners’ CBRS) a questionnaire
80% of affected individuals, and brain weight is
that assesses a variety of emotional, behavioral,
usually subnormal. Psychomotor retardation,
and academic problems in those 6 to 18 years of
marked by general lack of response to stimuli,
age and aids in the identification of certain dis-
and intellectual impairment are common. In de-
orders. It includes a 203-item parent form, a 204-
veloped nations rubella vaccination has resulted
item teacher form, and a 179-item self-report,
in a massive decline in the occurrence of this
and provides evaluations in nine areas: emo-
syndrome.
tional distress, aggressive behaviors, language
congenital sensory neuropathy with and math difficulties, hyperactivity/impulsivity,
anhidrosis a disorder marked by the absence social problems, separation fears, perfectionist
of pain perception. Severe injuries, such as mul- and compulsive behaviors, violence potential,
tiple fractures, may go untreated because they and physical symptoms. [originally developed in
cause no pain. Affected individuals tend to show 2008 by U.S. clinical psychologist C. Keith
delayed intellectual development, with IQs Conners]
below 80. Skin biopsies show normal but non-
functional sweat glands. Conners’ Rating Scales (CRS) a question-
naire used to assess attention-deficit/hyper-
congruence n. 1. in general, agreement, har- activity disorder and diagnose the most
mony, or conformity. 2. in the phenomenologi- common comorbid disorders in those 6 to 18
cal personality theory of Carl rogers, (a) the years of age. It includes a 110-item parent form, a
need for a therapist to act in accordance with his 115-item teacher form, and a 99-item self-report,
or her true feelings rather than with a stylized and provides evaluations in seven areas: inatten-
image of a therapist or (b) the conscious integration, hyperactivity/impulsivity, learning prob-
tion of an experience into the self. —congru- lems, executive functioning, aggression, peer
ent adj. relations, and family relations. Participants re-
congruity theory a cognitive consistency spond to items—such as “argues with adults” for
theory that focuses on the role of persuasive parents, “talks excessively” for teachers, and “I
communications in attitude change. Congruity break the rules” for self-report—using the four
theory is similar to balance theory in that it rating options of “not at all,” “just a little,”
postulates that people tend to prefer elements “pretty much,” or “very much.” This widely used
within a cognitive system to be internally consis- instrument was originally published in 1989 and
tent with one another. Accordingly, if the per- subsequently revised in 1997 (Conners’ Rating
133
Conradi’s disease
Scales–Revised; CRS-R) and in 2008 (Conners’ ness most often refers to the ordinary waking
Third Edition; Conners 3). [C. Keith Conners] state (see wakefulness), but it may also refer to
Conradi’s disease a congenital disorder the state of sleeping or to an altered state of
marked by short limbs, anomalies of the head consciousness. In cognitive theory, conscious-
and face, cataracts, dry skin, and, in some cases, ness appears to have a global-access function,
degenerating cartilage at the ends of the long presenting an endless variety of focal contents to
C executive control and decision making. In medi-
bones. In the rhizomelic form of the disease
mental retardation is common. However, it is cine and brain science, the distinctive electrical
rarely present in the Conradi–Hunermann form activity of the brain, as recorded on an electroen-
of the disease. [Erich Conradi, 20th-century Ger- cephalogram, is often used to identify conscious
man physician] states (see brain waves). Sensory consciousness
of the perceptual world depends on the posterior
conscience n. an individual’s sense of right and
sensory area of the brain. Abstract consciousness
wrong or of transgression against moral values.
refers to abstract ideas, judgments, specific in-
In psychoanalysis, conscience is the superego,
tentions, expectations, and events of fringe
or ethical component of personality, which acts
consciousness; it may involve the frontal
as judge and critic of one’s actions and attitudes.
cortex in addition to sensory cortex. The dis-
More recent biopsychological approaches sug-
tinction between sensory and abstract experi-
gest that the capacity of conscience may be ge-
ences was originally made by Greek philosopher
netically determined, and research on brain
Plato (c. 427–c. 347 bce). See also higher order
damage connects behavioral inhibitions to spe-
consciousness.
cific brain regions (e.g., the prefrontal cor-
tex). Psychosocial approaches emphasize the consciousness-altering substance any of a
role of conscience in the formation of groups large class of psychoactive compounds that af-
and societies. fect conscious experience and perception. These
conscientiousness n. the tendency to be orga- substances are related to neurotransmitters (e.g.,
nized, responsible, and hardworking, construed serotonin) and include lsd, cannabis, and alco-
as one end of a dimension of individual differ- holic beverages. See also altered state of con-
ences (conscientiousness versus lack of direc- sciousness.
tion) in the big five personality model. It is consciousness of freedom the sense of
also a dimension in the five-factor personal- choice people tend to have in making decisions
ity model. —conscientious adj. and controlling actions. It may be the intuitive
conscious 1. (Cs) n. in the classical psychoana- basis for the widespread belief in free will.
lytic theory of Sigmund freud, the region of the consciousness raising a process, often used in
psyche that contains thoughts, feelings, percep- group discussion, directed toward greater aware-
tions, and other aspects of mental life currently ness of (a) oneself, for example, one’s condition,
present in awareness. The content of the con- needs, values, and goals; or (b) a political or so-
scious is thus inherently transitory and continu- cial issue, such as discrimination against a partic-
ously changing. Compare preconscious; ular group of people.
unconscious. 2. adj. relating to or marked by
conscious process a mental operation of which
awareness or consciousness.
a person is aware and often in control. Compare
conscious access hypothesis the notion that unconscious process. See also automat-
the primary function of consciousness is to mo- icity.
bilize and integrate brain functions that are oth-
erwise separate and independent. conscious resistance in psychoanalysis, the
patient’s deliberate withholding of unconscious
conscious memory see declarative mem- material that has newly risen into consciousness.
ory; explicit memory. This withholding tends to occur because of
conscious moment the present moment, shame, fear of rejection, or distrust of the ana-
often thought to be about 3 s in duration. This lyst. See resistance. Compare id resistance;
theoretical measurement approximates to the repression-resistance.
decay time for conscious sensory images.
conscious state see consciousness.
consciousness n. 1. the phenomena that hu-
mans report experiencing, including mental consensual validation the process by which a
contents ranging from sensory and somatic per- therapist helps a client check the accuracy of his
ception to mental images, reportable ideas, inner or her perception or the results of his or her ex-
speech, intentions to act, recalled memories, se- perience by comparing it with those of others,
mantics, dreams, hallucinations, emotional feel- often in the context of group therapy.
ings, “fringe” feelings (e.g., a sense of knowing), consensus trance a continuous state of cul-
and aspects of cognitive and motor control. Op- ture-induced trance in which individuals are hy-
erationally, these contents of consciousness are pothesized to exist. According to this idea,
generally assessed by the ability to report an feelings, impressions, and images considered to
event accurately (see reportability). 2. any of be part of conscious reality are the result of pow-
various subjective states of awareness in which erful, repeated suggestions instilled in people
conscious contents can be reported. Conscious- since birth.
134
constructive coping
consent n. voluntary assent or approval given by cific mental and physical disorders. These factors
an individual: specifically, permission granted include hereditary predispositions and physio-
by an individual for medical or psychological logical characteristics (circulatory, musculo-
treatment, participation in research, or both. In- skeletal, glandular, etc.).
dividuals should be fully informed about the constitutional psychopathic inferior a
treatment or study and its risks and potential former name for an individual with antisocial
benefits (see informed consent). C
personality disorder. The term psychopathic
conservation withdrawal a response to inferior was introduced in 1888 by German phy-
emotional or physical stressors (or both) in sician Robert Koch (1843–1910) and included by
which a person tends to withdraw from family German psychiatrist Emil Kraepelin (1856–
and friends, become fatigued, and have less en- 1928) in his classification of mental disorders
ergy and strength for activities. A means of con- (1893). U.S. psychiatrist Adolf Meyer (1866–
serving energy and recouping psychological and 1950) added the word constitutional in the sense
physical strength, this response resembles symp- of deep-seated (but not congenital).
toms experienced as part of a major depressive constitutional type a classification of individ-
episode. uals based on physique and other biological
conservatorship n. a legal arrangement by characteristics or on a hypothetical relationship
which an individual is appointed by a court to between physical and psychological characteris-
protect the interests and property of a person tics, such as temperament, personality, and a
who cannot be declared incompetent (see in- tendency to develop a specific type of mental
competence) but is unable by reason of a physi- disorder. See kretschmer typology; shel-
cal or mental condition to take full responsibility don’s constitutional theory of personal-
for managing his or her own affairs. ity.
consistency motive the desire to get feedback constraint question one of a series of ques-
that confirms what one already believes about tions that narrow the field of inquiry, particu-
one’s self. This contributes to maintaining a sta- larly in psychotherapy.
ble, unchanging self-concept, whether posi- construal n. a person’s perception and interpre-
tive or negative. Compare appraisal motive; tation of attributes and behavior of the self or
self-enhancement motive. See also self- others. See also independent self-construal;
verification hypothesis. interdependent self-construal.
consistency principle the theory that healthy construct n. 1. a complex idea or concept
and well-adjusted people strive to be consistent formed from a synthesis of simpler ideas. 2. an
in their behavior, opinions, and attitudes. explanatory model based on empirically verifi-
Consonar n. a trade name for brofaromine. able and measurable events or processes—an
conspecific 1. adj. belonging to the same spe- empirical construct—or on processes inferred
cies. 2. n. a member of the same species. from data of this kind but not themselves di-
rectly observable—a hypothetical construct.
constancy law see principle of constancy.
Many of the models used in psychology are hy-
constant error a systematic error in some par- pothetical constructs. See also as-if hypothesis;
ticular direction. Constant error is computed as heuristic. 3. in the study of social cognition, an
the average positive or negative difference be- element of knowledge (a cognitive construct).
tween the observed and actual values along a di-
constructional apraxia an inability, because
mension of interest. For example, if a weight of 1
of brain damage, to copy an object or assemble it
kg is judged on average to be 1.5 kg, the constant
from its component parts. Tests for the condi-
error is 500 g. See also absolute error; ran-
tion include drawing from a model, reconstruc-
dom error.
tions of puzzles, and building a particular
constellation n. in cognitive psychology, a structure using wooden sticks or blocks. See
group of ideas with a common theme or associa- apraxia.
tion. —constellatory adj.
constructive alternativism in the personal-
constitution n. 1. the sum of an individual’s in- ity construct theory of U.S. psychologist George
nate characteristics. 2. more broadly, the basic A. Kelly (1905–1967), the capacity to view the
psychological and physical makeup of an indi- world from multiple perspectives, that is, to en-
vidual, due partly to heredity and partly to life vision a variety of alternative constructs.
experience and environmental factors. —con-
constructive coping any instrumental ap-
stitutional adj.
proach to stress management that is generally
constitutional disorder a condition, disease, considered to be adaptive or otherwise positive.
behavior, or constellation of behaviors arising Examples include planning and strategizing,
from or inherent within some aspect of the indi- seeking help and support from others,
vidual’s physical makeup or physiological char- reframing the situation, and meditating. Con-
acteristics. structive coping strategies are task relevant and
constitutional factor a basic physiological action oriented, and are divided into one of
tendency that is believed to contribute to per- three categories: problem-focused coping,
sonality, temperament, and the etiology of spe- emotion-focused coping, and appraisal-fo-
135
constructive hypothesis of consciousness
cused coping. They rely on realistic assessments constructed through social and cultural experi-
of stressors and available coping resources; in- ence. See social constructivism.
deed, their use is associated with better physical construct validation the process of establish-
and mental health outcomes than the use of ing the construct validity of an instrument.
other strategies (e.g., active coping, passive The process usually requires the simultaneous
coping, defense mechanisms). Research sug- examination of convergent validity, dis-
C gests that constructive coping is likely to be used criminant validity, and content validity.
when stressors are of high intensity or when
there is little negative emotional arousal gener- construct validity the degree to which a test
ated in the context of the stressful experience or or instrument is capable of measuring a theoreti-
event. cal construct, trait, or ability (e.g., intelligence).
consultant n. 1. a mental health care or medical
constructive hypothesis of conscious-
specialist called upon to provide professional ad-
ness the hypothesis that the function of con-
vice or services in terms of diagnosis, treatment,
sciousness is to construct experience in a flexible
or rehabilitation. 2. in the United Kingdom, a
way depending on the context and available
hospital doctor of the most senior rank in his or
mental contents. [originated by Austrian-born
her field.
U.S. psychologist George A. Mandler (1924– )]
consulting n. the use of the particular skill, ex-
constructive memory a form of remembering perience, and expertise of an individual or group
marked by the use of general knowledge stored to advise individuals, groups, or organizations.
in one’s memory to construct a more complete
and detailed account of an event or experience. consulting psychology the branch of psy-
See bartlett technique; reconstructive chology that provides expert psychological guid-
memory. ance to business and industry, federal and state
agencies, the armed forces, educational and sci-
constructive thinking the ability to solve entific groups, religious groups, and volunteer
problems in everyday life with minimal stress. and public service organizations. Consulting
Constructive Thinking Inventory (CTI) a psychologists specialize in a variety of ap-
self-report measure of experiential intelligence, proaches—clinical, community, school, educa-
yielding scores on such dimensions as super- tion, and industrial and organizational—and
stitious thinking, categorical thinking, naive offer a wide variety of services, the most com-
optimism, and defensiveness. Designed for indi- mon of which are individual assessment, indi-
viduals aged 18 to 80 years, it consists of 108 self- vidual and group-process consultation,
statements about thoughts and behavior to organizational development, education and
which participants respond using a 5-point training, employee selection and appraisal, re-
likert scale format, ranging from “definitely search and evaluation test construction, man-
false” to “definitely true.” [originally developed agement coaching, and change management.
in 1989 by U.S. psychologist Seymour Epstein consumer n. an individual who purchases (or
(1924– )] otherwise acquires) and uses goods or services. In
constructivism n. the theoretical perspective, the context of medical and mental health care,
central to the work of Jean piaget, that people consumers are those who purchase or receive
actively build their perception of the world and health care services.
interpret objects and events that surround them consumer counseling counseling for individ-
in terms of what they already know. Thus, their uals that focuses on good decision making in
current state of knowledge guides processing, personal money management.
substantially influencing how (and what) new consumer empowerment a practice in which
information is acquired. Also called construc- the end-users of services increase their exercise
tionism. See also social constructivism. of service choice and their influence over how,
constructivist psychotherapy 1. a form of when, and by whom services are developed, de-
individual psychotherapy, derived from con- livered, and changed.
structivism, that focuses on meaning-making consumerism n. a movement to protect the
to help clients reconceptualize their problems in rights of the consumer with regard to the quality
a more life-enhancing way using story, myth, and safety of available products and services (in-
poetry, and other linguistic and nonverbal cluding psychotherapeutic and medical care).
forms. 2. a group of psychotherapies all of which Consumers of mental health care have a number
rely on a philosophy of interpersonal and social of clearly defined rights, including the right to
processes of meaning-making. Such therapies know, to confidentiality, to choice, to determi-
are typically derived from constructivism and nation of treatment, to nondiscrimination, to
encompass developments in existential, human- treatment review, and to accountability of treat-
istic, and family therapy. See also narrative ing professionals. —consumerist adj.
therapy. [developed by U.S. clinical psycholo-
contact comfort the positive effects experi-
gist George Kelly (1905–1967)]
enced by infants or young animals when in close
constructivist theory of emotion any the- contact with soft materials. The term originates
ory holding that emotions are not innate but from the classic experiments of U. S. psycholo-
136
contextualism
gist Harry Harlow (1905–1981), in which young that the world is disgusting, decaying, and
rhesus monkeys exposed both to an artificial dying. In extreme cases, it is regarded as a symp-
cloth mother without a bottle for feeding and to tom of schizophrenia.
an artificial wire mother with a bottle for feeding contemporaneity n. in psychotherapy, the
spent more time on the cloth mother and, when principle of focusing on immediate experience.
frightened, were more readily soothed by the See also here and now.
presence of the cloth mother than the wire C
contempt n. an emotion characterized by nega-
mother.
tive regard for anything or anybody considered
contact desensitization a variation of sys- to be inferior, vile, or worthless. —contemptu-
tematic desensitization involving partici- ous adj.
pant modeling instead of relaxation training: content n. in psychology, the thoughts, images,
used especially in the treatment of anxiety. The and sensations that occur in conscious experi-
therapist demonstrates appropriate behaviors, ence. Contents are contrasted with the mental
beginning with those in the weakest anxiety- processes or the neural structures that underlie
provoking situation for the client, and then as- them.
sists the client in performing such behaviors. For
example, in working with a client who is afraid contentiousness n. a tendency toward disputes
of spiders, the therapist might first sit near a spi- and strife: quarrelsomeness. Contentiousness
der, then touch the spider, and then pick it up may be observed in mania and in the early stages
while the client observes. The client, with the of predominantly persecutory delusional dis-
guidance and assistance of the therapist, would orders when individuals perceive that they are
then perform the same activities in the same being treated unfairly.
order. content psychology an approach to psychol-
ogy that is concerned with the role of conscious
contagion n. in social theory, the spread of be- experience and the content of that experience.
haviors, attitudes, and affect through crowds
The term is mainly applied to early struc-
and other types of social aggregation from one
turalism. Compare act psychology.
member to another. Early analyses of contagion
suggested that it resulted from the heightened contents of consciousness see conscious-
suggestibility of members and likened the pro- ness.
cess to the spread of contagious diseases. Subse- content-thought disorder a type of thought
quent studies have argued that contagion is disturbance, typically found in schizophrenia
sustained by relatively mundane interpersonal and some other mental disorders (e.g., obses-
processes, such as social comparison (see social sive-compulsive disorder, mania), character-
comparison theory), imitation, social fa- ized by multiple fragmented, bizarre delusions.
cilitation, conformity, and universality. content validity the extent to which a test
Also called social contagion. See also collec- measures a representative sample of the subject
tive hysteria; mass contagion. matter or behavior under investigation. For ex-
containment n. in object relations theory, ample, if a test is designed to survey arithmetic
the notion that either the mother or the analyst skills at a third-grade level, content validity will
aids growth and alleviates anxieties by acting as indicate how well it represents the range of arith-
a “container,” or “holding environment,” for metic operations possible at that level.
the projected aspects of the child’s or patient’s context n. 1. generally, the conditions or cir-
psyche (see projection). For instance, the in- cumstances in which a particular phenomenon
fant, overwhelmed by distress and having no occurs. 2. in studies of cognition, the environ-
context to understand the experience, is held ment in which a stimulus event occurs, espe-
and soothed by the parent, who thus creates a cially as this influences memory, learning,
safe context for the child and endows the experi- judgment, or other cognitive processes. 3. in lab-
ence with meaning. oratory tasks involving the recognition of stim-
contamination n. 1. in testing and experimen- uli, the setting in which a target stimulus is
tation, the process of permitting knowledge, ex- presented, including any distractors or maskers.
pectations, or other factors about the variable —contextual adj.
under study to influence the collection and in- context shifting in conversation or therapy, a
terpretation of data about that variable. 2. the tendency to change subjects abruptly, generally
mixing together of two or more discrete per- to avoid anxiety-laden issues.
cepts, such as might occur on the rorschach context-specific learning learning that has
inkblot test or the machover draw-a- occurred in a particular place, or context, and is
person test. 3. the creation of a neologism by displayed only in that context and not when
combining a part of one word with a part of an- testing occurs in another context.
other, usually resulting in a word that is unintel- contextualism n. 1. the theory that memory
ligible. and learning are not the result only of linkages
contamination obsession an intense preoc- between events, as in the associationist doctrine,
cupation with disease, dirt, germs, mud, excre- but are due to the meaning given to events by
ment, sputum, and so forth, based on a feeling the context surrounding the experiences. 2. a
137
contextualize
worldview asserting that the environment in continuing bond the emotional attachment
which an event occurs intrinsically informs the that a bereaved person continues to maintain
event and its interpretation. with the deceased long after the death. The in-
contextualize vb. to interpret an event within creasingly influential continuing-bond ap-
a preexisting mental framework. See context. proach focuses on ways in which the emotional
—contextualization n. and symbolic relationship with the deceased can
C be reconstructed and integrated into the individ-
continence n. the ability to control sexual urges
ual’s life. See also bereavement; grief; mourn-
or the urge to defecate or urinate. —continent
ing; object loss.
adj.
contingencies of self-worth particular areas continuing care unit (CCU) a hospital unit to
of life in which people invest their self-esteem, which a patient with a catastrophic or chronic
such that feedback regarding their standing or illness is transferred for additional care after the
abilities in these domains has a crucial impact on acute hospitalization period. Compare inten-
their self-concept. Research indicates that peo- sive care unit. See also convalescent center;
ple choose to stake their self-esteem in different skilled nursing facility.
domains, so that for some people material or continuing medical education (CME)
professional success is vital to their sense of self- postdoctoral educational activities that serve to
worth, whereas for others this is much less im- develop or extend the knowledge, skills, and
portant than being well liked or sexually attrac- professional qualities that a physician uses to
tive. provide health care services.
contingency n. a conditional, probabilistic rela- continuity n. the quality or state of being un-
tion between two events. When the probability ending or connected into a continuous whole.
of Event B given Event A is 1.0, a perfect positive For example, the traditional concept of continu-
contingency is said to exist. When Event A pre- ity of care implies the provision of a full range of
dicts with certainty the absence of Event B, a per- uninterrupted medical and mental health care
fect negative contingency is said to exist. services to a person throughout his or her life-
Probabilities between –1.0 and 1.0 define a con- span, from birth to death, as needed.
tinuum from negative to positive contingencies, continuity hypothesis 1. the assumption
with a probability of zero indicating no contin- that successful discrimination learning or
gency. Contingencies may be arranged via de- problem solving results from a progressive, in-
pendencies or they may emerge by accident (see cremental, continuous process of trial and error.
accidental reinforcement). See also rein- Responses that prove unproductive are extin-
forcement contingency. guished, whereas every reinforced response re-
contingency contract a mutually agreed- sults in an increase in associative strength,
upon statement between a teacher and student, thus producing the gradual rise of the learning
a parent and child, or a client and therapist re- curve. Problem solving is conceived as a step-by-
garding the change or changes desired, typically step learning process in which the correct re-
specifying behaviors and their positive and neg- sponse is discovered, practiced, and reinforced.
ative consequences. Compare discontinuity hypothesis. 2. the
contingency management in behavior contention that psychological processes of vari-
therapy, a technique in which a reinforcement, ous kinds (e.g., learning, childhood develop-
or reward, is given each time the desired behav- ment) take place either in small steps or
ior is performed. This technique is particularly continuously, rather than in jumps from one
common in substance abuse treatment. identifiable stage to another. Also called conti-
contingency table a two-dimensional table in nuity theory.
which the number of cases that are simulta- continuous amnesia ongoing memory loss
neously in a given spot in a given row and col- for all events after a particular period of time, up
umn of the table are specified. For example, the to and including the present.
ages and geographical locations of a sample of continuous bath treatment see hydro-
individuals applying for a particular job may be therapy.
displayed in a contingency table, such that there
are X number of individuals under 25 from New continuous group see open group.
York City, Y number of individuals under 25 continuous operations (CONOPS) opera-
from Los Angeles, Z number of individuals be- tions conducted without interruption, which
tween the ages of 25 and 35 from New York City, require strict discipline, planning, time manage-
and so on. ment, and coordination. They may cause sleep
continued-stay review (CSR) a utilization loss and affect ability to perform operational
review in which an internal or external auditor tasks.
determines if continued inpatient care is medi- continuous performance test (CPT) any
cally necessary or if the current health care facil- test that measures sustained attention and con-
ity is still the most appropriate to provide the centration, usually by requiring responses to an
level of care required by the patient. See also auditory or verbal target stimulus while ignoring
concurrent review; extended-stay review. nontarget stimuli.
138
control-mastery theory
continuous rating scale a scale on which rat- contrasuggestibility n. a tendency to do or

ings are assigned along a continuum (e.g., a line) say the opposite of what has been suggested or
rather than according to categories. Such ratings requested.
are made by making a mark on the scale to indi- contributing cause a cause that is not suffi-
cate the “placement” of the rating or by assign- cient to bring about an end or event but that
ing a numerical value to indicate the magnitude helps in some way to bring about that end or
of response. C
event. A contributing cause may be a necessary
continuous recognition task a memory task condition or it may influence events more indi-
in which a series of items is presented, with some rectly by affecting other conditions that make
items presented on multiple occasions in the se- the event more likely.
ries. The participant responds to each item by in-
control n. 1. authority, power, or influence over
dicating whether it is old (seen previously in the
events, behaviors, situations, or people. 2. the
series) or new (not seen earlier in the series).
regulation of all extraneous conditions and vari-
continuous variable a random variable ables in an experiment so that any change in the
that can take on an infinite number of values; dependent variable can be attributed solely to
that is, a variable measured on a continuous manipulation of the independent variable. In
scale, as opposed to a categorical variable. other words, the results obtained will be due
Also called continuous random variable. solely to the experimental condition or condi-
continuum approach an approach based on tions and not to any other factors.
the view that behavior ranges over a continuum control analysis psychoanalytic treatment
from effective functioning to severe abnormal- conducted by a trainee under the guidance of a
ity. It assumes that differences between people’s qualified psychoanalyst, who helps the
behavior are a matter of degree rather than kind. trainee to decide the direction of the treatment
contraception n. the prevention of concep- and to become aware of his or her counter-
tion, that is, the natural fertilization of the fe- transference. Also called supervised analy-
male ovum by the male spermatozoa. See birth sis; supervisory analysis.
control. —contraceptive n., adj. control condition see control group.
contract n. an explicit written agreement be- control group a group of participants in an ex-
tween parties or individuals. A contract between periment that are exposed to the control condi-
a client and therapist may detail (a) both the cli- tions, that is, the conditions of the experiment
ent’s and the therapist’s obligations, (b) the pro- not involving a treatment or exposure to the in-
visions for benefits or privileges to be gained dependent variable. Compare experimental
through achievements, and (c) the specified con- group.
sequences of failures (e.g., missing sessions). See
also behavioral contract; contingency controlled drinking a controversial approach
contract. to alcoholism treatment formerly advocated by
some behaviorists as a viable alternative to total
contracture n. an abnormal shortening or
abstinence. The development of treatment pro-
tightening of a muscle, which can result in per-
grams based on social learning approaches and
manent disability due to difficulty in stretching
training in self-regulation and coping skills did
the muscle. A contracture often follows a disor-
not consistently materialize, and, since the
der or injury that makes movement painful or is
1980s, research has not supported controlled
a consequence of prolonged, enforced inactivity
drinking as an efficacious or ethical primary goal
(e.g., a coma).
of intervention.
contrarian n. a person who tends to disagree
with someone or argue against something, re- Controlled Oral Word Association
gardless of the validity of the topic under discus- (COWA) a test that requires participants to
sion. name all the words that they can beginning with
specific letters (most commonly F, A, and S). The
contrast n. 1. that state in which the differences words cannot include proper names and cannot
between one thing, event, or idea and another consist of previously used words with a suffix.
are emphasized by a comparison of their quali- The most widely utilized word fluency task,
ties. This may occur when the stimuli are juxta- COWA is used to measure executive func-
posed (simultaneous contrast) or when one tions. Also called FAS Test. [originally devel-
immediately follows the other (successive con- oped in 1968 by U.S. neuropsychologist Arthur
trast). In making judgments, for example, meet- Lester Benton (1909–2006)]
ing a person in a social context that includes
physically attractive people could lead to a more controlled processing in cognitive psychol-
negative evaluation of the attractiveness of that ogy, attentive processing: that is, processing that
person than would have been the case otherwise. requires control, effort, and intention. See at-
The evaluation of the person’s attractiveness has tention.
been contrasted away from the social context. 2. control-mastery theory 1. a perspective, un-
in the analysis of variance, a comparison derlying an integrative form of psychotherapy,
among group means using one degree of free- that focuses on changing a client’s unconscious
dom. and maladaptive beliefs developed in childhood
139
control processes
due to thwarted attempts to achieve attachment which an individual uses linear, logical steps to
and safety in the client’s family. The client is analyze a number of already formulated solu-
seen to have an inherent motivation toward tions to a problem to determine the correct one
health that results in testing these beliefs or the one that is most likely to be successful.
through transference and through passive- Compare divergent thinking.
into-active behaviors; when such testing is pro- convergent validity a form of construct va-
C ductive, the client is then free to pursue adaptive lidity based on the degree to which the mea-
goals. [developed by U.S. psychiatrist Joseph surement instrument in question exhibits high
Weiss] 2. an integrative approach to child devel- correlation with conceptually similar instru-
opment that focuses on thoughts, feelings, and ments. See also discriminant validity.
behaviors resulting from children’s needs for at-
tachment and safety in the family. conversion n. 1. an unconscious process in
which anxiety generated by psychological con-
control processes 1. in the theory of memory flicts is transformed into physical symptoms.
proposed by U.S. cognitive psychologists Rich- Traditionally, this process was presumed to be
ard C. Atkinson (1930– ) and Richard M. involved in conversion disorder, but current
Shiffrin (1942– ), those processes that manipu- DSM–IV–TR diagnostic criteria for the disorder
late information in short-term memory, such as do not make such an implication. 2. in a thera-
rehearsal or recoding. 2. those processes that peutic context, the movement of clients away
organize the flow of information in an informa- from their initial interpretations to one recom-
tion-processing system. See also cognitive mended by their therapists. 3. actual change in
control; executive. an individual’s beliefs, attitudes, or behaviors
control variable a variable that is purposely that occurs as a result of social influence. Un-
not changed during an experiment in order to like compliance, which is outward and tempo-
minimize its effects on the outcome. Because rary, conversion occurs when the targeted
control variables are outside factors related in individual is personally convinced by a persua-
some way to the other variables under investiga- sive message or internalizes and accepts as his or
tion, their influence may potentially distort re- her own the beliefs expressed by other group
search results. members. Also called private acceptance. See
also conformity. —convert vb.
contusion n. a bruise. For example, various
kinds of head injury can result in cerebral con- conversion anesthesia a sensory conver-
tusion. sion symptom marked by the absence of sensa-
tion in certain areas of the body that cannot be
convalescent center an extended care facil-
accounted for by any identifiable organic pa-
ity for patients whose recovery from disease or
thology or defect. See glove anesthesia;
injury has reached a stage where full-time hospi-
stocking anesthesia.
tal inpatient services are no longer required.
Convalescent centers generally provide profes- conversion disorder in DSM–IV–TR, a
sional personnel, including an available physi- somatoform disorder in which patients pre-
cian and 24-hour nursing service, rehabilitation sent with one or more symptoms or deficits
services, and an authorized system of dispensing affecting voluntary motor and sensory function-
medications. See also continuing care unit; ing that suggest a physical disorder but for which
skilled nursing facility. there is instead evidence of psychological in-
volvement. These conversion symptoms are not
convenience sampling the process of obtain-
intentionally produced or feigned and are not
ing a sample because it is convenient for the pur-
under voluntary control. They include paralysis,
pose, regardless of whether it is representative of
loss of voice, blindness, seizures, globus pha-
the population being investigated.
ryngeus, disturbance in coordination and bal-
conventional antipsychotic see antipsy- ance, and loss of pain and touch sensations (see
chotic. motor conversion symptoms; sensory con-
conventionalism n. a personality trait marked version symptoms).
by excessive concern with and inflexible adher- conversion hysteria a former name for con-
ence to social customs and traditional or ac- version disorder.
cepted values and standards of behavior. The conversion nonepileptic seizure a form of
term is also used to refer specifically to one of the psychogenic nonepileptic seizure (PNES)
traits associated with the authoritarian per- that is a result of a diagnosed conversion dis-
sonality. order. It is not associated with abnormal elec-
convergent production the capacity to pro- trical activity on an electroencephalogram. Most
duce the right answer to a question or to choose PNESs are conversion nonepileptic seizures. Also
the best solution to a problem. It is one of the called conversion seizure.
abilities recognized in Joy P. guilford’s theory conversion paralysis a psychogenic disor-
of intelligence (see guilford dimensions of in- der in which there is an apparent loss of func-
telligence). Compare divergent production of the muscles of a limb or a portion of the
tion. body for which no neurological cause can be
convergent thinking critical thinking in identified. Unlike organic paralysis, reflexes may
140
coprophrasia
be intact, muscle tone may be normal, and the fear. See also coping-skills training. [devel-
paralyzed limb may be moved inadvertently oped by U.S. psychologist Joseph R. Cautela
when the patient’s attention is elsewhere. This is (1927–1999)]
one of the possible symptoms of conversion coping mechanism any conscious or uncon-
disorder. scious adjustment or adaptation that decreases
conversion seizure see conversion non- tension and anxiety in a stressful experience or C
epileptic seizure. situation. Modifying maladaptive coping mech-
conversion symptom see conversion disor- anisms is often the focus of psychological inter-
der. ventions. See also coping behavior; coping
strategy.
conversion therapy a highly controversial
and generally discredited therapy based on the coping potential an individual’s evaluation of
belief that individuals of same-sex sexual orien- the prospects of successfully managing environ-
tation may become heterosexual. Also called re- mental demands or personal commitments.
orientation therapy; reparative therapy. Coping potential differs from coping in that it
deals with prospects of successful management
convulsant n. any substance that causes or oth-
(rather than with actual deployment of re-
erwise results in convulsions, usually by block-
sources).
ing inhibitory neurotransmission.
convulsion n. an involuntary, generalized, vio- coping-skills training therapy or educational
interventions to increase an individual’s ability
lent muscular contraction, in some cases tonic
to manage a variety of often uncomfortable or
(contractions without relaxation), in others
anxiety-provoking situations, ranging from rela-
clonic (alternating contractions and relaxations
tively normal or situational problems (e.g., test
of skeletal muscles).
taking, divorce) to diagnosed disorders (e.g.,
convulsive disorder any form of epilepsy that phobias). The types of skills taught are tailored to
involves recurrent generalized seizures or the situation and can involve increasing cogni-
partial seizures with convulsions. tive, behavioral, and affective proficiencies.
convulsive therapy any treatment that is coping strategy an action, a series of actions,
based on the induction of a generalized seizure or a thought process used in meeting a stressful
by electrical or chemical means. See electro- or unpleasant situation or in modifying one’s re-
convulsive therapy. action to such a situation. Coping strategies typi-
Coolidge Assessment Battery (CAB) a self- cally involve a conscious and direct approach to
administered rating-scale instrument used to problems, in contrast to defense mechanisms.
measure DSM–IV–TR personality (Axis II) disor- See also coping behavior; coping mecha-
ders, as well as five major clinical (Axis I) disor- nism; emotion-focused coping; problem-
ders and executive function. Developed in focused coping.
1999, it comprises 225 items to which partici- coping style the characteristic manner in which
pants respond using a 4-point likert scale an individual confronts and deals with stress,
ranging from strongly false (1) to strongly true anxiety-provoking situations, or emergencies.
(4). The CAB is a more comprehensive successor
to the Coolidge Axis II Inventory. [Frederick L. coprolagnia (koprolagnia) n. a paraphilia
Coolidge (1948– ), U.S. neuropsychologist] in which the sight, or even the thought, of excre-
ment may result in sexual pleasure.
COPD abbreviation for chronic obstructive
pulmonary disease. coprolalia n. spontaneous, unprovoked, and
uncontrollable use of obscene or profane words
coping n. the use of cognitive and behavioral and expressions, particularly those related to
strategies to manage the demands of a situation feces. It is a symptom that may be observed in in-
when these are appraised as taxing or exceeding dividuals with a variety of neurological disor-
one’s resources or to reduce the negative emo- ders, particularly tourette’s disorder. See also
tions and conflict caused by stress. See also cop- latah. Also called coprophrasia.
ing strategy. —cope vb.
coprophagia n. the eating of feces. Also called
coping behavior a characteristic and often au- coprophagy.
tomatic action or set of actions taken in dealing
with stressful or threatening situations. Coping coprophemia (koprophemia) n. the use of
behaviors can be both positive (i.e., adaptive), obscenities as a paraphilia, for example to stim-
for example, taking time to meditate or exercise ulate sexual excitement. See scatophilia.
in the middle of a hectic day; or negative (i.e., coprophilia n. literally, the love of feces, which
maladaptive, avoidant), for example, not con- is manifested in behavior as an excessive or
sulting a doctor when symptoms of serious ill- pathological preoccupation with the bodily
ness appear or persist. See also coping product itself or with objects and words that rep-
mechanism; coping strategy. resent it. In classical psychoanalytic theory,
coping imagery a desensitization technique these tendencies are held to represent a fixation
in which relaxation is accompanied by images during the anal stage of development. See also
that have proved successful in controlling anxi- paraphilia not otherwise specified.
ety in situations that had previously aroused coprophrasia n. see coprolalia.
141
core conflictual relationship theme
core conflictual relationship theme a hemispheric commissures, it is known as the

method of research, case formulation, and great commissure.
psychodynamic psychotherapy that empha- correctional psychology a branch of foren-
sizes central relationship patterns in clients’ sto- sic psychology concerned with the applica-
ries. Three components are analyzed: the wishes, tion of counseling and clinical techniques to
needs, or intentions of the client with regard to criminal and juvenile offenders in penal and cor-
C the other person; the other person’s expected or rectional institutions (e.g., reformatories, train-
actual reaction to these; and the client’s emo- ing schools, penitentiaries). Correctional
tion, behavior, or symptoms as they relate to the psychologists also participate professionally in
other person’s reaction. [developed by U.S. psy- court activities, probation departments, parole
chologist Lester Luborsky (1920–2009)] boards, prison administration, supervision of in-
core gender identity in psychoanalytic the- mate behavior, and programs for the rehabilita-
ory, an infant’s sense of himself or herself as tion of offenders.
male or female, typically solidifying in the sec- corrective emotional experience a concept
ond year of life. See also gender identity. from psychoanalysis positing that clients
core relational themes 1. in the cognitive achieve meaningful and lasting change through
appraisal theory of emotions, a person’s judg- new interpersonal affective experiences with the
ments of the specific significance of particular therapist, particularly with regard to situations
events to himself or herself, resulting in the gen- that clients were unable to master as children.
eration of specific emotional states (e.g., anger, This concept has been debated both within and
joy, envy, or shame) in that person. Any core outside psychoanalytic treatment circles. [advo-
relational theme has three components: goal rel- cated by Hungarian psychoanalyst Franz Alexan-
evance, ego involvement, and coping poten- der (1891–1964)]
tial. See primary appraisal; secondary ap- correlation n. the degree of a relationship (usu-
praisal. 2. repetitive patterns of relating to ally linear) between two attributes.
others that are presumed to be determined by re- correlational design a research method that
lationships with parents and other influential attempts to identify and describe the relation-
individuals in early life. These relational themes ship between two variables without directly ma-
can include dependent patterns and distrustful nipulating them. Correlational designs are often
patterns, among others. used in clinical and other applied areas of psy-
Coricidin n. a trade name for dextrometh- chology and do not allow for inferences regard-
orphan. ing cause and effect; that is, a change in one
particular variable employed in the research can-
Cornelia de Lange’s syndrome see de
not be said with any certainty to result in a
lange’s syndrome.
change in the other.
Cornell Medical Index (CMI) a psychological correlational study a study of the relation-
test originally designed for screening military ship between two or more variables.
personnel in World War II and later adapted for
other purposes, such as diagnosing psychoso- correlation coefficient (symbol: r) a numeri-
matic disorders on the basis of pathological cal index reflecting the degree of relationship
mood and anxiety. The test is now rarely used. (usually linear) between two attributes scaled so
Also called Cornell Selective Index. that the value of +1 indicates a perfect positive
relationship, –1 a perfect negative relationship,
coronary heart disease (CHD) a cardiovascu- and 0 no relationship. The most commonly used
lar disorder characterized by restricted flow of type of correlation coefficient is the product–
blood through the coronary arteries supplying moment correlation.
the heart muscle. The cause is usually athero-
sclerosis of the coronary arteries and often correlation matrix a square symmetric ma-
leads to fatal myocardial infarction. Behav- trix in which the correlation coefficient be-
ioral and psychosocial factors are frequently in- tween the ith and jth variables in a set of
volved in the development and prognosis of the variables is displayed in the intersection of the
disease. Also called coronary artery disease. ith row and the jth column of the matrix. The di-
agonal elements of a correlation matrix are all
coronary-prone behavior actions or patterns equal to 1.
of actions believed to be associated with an in-
correspondence training a behavior ther-
creased risk of coronary heart disease. The pre-
apy intervention for children and adolescents in
ferred term for such a behavior pattern is now
which the clients are tangibly or socially rein-
type a behavior.
forced either for verbally promising to do some-
corpse phobia see necrophobia. thing and then following through or for doing a
corpus callosum a large tract of nerve fibers desired behavior and then verbally reporting on
running across the longitudinal fissure of the the activity. Promises and reports can be made to
brain and connecting the cerebral hemispheres: either an adult or a peer.
It is the principal connection between the cortex n. (pl. cortices) the outer or superficial
two sides of the brain. The largest of the inter- layer or layers of a structure, as distinguished
142
Cotard’s syndrome
from the central core. In mammals, the cortex of levels. Blood levels of cortisol in humans vary ac-
a structure is identified with the name of the cording to sleep–wake cycles (being highest
gland or organ, for example, the adrenal cor- around 9:00 a.m. and lowest at midnight) and
tex, cerebellar cortex, or cerebral cortex. other factors; for example, they increase with
Compare medulla. —cortical adj. stress and during pregnancy but decrease during
cortical amnesia a form of amnesia due to or- diseases of the liver and kidneys. Since 1963,
cortisol and its synthetic analogs have been ad- C
ganic causes, such as a stroke or brain injury.
ministered in the treatment of chronic inflam-
cortical dementia dementia arising from de- matory and autoimmune disorders. Also called
generation of the cortical areas of the brain, hydrocortisone.
rather than the subcortical (deeper) areas. The
most common dementia of this type is alzhei- cortisone n. a corticosteroid that is produced
mer’s disease. Compare subcortical demen- naturally by the adrenal cortex or synthetically.
tia. Cortisone is biologically inactive but is con-
verted to the active hormone cortisol in the
cortical lesion a pathological change in the ce- liver and other organs. It is used therapeutically
rebral cortex of the brain, which may be con- in the management of disorders due to
genital or acquired and due to any cause. corticosteroid deficiency.
cortical undercutting a former psycho-
cosmic identification a feeling of identifica-
surgical procedure—a type of prefrontal lobot-
tion with the universe, which is most often seen
omy—used in controlling severe emotional and
in patients with schizoid personality disor-
mental disturbance. In this procedure the skull
der or borderline disorders. The patient can-
was opened and long association fibers severed.
not distinguish between that which is himself or
The object was to prevent frontal lobe damage,
herself and the outside world. Also called magic
which affects thinking processes.
omnipotence. See also mystic union; oce-
corticosteroid n. any of the steroid hormones anic feeling.
produced by the adrenal cortex. They include
the glucocorticoids (e.g., cortisol), which cost analysis a systematic determination of the
are involved in carbohydrate metabolism; and costs associated with the implementation of a
the mineralocorticoids (e.g., aldosterone), program’s services. These include direct person-
which have a role in electrolyte balance and so- nel, material, and administrative costs, calcu-
dium retention. Also called adrenocorticoid. lated from the perspective of a given purchaser
(e.g., government agency, client), budgetary cat-
corticosteroid therapy medical treatment egory, and time period. Once determined, these
that involves the use of corticosteroid drugs. costs are utilized further in cost–benefit anal-
Both mineralocorticoids and glucocorti- ysis or cost-effectiveness analysis.
coids may be used as replacement therapy in
patients whose secretion of the natural hor- cost–benefit analysis an analytic procedure
mones is deficient, either through disease or sur- that attempts to determine and compare the eco-
gical removal of one or both adrenal glands. nomic efficiency of different programs. Costs
However, glucocorticoids are most widely used and benefits are reduced to their monetary value
as anti-inflammatory agents; they are also used and expressed in a cost–benefit (or benefit–cost)
in the treatment of asthma, dermatologic condi- ratio.
tions, and seasonal rhinitis. cost containment a program goal that seeks to
corticotropin n. a hormone secreted by the an- control the costs involved in managing and de-
terior pituitary gland, particularly when a person livering the program outcome. In health ad-
experiences stress. It stimulates the release of ministration, a range of fiscal strategies is used to
various other hormones (primarily cortico- prevent health care costs from increasing. See
steroids) from the adrenal cortex, the outer also cost analysis.
layer of the adrenal gland. Also called adreno- cost-effectiveness analysis a measure of
corticotropic hormone (ACTH); adreno- program efficacy or economic efficiency ex-
corticotropin. pressed in terms of the cost of achieving a unit of
corticotropin-releasing factor (CRF) a program outcome. The analysis is most appro-
neuropeptide produced by the hypothalamus priate when programs have one main identifi-
that is important in the control of the hypo- able evaluation outcome, when future costs are
thalamic–pituitary–adrenal response to stress not confounded with changes in outcome, or
(see hypothalamic–pituitary–adrenocortical when outcomes are not directly reducible to
system). It controls the daily rhythm of cortico- monetary payoffs.
tropin (ACTH) release by the pituitary gland Cotard’s syndrome a psychotic condition
and is also involved in a number of behaviors, characterized by severe depression and intense
such as anxiety, food intake, learning, and mem- nihilistic delusions (see nihilism) in which indi-
ory. Also called ACTH-releasing factor; viduals insist that their bodies or parts thereof,
corticotropin-releasing hormone (CRH). and in some cases the whole of reality, have dis-
cortisol n. a corticosteroid hormone whose integrated or ceased to exist. [first reported in
glucocorticoid activity increases blood sugar 1880 by Jules Cotard (1840–1887), French neu-
143
cotherapy
rologist, who called it délire de négation (“delir- groups. Services are typically provided by li-
ium of negation”)] censed counselors, psychologists, social workers,
cotherapy n. therapy by two therapists working and nurses. See also counseling.
with a client, pair of clients (e.g., a couple), fam- counselor n. an individual professionally
ily, or group to enhance understanding and trained in counseling, psychology, social work,
C change behavior and relationships during treat- or nursing who specializes in one or more coun-
ment. Also called dual-leadership therapy. seling areas, such as vocational, rehabilitation,
couch n. in psychoanalysis, the article of furni- educational, substance abuse, marriage, relation-
ture on which the patient reclines. The use of the ship, or family counseling. A counselor provides
couch is based on the theory that this posture professional evaluations, information, and sug-
will facilitate free association, encourage the gestions designed to enhance the client’s ability
patient to direct attention to his or her inward to solve problems, make decisions, and effect de-
world of feeling and fantasy, and enable the pa- sired changes in attitude and behavior.
tient to uncover his or her unconscious mind. counteraction need the drive to overcome
The expression “on the couch” is sometimes difficult challenges rather than accept defeat. It
used popularly to indicate psychoanalytic treat- is motivated by the desire for power, knowledge,
ment. Also called analytic couch. prestige, or creative achievement. [defined by
cough suppressants see antitussives. U.S. psychologist Henry Alexander Murray
(1893–1988)]
counseling n. professional assistance in coping
with personal problems, including emotional, counterattitudinal role play a technique
behavioral, vocational, marital, educational, re- used in psychodrama or role play in which
habilitation, and life-stage (e.g., retirement) the individuals taking part are directed to ex-
problems. The counselor makes use of such press opinions contrary to those in which they
techniques as active listening, guidance, ad- believe.
vice, discussion, clarification, and the admin- counterbalancing n. the process of arranging
istration of tests. a series of experimental conditions or treatments
counseling process the interpersonal process in such a way as to minimize the influence of
engaged in by counselor and client as they at- other factors, such as practice or fatigue, on ex-
tempt to define, address, and resolve specific perimental effects. A simple form of counterbal-
problems of the client in face-to-face interviews. ancing would be to administer experimental
See also counseling. conditions in the order AB to half the partici-
pants and in the order BA to the other half.
counseling psychology the branch of psy-
chology that specializes in facilitating personal countercathexis n. see anticathexis.
and interpersonal functioning across the life countercompulsion n. a compulsion that is
span. Counseling psychology focuses on emo- secondarily developed to resist the original com-
tional, social, vocational, educational, health- pulsion when the latter cannot be continued.
related, developmental, and organizational con- The new compulsion then replaces the original
cerns—such as improving well-being, alleviat- so that the compulsive behavior can continue.
ing distress and maladjustment, and resolving See obsessive-compulsive disorder.
crises—and addresses issues from individual, counterconditioning n. an experimental pro-
family, group, systems, and organizational per- cedure in which an animal, already conditioned
spectives. The counseling psychologist has re- to respond to a stimulus in a particular way, is
ceived professional education and training in trained to produce a different response to the
one or more counseling areas, such as educa- same stimulus that is incompatible with the
tional, vocational, employee, aging, personal, original response. This same principle underlies
marriage, or rehabilitation counseling. In con- many of the techniques used in behavior ther-
trast to a clinical psychologist (see clinical psy- apy to eliminate unwanted behavior.
chology), who usually emphasizes origins of
maladaptations, a counseling psychologist em- counterfactual thinking imagining ways in
phasizes adaptation, adjustment, and more effi- which events in one’s life might have turned out
cient use of the individual’s available resources. differently. This often involves feelings of regret
or disappointment (e.g., If only I hadn’t been so
counseling relationship the interaction be- hasty) but may also involve a sense of relief, as at
tween counselor and client in which the rela- a narrow escape (e.g., If I had been standing three
tionship is professional yet also characterized by feet to the left …).
empathic warmth and authenticity, with the
counselor bringing professional training, experi- counterfeit role a false (i.e., inaccurate or de-
ence, and personal insight to bear on the prob- ceptive) role. See also role play.
lems revealed by the client. The relationship is counteridentification n. in psychoanalysis,
considered to be of central importance in bring- a form of countertransference in which
ing about desired change. the psychoanalyst identifies with the patient.
counseling services professional help pro- —counteridentify vb.
vided by a government, social service, or mental counterphobic character a personality that
health agency to individuals, families, and takes pleasure in pursuing risky or dangerous ac-
144
covert desensitization
tivities that other people would normally find moral risks involved in doing so. Examples of
anxiety-provoking. In psychoanalytic theory, acts of courage include saving another’s or one’s
this is explained as a manic defense that achieves own life against a meaningful threat; coping
satisfaction from the feeling of mastering anxi- with a painful, debilitating, or terminal illness;
ety. overcoming a destructive habit; and voicing an
countershock n. a mild electric shock adminis- unpopular opinion. Also called bravery; valor.
—courageous adj. C
tered to a patient undergoing electrocon-
vulsive therapy (ECT) for 1 min after the course n. the length of time a disorder, illness, or
convulsive shock. The countershock is intended treatment typically lasts, its natural progression,
to relieve some of the common aftereffects of and (if applicable) its recurrence over time.
ECT, such as postconvulsion confusion or amne- course modifier a pattern that develops in a
sia. disorder (e.g., recurrence, seasonal variation)
countersuggestion n. in psychotherapy, a sug- that helps to predict its future course or may
gestion by the therapist that contradicts or op- serve to alter its usual course.
poses a previous suggestion or a particular fixed courtesan fantasy see hetaeral fantasy.
idea. This strategy is used to decrease the influ- court-ordered treatment any assessment,
ence of the previous suggestion or idea, provide treatment, consultation, or other service for de-
an alternative, or both. fendants, plaintiffs, or criminal offenders that is
countertransference n. the therapist’s un- mandated by a judge or magistrate.
conscious reactions to the patient and to the couvade n. 1. a custom in some cultures in
patient’s transference. These thoughts and which the father takes to bed before or after his
feelings are based on the therapist’s own psycho- child is born, as if he himself suffered the pain
logical needs and conflicts and may be unex- of childbirth. 2. abdominal pain or other so-
pressed or revealed through conscious responses matic symptoms appearing in male partners of
to patient behavior. The term was originally pregnant women, usually presumed to be psy-
used to describe this process in psychoanalysis chogenic in origin. Also called couvade syn-
but has since become part of the common lexi- drome.
con in other forms of psychodynamic psycho-
covariance n. a scale-dependent measure of the
therapy and in other therapies. In classical
relationship between two variables.
psychoanalysis, countertransference is viewed
as a hindrance to the analyst’s understanding of covariate n. a correlated variable that is often
the patient, but to some modern analysts and controlled or held constant through the analy-
therapists it may serve as a source of insight into sis of covariance. Also called concomitant
the patient’s impact on other people. In either variable.
case, the analyst or therapist must be aware of, coverage n. health care benefits and services pro-
and analyze, countertransference so that it does vided within a given health plan.
not interfere with the therapeutic process. See cover memory see screen memory.
also control analysis.
covert behavior behavior that is not directly
couples counseling counseling in which observable and can only be inferred or self-
guidance and advice focuses on issues confront- reported. For example, imagining something is
ing relationships between partners. Couples covert behavior.
counseling is short-term and problem oriented; covert conditioning a technique of behavior
it may include a variety of approaches to such therapy that relies on the use of imagination
difficult areas as shared responsibilities, expecta- and assumes that overt and covert behaviors are
tions for the future, and loyalties. Compare cou- associated, that each affects the other, and that
ples therapy. both forms of behavior depend on the laws of
couples therapy therapy in which both part- learning. The individual imagines performing a
ners in a committed relationship are treated at desired behavior in a problematic real-life situa-
the same time by the same therapist or thera- tion, rewards himself or herself for mentally en-
pists. Couples therapy is concerned with prob- gaging in the behavior, and finally achieves an
lems within and between the individuals that actual change in behavior. Also called covert
affect the relationship. For example, one partner behavioral reinforcement. [developed in
may have an undiagnosed, physiologically based 1966 by U.S. psychologist Joseph R. Cautela
depression that is affecting the relationship, and (1927–1999)]
both partners may have trouble communicating covert desensitization a form of desensiti-
effectively with one another. Individual sessions zation therapy in which an individual is helped
may be provided separately to each partner, par- to overcome a fear or anxiety by learning to relax
ticularly at the beginning of therapy; most of the while recollecting the anxiety-producing stimu-
course of therapy, however, is provided to both lus in his or her imagination. A hierarchy is de-
partners together. Couples therapy for married vised with a sequence of items that range from
couples is known as marital therapy. the least to the most anxiety-producing aspects
courage n. the ability to meet a difficult chal- of the stimulus. The client then uses relaxation
lenge despite the physical, psychological, or techniques while progressively imagining items
145
covert extinction
on the hierarchy until able to imagine the stimu- COWA abbreviation for controlled oral
lus without feeling anxious. Compare in vivo word association.
desensitization. See also systematic desensi- CP abbreviation for cerebral palsy.
tization.
CPA abbreviation for canadian psychological
covert extinction a covert conditioning association.
C procedure in which the client first imagines per-
forming an unwanted behavior and then imag- CPI abbreviation for california psychologi-
ines failing to be rewarded or to receive cal inventory.
reinforcement for the behavior. See also co- CPQ abbreviation for children’s personality
vert positive reinforcement. questionnaire.
covert modeling a covert conditioning CPR fees abbreviation for customary, prevail-
procedure in which the client pictures a role ing, and reasonable fees.
model, imagines behaving as this person might, CPS abbreviation for comrey personality
and then visualizes specific favorable conse- scales.
quences of the behavior. See also covert posi-
CPT 1. abbreviation for cognitive processing
tive reinforcement.
therapy. 2. abbreviation for continuous per-
covert negative reinforcement in behav- formance test.
ior therapy, a technique in which the client
CPZ abbreviation for chlorpromazine.
first imagines an aversive event and then
switches to imagining engaging in the target be- crack n. a dried mixture of cocaine and baking
havior. For example, a client might imagine that soda that can be smoked. It contains a relatively
he or she is alone at a restaurant, feeling insecure small, inexpensive amount of cocaine, which
and unhappy, and then switches the imaginary produces a rapid and short-lived high, thus in-
scene to one in which he or she is asking another creasing the drug’s accessibility.
person for a date and that person says yes. Com- cracking facades the process of encouraging
pare covert positive reinforcement. people to reveal their true selves. It is associated
covert positive reinforcement in behavior with Carl rogers’s encounter-group work.
therapy, a technique in which a person imag- cramp n. a painful muscle spasm (contraction).
ines performing a desired behavior that is fol- cranial bifida a congenital disorder manifested
lowed by a pleasant consequence and by a horseshoe-shaped depression of the medial
subsequently rehearsing the behavior in the (middle) plane of the forehead. A median-cleft
hope that it will eventually be adopted. Also palate, a cleft of the nose ranging from a notch to
called covert reinforcement. Compare co- complete division, and widely spaced eyes are
vert negative reinforcement. present. Because of a failure of the two sides of
covert rehearsal a technique in which either the head to fuse normally during prenatal devel-
rote or elaborate repetitive rehearsing in one’s opment, the corpus callosum, the nerve tract
mind of words or behaviors is used to improve connecting the two sides of the brain, may be de-
memory or to prepare for overt speech or behav- fective. Mental retardation is common.
ior. See also behavior rehearsal. cranial electrical stimulation see electro-
covert reinforcement see covert positive sleep therapy.
reinforcement. cranial index the ratio of the maximum
covert response any generally unobservable re- breadth of the skull to its maximum length, mul-
sponse, such as a thought, image, emotion, or tiplied by 100. Compare cephalic index.
internal physiological reaction, the existence of cranial nerve any of the 12 pairs of nerves that
which is typically inferred or measured indi- arise directly from the brain and are distributed
rectly. For example, covert preparation for physi- mainly to structures in the head and neck. Some
cal responses can be observed in an electric brain of the cranial nerves are sensory, some are
potential called the lateralized readiness po- motor, and some are mixed (i.e., both sensory
tential and in electromyographic measures of and motor). Cranial nerves are designated by
muscle activity. Also called implicit response. Roman numerals, as follows: I, olfactory nerve;
Compare overt response. II, optic nerve; III, oculomotor nerve; IV, troch-
covert self an individual’s perception of his or lear nerve; V, trigeminal nerve; VI, abducens
her true nature. nerve; VII, facial nerve; VIII, vestibulocochlear
covert sensitization a behavior therapy nerve; IX, glossopharyngeal nerve; X, vagus nerve;
technique for reducing an undesired behavior in XI, accessory nerve; XII, hypoglossal nerve.
which the client imagines performing the unde- craniofacial dysostosis see crouzon’s syn-
sired behavior (e.g., overeating) and then imag- drome.
ines an unpleasant consequence (e.g., vomiting). craniostenosis n. a skull deformity caused by
covert speech talking to oneself. Covert speech premature closing of the cranial sutures. The
is usually seen as the externalization of a per- condition restricts normal development of brain
son’s inner voice: Some explanations have structures and usually results in mental retarda-
equated it with thought itself. tion.
146
cri du chat syndrome
craniotomy n. the surgical opening of the skull, objects or ideas but creates a new relationship
a procedure that may be performed, for example, between the elements it utilizes. Examples in-
to administer surgical treatment or to release clude new machines, social ideas, scientific theo-
pressure when the brain is expanding due to hy- ries, and artistic creations. Compare critical
drocephalus or cerebral edema. Craniotomy thinking. See also divergent thinking.
is one of the oldest types of surgery: Evidence of creativity n. the ability to produce or develop
it has been found in prehistoric skulls in nearly C
original work, theories, techniques, or thoughts.
every part of the world. A creative individual typically displays original-
crank n. a street name for smokable metham- ity, imagination, and expressiveness. Analyses
phetamine. have failed to ascertain why one individual is
crash n. 1. the withdrawal symptoms, usually more creative than another, but creativity does
dominated by feelings of severe depression, that appear to be a very durable trait. See also cre-
occur following a lengthy period of amphet- ative imagination; creative thinking; di-
amine intoxication. The user may sleep for sev- vergent thinking. —creative adj.
eral days more or less continuously, displaying creativity test any psychological test designed
signs of exhaustion and irritation during waking to identify creativity or divergent thinking.
periods. See amphetamine withdrawal. 2. the Existing tests focus on a variety of factors, such
period following the “rush” or “high” produced as an individual’s fluency with words and ideas
by intravenous cocaine. As feelings of euphoria or ability to generate original associations; tasks
wear off, they are replaced by irritability, depres- may involve finding solutions to practical prob-
sion, and anxiety, as well as strong craving for lems, suggesting different endings to stories, or
another dose. See cocaine withdrawal. listing unusual uses for objects. See also
creative arts therapy therapeutic interven- torrance tests of creative thinking.
tions that use artistic endeavors or mediums, credentialing n. the administrative process of
such as music, poetry, dance, and drama, to facil- reviewing a health care provider’s qualifications,
itate communication and emotional expression, practice history, and medical certification or
enhance self-awareness, and foster health and license to determine if criteria for clinical privi-
change. See also art therapy; dance therapy; leges are met. See also professional licensing.
drama therapy; music therapy; poetry ther-
apy. creeping commitment see escalation of
commitment.
creative dramatics the use, especially with
children, of spontaneous drama-oriented play Creutzfeldt–Jakob disease (CJD) a rapidly
(“pretending”) as a therapeutic technique de- progressive neurological disease characterized by
signed to enhance creativity and imagination, dementia, involuntary muscle movements (es-
improve communication and social skills, and pecially myoclonus), ataxia, visual distur-
foster health. The emphasis in creative dramatics bances, and seizures. Vacuoles form in the gray
is not on the end product (e.g., performance) but matter of the brain and spinal cord, giving it a
rather on the creative process itself. spongy appearance; the prion is thought to
cause misfolding of other proteins, leading to
creative imagination the faculty by which the cellular pathology. Classical CJD occurs spo-
new, uncommon ideas are produced, especially radically worldwide and typically affects individ-
when this does not seem explicable by the mere uals who are middle-aged or older. A small
combination of existing ideas. The operations of proportion (about 10%) of cases are inherited.
the creative imagination are sometimes ex- Early symptoms are muscular incoordination
plained by the interaction of dormant or uncon- (ataxia), with abnormalities of gait and speech,
scious elements with active, conscious thoughts. followed by worsening dementia and myo-
See also creative thinking; creativity; diver- clonus. Death occurs usually within 1 year of
gent thinking; imagination. the onset of symptoms. Variant CJD (vCJD) was
creative intelligence in the triarchic the- first reported in Great Britain in the 1990s. It
ory of intelligence, the set of skills used to causes similar symptoms but typically affects
create, invent, discover, explore, imagine, and younger people, who are believed to have
suppose. This set of skills is alleged to be rela- acquired the disease by eating meat or meat
tively (although not wholly) distinctive with re- products from cattle infected with bovine
spect to analytical and practical skills. Compare spongiform encephalopathy (BSE). Also called
analytical intelligence; practical intelli- Jakob–Creutzfeldt disease; subacute
gence. spongiform encephalopathy (SSE). [Hans
creative synthesis the combination of several Gerhard Creutzfeldt (1885–1964) and Alfons
ideas, images, or associations into a new whole, Jakob (1884–1931), German neuropathologists]
especially when this differs fundamentally from cri du chat syndrome a chromosomal disor-
any of its components. [coined by Wilhelm der involving deletion of the short arm of chro-
wundt] mosome 5, which results in severe mental
creative thinking the mental processes lead- retardation, walking and talking difficulty or in-
ing to a new invention, solution, or synthesis in ability, and an anomaly of the epiglottis and lar-
any area. A creative solution may use preexisting ynx that causes a high-pitched wailing cry like
147
criminal commitment
that of a cat. Almost all affected individuals have crisis intervention service any of the ser-
very small heads (see microcephaly). The devices provided (usually by governmental or so-
fect seems to be hereditary. Also called cat-cry cial agencies) during emergencies, disasters, and
syndrome; chromosome 5, deletion of for personal crises. Such services include hot
short arm; crying-cat syndrome; Lejeune lines, drop-in services, and on-site intervention
syndrome; monosomy 5p. at the scene of a disaster.
C
criminal commitment the confinement of crisis management the organization and mo-
people in mental institutions either because they bilization of resources to overcome the difficul-
have been found not guilty by reason of in- ties presented by a sudden and unexpected
sanity or in order to establish their competency threat. The psychological stress produced by a
to stand trial as responsible defendants. crisis can reduce the information-processing ca-
criminal intent see mens rea. pacities of those affected, which should be taken
into account by crisis managers when consider-
criminally insane describing defendants who
ing possible solutions.
are judged to be suffering from a mental illness
or defect that absolves them of legal responsibil- crisis team a group of professionals and
ity for the criminal acts they are alleged to have paraprofessionals trained to help individuals
committed. The term is now seldom used. cope with psychological reactions during and
criminal psychopath a person with antiso- following emergencies or mental health crises,
cial personality disorder who repeatedly vi- for example, natural disasters or suicide threats
olates the law. or attempts.
criminal responsibility a defendant’s ability crisis theory the body of concepts that deals
to formulate a criminal intent (see mens rea) at with the nature, precipitants, prevention, inter-
the time of the crime with which he or she is vention, and resolution of, as well as the behav-
charged, which must be proved in court before ior associated with, a crisis.
the person can be convicted. Criminal responsi- criteria of evaluation the criteria used to
bility may be excluded for reason of insanity specify or measure program impact or, often,
(see durham rule; irresistible impulse rule; program outcome as stated in the evalua-
mcnaughten rule) or mitigated for a number tion objectives of a study.
of other reasons (see diminished capacity; di-
criterion n. (pl. criteria) 1. a standard against
minished responsibility).
which a judgment, evaluation, or comparisons
criminal type a classification of individuals can be made. 2. a test score or item against
who repeatedly engage in criminal or illegal acts, which other tests or items can be validated. For
supposedly because of a genetic predisposition example, a well-validated test of creativity might
to do so. be used as the criterion to select new tests of
crisis n. (pl. crises) 1. a situation (e.g., a trau- creativity.
matic change) that produces significant cogni- criterion-based content analysis (CBCA) a
tive or emotional stress in those involved in it. 2. form of statement validity analysis in which
a turning point for better or worse in the course children’s statements in instances of alleged
of an illness. abuse are analyzed in terms of key content crite-
crisis center a facility established for emergency ria, in order to evaluate their truth.
therapy or referral, sometimes staffed by medical criterion group a group tested for traits its
and mental health professionals and para- members are already known to possess, usually
professionals. See drop-in center. for the purpose of validating a test. For example,
crisis counseling immediate drop-in, phone- a group of children with diagnosed visual dis-
in, or on-site professional counseling provided abilities may be given a visual test to assess its
following a trauma or sudden stressful event, validity as a means of evaluating the presence
often for emergency situations or in the after- of visual disabilities.
math of a disaster. See disaster counseling;
criterion-referenced testing an approach to
hotline.
testing based on the comparison of a person’s
crisis intervention 1. the brief ameliorative, performance with an established standard or cri-
rather than specifically curative, use of psycho- terion. The criterion is fixed, that is, each per-
therapy or counseling to aid individuals, fami- son’s score is measured against the same
lies, and groups who have undergone a highly criterion and is not influenced by the perfor-
disruptive experience, such as an unexpected be- mance of others. See norm-referenced test-
reavement or a disaster. Crisis intervention may ing.
prevent more serious consequences of the expe-
rience, such as posttraumatic stress disor- criterion score a predicted score on an attrib-
der. 2. psychological intervention provided on ute or variable that is derived from regression
a short-term, emergency basis for individuals ex- analysis.
periencing mental health crises, such as an criterion validity an index of how well a test
acute psychotic episode or attempted sui- correlates with a criterion, that is, an established
cide. standard of comparison. Criterion validity is di-
148
cross-cultural treatment
vided into two types: concurrent validity coauthored by Paul meehl) helped to establish
and predictive validity. validity as a keystone of psychological testing.
critical care unit (CCU) see intensive care Cronbach was particularly influential in the field
unit. of education in California, where he headed a
faculty consortium involved in evaluating edu-
critical-incident stress debriefing (CISD) cation in the state. His book Designing Educa-
a systematic and programmed process designed tional Evaluations (1982) summarized his ideas C
to help individuals who witness or work at the resulting from the work of the consortium.
scene of a critical incident or disaster (e.g., fire- Cronbach also made important contributions to
fighters). The process uses basic stress counseling the field of instruction, with research focusing
techniques; formal training in CISD is provided on the need to match student aptitude with the
in workshops for personnel in emergency ser- appropriate learning environment. This work
vices as well as for mental health professionals. is summarized in Aptitudes and Instructional
[developed by U.S. psychologist Jeffrey T. Mitch- Methods (1977, coauthored with R. E. Snow).
ell (1948– )] Cronbach’s honors included the Distinguished
critical life event an event in life that requires Scientific Contribution Award of the American
major adjustment and adaptive behavior. Such Psychological Association and membership in
events may be regarded in retrospect as unusu- the American Academy of Arts and Sciences. He
ally formative or pivotal in shaping attitudes and served as president of the American Psychologi-
beliefs. Common critical life events include be- cal Association in 1956.
reavement, divorce, and unemployment. See Cronbach’s alpha an index of internal con-
also life events. sistency reliability, that is, the degree to which
critical period an early stage in life when an or- a set of items that comprise a measurement in-
ganism is especially open to specific learning, strument tap a single, unidimensional construct.
emotional, or socializing experiences that occur Also called alpha coefficient; coefficient
as part of normal development and will not alpha. [Lee J. cronbach]
recur at a later stage. For example, the first 3 days cross-addiction n. see cross-tolerance.
of life are thought to constitute a critical period
cross-cultural approach in the social sci-
for imprinting in ducks, and there may be a crit-
ences, a research method in which specific social
ical period for language acquisition in human in-
practices, such as courtship behavior, child-
fants. See also sensitive period.
rearing practices, or therapeutic attitudes and
critical point a point in the course of psycho- techniques, are studied and compared across a
therapy at which the client sees his or her prob- number of different cultures. Also called cross-
lem clearly and decides on an appropriate course cultural method. See also cross-cultural
of action to handle or resolve it. psychology.
critical thinking a form of directed, problem- cross-cultural counseling see multicul-
focused thinking in which the individual tests tural therapy.
ideas or possible solutions for errors or draw- cross-cultural psychology a branch of psy-
backs. It is essential to such activities as examin- chology that studies similarities and variances in
ing the validity of a hypothesis or interpreting human behavior across different cultures and
the meaning of research results. Compare cre- identifies the different psychological constructs
ative thinking. See convergent thinking. and explanatory models used by these cul-
critical value the value of either end point of tures. It may be contrasted with cultural psy-
the critical region; that is, either of the values of chology, which tends to adopt a systemic,
the test statistic above and below which the within-culture approach. Also called ethno-
null hypothesis will be rejected. psychology.
critical variable a variable required to bring cross-cultural testing testing individuals
about a particular result or to make a particular with diverse cultural backgrounds and experi-
prediction. ences using a method and materials that do not
Cronbach, Lee J. (1916–2001) U.S. psycholo- favor certain individuals over others. Typically,
gist. Cronbach received his doctorate in educa- culture-fair tests are administered with non-
tion from the University of Chicago in 1940. verbal instructions and content, avoid objects
He held faculty positions at a number of uni- indigenous to a particular culture, and do not de-
versities, spending the longest periods at the pend on speed.
University of Illinois (1948–1964) and Stanford cross-cultural treatment treatment in situa-
University (from 1964 until his retirement). tions in which therapist and client differ in
Cronbach is best known for his contributions to terms of race, ethnicity, gender, language, or life-
the fields of educational psychology and psycho- style. Mental health providers should be atten-
logical testing. He developed a measure of test re- tive to cultural differences with clients for the
liability that became known as cronbach’s following (among other) reasons: (a) Social and
alpha; he also contributed importantly to the cultural beliefs influence diagnosis and treat-
topic of test validity. His widely cited paper ment, (b) diagnosis differs across cultures, (c)
“Construct Validity in Psychological Tests” (1955, symptoms are expressed differently across cul-
149
cross-dressing
tures, (d) diagnostic categories reflect majority chance and other factors may have inflated or bi-
cultural values, and (e) most providers are from ased the original validation.
the majority culture. Crouzon’s syndrome a condition in which a
cross-dressing n. the process or habit of putting wide skull with a protrusion near the anterior
on the clothes of the opposite sex. It is done for a fontanel (on top of the head, at the front) is asso-
C variety of reasons, for example, as part of a per- ciated with a beaked nose and ocular abnormali-
formance, as social commentary, or as a prelimi- ties. The latter may include atrophy, divergent
nary stage in sex-reversal procedures (see also strabismus, and blindness. Mild to moderate
transsexualism). Although synonymous with mental retardation is typical. Other neurological
transvestism, cross-dressing is distinct from disorders may result from intracranial pressure.
transvestic fetishism. Also called craniofacial dysostosis. See also
cross-gender behavior the process or habit apert’s syndrome. [described in 1912 by Oc-
of assuming the role of the opposite sex by tave Crouzon (1874–1938), French neurologist]
adopting the clothes, hair style, and manner of crutch n. 1. a device, usually made of metal or
speaking and gesturing that society considers wood, designed to aid people with disabilities or
characteristic of the opposite sex. See cross- other problems affecting the lower limbs by pro-
dressing. viding support in walking. The simplest type of
cross-lagged panel design a longitudinal ex- crutch consists of two long parallel shafts that
perimental design used to increase the plausibil- taper to a single point at the bottom and fit
ity of causal inference in which two variables, A under the armpit at the top; a crosspiece in the
and B, are measured at time 1 (A1, B1) and at time middle functions as a handgrip. In contrast, arm
2(A2, B2). Comparison of cross-lagged panel cor- crutches consist of a single shaft with a handgrip
relations between A1B2 and B1A2 may suggest a and a cuff that fits either the forearm or the
preponderance of causal influence of A over B or upper arm. 2. colloquially, a nonspecific coping
of B over A. or support mechanism, which may be of a psy-
chological, medicinal, or other nature.
crossover design an experimental design in
which different treatments are applied to the crying-cat syndrome see cri du chat syn-
same sampling units (e.g., individuals) during drome.
different periods. cryotherapy n. the use of cold for therapeutic
cross-sectional design an experimental de- effect; for example, abnormal tissue is destroyed
sign in which individuals of different ages or de- by freezing it. Cryotherapy is commonly used in
velopmental levels are directly compared, for sports medicine, though its effects on motor
example, in a cross-sectional study comparing 5- control remain unclear. It is possible that cryo-
year-olds with 10-year-olds. Compare longitu- therapy elevates the pain threshold.
dinal design. cryptophasia n. secret or incomprehensible
cross-situational consistency the degree to language, especially the peculiar communica-
which a psychological attribute, such as a per- tion patterns that are sometimes developed be-
sonal disposition or a cognitive style, is dis- tween twins and are understandable only to
played in the same, or a functionally equivalent, them.
manner in different social environments. cryptophoric symbolism a type of represen-
cross-tabulation n. a method of arranging or tation expressed indirectly in the form of a
presenting data (e.g., values, levels) in tabular metaphor. For example, a person may describe a
form to show the mutual influence of one vari- difficult relationship in terms of an illegible map
able or variables on another variable or variables. or a stuck door. In metaphor therapy patients
cross-tolerance n. the potential for a drug, are encouraged to alter their attitudes or percep-
often a cns depressant, to produce the dimin- tions by finding new metaphors. Also called
ished effects of another drug of the same type metaphoric symbolism. [described by U.S.
when tissue tolerance for the effects of the latter psychotherapist Richard Royal Kopp (1942– )]
substance has developed. Thus, a person with al- cryptophthalmos syndrome a familial or
cohol dependence can substitute a barbiturate or hereditary disorder in which a child is born with
another sedative to prevent withdrawal symp- skin covering the eyes. The anomaly may occur
toms, and vice versa. Similarly, cross-tolerance on one side or both. The eyes are usually present
exists among most of the hallucinogens, except under the facial skin and lack eyelids, eyelashes,
marijuana. Also called cross-addiction. and, usually, tear ducts, and the individual may
cross-validation n. a model-evaluation ap- be able to discern light and colors. Hearing loss is
proach in which the validity of a model is as- common, as are ear anomalies. This syndrome
sessed by applying it to new data (i.e., data that often occurs with mental retardation.
were not used in developing the model). For ex- crystal healing a pseudoscientific medical
ample, a test’s validity may be confirmed by ad- practice in which the alleged power of certain
ministering the same test to a new sample in crystals to affect the human energy field is used
order to check the correctness of the initial vali- to treat physical or mental ailments. See also
dation. Cross-validation is necessary because faith healing; psychic healing.
150
cultural relativism
crystallized intelligence (crystallized abil- criminally responsible for one’s actions and
ity) see cattell–horn theory of intelli- subject to legal sanctions. See criminal respon-
gence. sibility. —culpable adj.
Cs abbreviation for conscious. cultural bias the tendency to interpret and
CSR 1. abbreviation for combat stress reac- judge phenomena in terms of the distinctive val-
tions. 2. abbreviation for continued-stay re- ues, beliefs, and other characteristics of the soci- C
view. ety or community to which one belongs. This
CT 1. abbreviation for cognitive therapy. 2. ab- sometimes leads people to form opinions and
breviation for computed tomography. make decisions about others in advance of any
actual experience with those others (see preju-
CTD abbreviation for cumulative trauma disorder dice). Cultural bias has become a significant
(see repetitive strain injury). concern in many areas, including psycho-
CTI abbreviation for constructive thinking in- metrics and clinical psychology. See also
ventory. culture-fair test; culture-free test.
CTZ abbreviation for chemoreceptor trigger cultural deprivation 1. lack of opportunity
zone. to participate in the cultural offerings of the
cube model a three-dimensional model of the larger society due to such factors as economic de-
information cues that determine causal attribu- privation, substandard living conditions, or dis-
tions. The cues are consistency (the extent to crimination. See pseudoretardation. 2. lack
which observed behavior agrees with previous of culturally stimulating phenomena in one’s
behavior), distinctiveness (the contextual, or sit- environment.
uational, variability surrounding the behavior),
cultural determinism the theory or premise
and consensus (the extent to which others act
that individual and group character patterns are
similarly in the same situations). See attribu-
produced largely by a given society’s economic,
tion theory.
social, political, and religious organization. See
cuddling behavior holding close, a form of also determinism; social determinism.
attachment behavior between individuals
that is intended to convey affection or give com- cultural-familial mental retardation
fort. In developmental psychology, it typically mental retardation, usually mild, that occurs in
refers to such behavior between a parent or care- the absence of any known organic cause and is
giver and a child. therefore attributed to hereditary or early (pre-
school) environmental factors. Hereditary fac-
cue n. a stimulus that serves to guide behavior, tors include natural variation, in the absence of
such as a retrieval cue. genetic anomalies, in intellectual abilities
cue-controlled relaxation a technique in among members of populations. Also called fa-
which a client is taught to associate a cue word milial retardation; sociocultural mental
with the practice of relaxing. See also applied retardation.
relaxation.
cultural psychology an interdisciplinary ex-
cued panic attack in DSM–IV–TR, a panic at- tension of general psychology concerned with
tack that occurs almost invariably upon expo- those psychological processes that are inher-
sure to, or in anticipation of, a specific ently organized by culture. It is a heterogeneous
situational trigger. For example, an individual class of perspectives that focus on explaining
with social phobia may have a panic attack as a how human psychological functions are cultur-
result of just thinking about an upcoming pre- ally constituted through various forms of rela-
sentation. Also called situationally bound tions between people and their social contexts.
panic attack. See also situationally predis- As a discipline, cultural psychology relates to
posed panic attack. Compare uncued panic cultural anthropology, sociology, semiotics, lan-
attack. guage, philosophy, and culture studies. Within
cued recall a type of memory task in which an psychology, cultural psychology relates most
item to be remembered is presented for study closely to cross-cultural, social, developmental,
along with a cue and the participant subse- and cognitive issues. It may be contrasted with
quently attempts to recall the item when given cross-cultural psychology, which tends to
the cue. examine multiple cultures in order to identify
cue exposure a behavior therapy technique the similarities and variances among them.
in which a client is exposed to stimuli that in- cultural relativism the view that attitudes,
duce cravings for substances (e.g., alcohol, to- behaviors, values, concepts, and achievements
bacco), while the therapist uses other techniques must be understood in the light of their own cul-
to reduce or eliminate the craving. This tech- tural milieu and not judged according to the
nique is most frequently used in substance abuse standards of a different culture. In psychology,
and smoking cessation programs. See also expo- the relativist position questions the universal ap-
sure therapy. plication of psychological theory, research, ther-
culpability n. 1. responsibility for an adverse apeutic techniques, and clinical approaches,
outcome. 2. in law, the state of being found since those used or developed in one culture may
151
cultural specificity of emotions
not be appropriate or applicable to another. nonacademic items are used, such as matching
Compare cultural universalism. identical forms, selecting a design that com-
cultural specificity of emotions the find- pletes a given series, or drawing human figures.
ing that the elicitors and the expressions of emo- Studies have shown, however, that any assess-
tions differ dramatically in members of different ment reflects certain socioethnic norms in some
cultures and societies. Compare universality degree, and hence may tend to favor people with
C certain backgrounds rather than others. For ex-
of emotions.
ample, an item that included the phrase “bad
cultural test bias partiality of a test in favor of rap” could be unclear, as the phrase could refer
individuals from certain backgrounds at the ex- to unjust criticism or to rap music that was either
pense of individuals from other backgrounds. not very good or rather good, depending on an
The partiality may be in the content of the items, individual’s common use of the word “bad.” See
in the format of the items, or in the very act of also cross-cultural testing.
taking a test itself. For example, suppose a verbal
comprehension exam was delivered on a com- culture-free test an intelligence test designed
puter and incorporated passages, pictures, and to eliminate cultural bias completely by con-
questions drawn from American literature. The structing questions that contain either no envi-
exam is likely to favor individuals who grew up ronmental influences or no environmental
in American families that could afford to have influences that reflect any specific culture. How-
computers and a variety of books at home. In ever, the creation of such a test is probably
contrast, poorer individuals who emigrated to impossible, and psychometricians instead gener-
America and were without computers or many ally seek to develop a culture-fair test.
books in the home might find that the exam had culture shock feelings of inner tension or con-
some degree of cultural test bias. See also test flict experienced by an individual or group that
bias. has been suddenly thrust into an alien culture or
that experiences loyalties to two different cul-
cultural universalism the view that the val-
tures.
ues, concepts, and behaviors characteristic of di-
verse cultures can be viewed, understood, and culture-specific syndrome see culture-
judged according to universal standards. Such a bound syndrome.
view involves the rejection, at least in part, of cumulative frequency distribution a
cultural relativism. Also called cultural ab- table with three columns, where the first column
solutism. (labelled X) lists the possible values for a vari-
culture-bound syndrome a pattern of men- able, the second column (labeled f, for fre-
tal illness and abnormal behavior that is unique quency) lists the number of scores that occur at
to a small ethnic or cultural population and does each of the possible values given in the first col-
not conform to Western classifications of psy- umn, and the third column (labeled CF, for cu-
chiatric disorders. Culture-bound syndromes in- mulative frequency) gives the running total of
clude, among others, amok, amurakh, ban- each of the values in the second column. For ex-
gungut, hsieh-ping, imu, jumping french- ample, a teacher administers a test and the stu-
men of maine syndrome, koro, latah, mal de dents’ scores are 1 F, 2 Ds, 4 Cs, 3 Bs, and 2 As. In
pelea, myriachit, piblokto, susto, voodoo a cumulative frequency distribution, the first
death, and windigo. Also called culture- column (X) represents exam scores, with F, D, C,
specific syndrome. B, and A listed from the bottom to the top. In the
second column (f) are the values of 1, 2, 4, 3, and
culture conflict 1. tension or competition be-
2 to indicate 1 F, 2 Ds, 4 Cs, 3 Bs, and 2 As. In the
tween different cultures. It often results in the
final column (CF) are running totals of the sec-
weakening of a minority group’s adherence to
ond column from the bottom up, listing 1, 3, 7,
cultural practices and beliefs as these are super-
10, and 12 to indicate the summed total of scores
seded by those of a dominant or adjoining
at each of the grades, with the total number of
culture. Also called intergroup culture con-
scores listed at the top (i.e., there are 12 total
flict. 2. the conflicting loyalties experienced by
scores in this cumulative frequency distribu-
individuals who endorse the cultural beliefs of
tion). This type of table is useful in descriptive
their subgroup but are also drawn to the prac-
statistics to depict the number of scores at or
tices and beliefs of the dominant culture. Also
below each score level. Also called cumulative
called internal culture conflict. See cul-
distribution; cumulative frequency table.
ture shock.
cumulative trauma disorder (CTD) see re-
culture-fair test a test based on common petitive strain injury.
human experience and considered to be rela-
tively unbiased with respect to special back- cunnilingus n. stimulation of the external fe-
ground influences. Unlike some standardized male genital organs (i.e., the clitoris and vulva)
intelligence assessments, which may reflect pre- with the mouth or tongue. Also called cun-
dominantly middle-class experience, a culture- nilinctio; cunnilinction; cunnilinctus; cun-
fair test is designed to apply across social lines nilingam. See also orogenital activity.
and to permit equitable comparisons among curare n. any of various toxic plant extracts, es-
people from different backgrounds. Nonverbal, pecially extracts from plants of the genus
152
cyclobenzaprine
Strychnos. Curare and related compounds exert should maintain legal custody of a child. See
their effects by blocking the activity of acetyl- child custody.
choline at neuromuscular junctions, resulting customary, prevailing, and reasonable
in paralysis. Curare has a long ethnopharma- fees (CPR fees) a criterion invoked in reimburs-
cological history among indigenous peoples of ing health care providers. It is determined by
the Amazon and Orinoco river basins, where it profiling the prevailing fees in a geographic area.
was applied to the tips of arrows to paralyze prey. C
Also called usual, customary, and reason-
It was brought to Europe in the 16th century by able (UCR) fees.
explorers of South America, but was not intro-
cutoff point a numerical value that divides a
duced into clinical use until the 1930s, when it
distribution into two distinct parts.
was used to treat patients with tetanus and other
spastic disorders. It has also been used in experi- cutting n. the act of cutting one’s wrists or the
ments showing that stimulus–response associa- inside of one’s forearms, often accompanied by a
tions can be formed in paralyzed animals. The sense of heightened arousal and little sensation
development of neuromuscular blocking agents of pain. This occurs most frequently in the con-
with more predictable pharmacological profiles text of borderline personality disorder and
led to the abandonment of curare as a clinical occasionally in major depressive episodes.
agent. CVLT abbreviation for california verbal
curative factors model a model that seeks to learning test.
identify those elements present in therapeutic CVLT–C abbreviation for California Verbal
groups that aid and promote personal growth Learning Test for Children. See california ver-
and adjustment. U.S. psychologist Irwin Yalom bal learning test.
(1931– ) identified 10–15 curative factors, in- CVLT–II abbreviation for California Verbal
cluding the installation of hope, universality, Learning Test–II. See california verbal learn-
the imparting of information, altruism, and in- ing test.
terpersonal learning. CVS abbreviation for chorionic villus sam-
curiosity n. the impulse or desire to investigate, pling.
observe, or gather information, particularly cycle of violence a conceptual framework for
when the material is novel or interesting. This understanding the persistence of battering rela-
drive appears spontaneously in animals and in tionships. The cycle has three phases: (a) a “hon-
young children, who use sensory exploration eymoon phase,” in which the batterer treats the
and motor manipulation to inspect, bite, han- battered partner lovingly; (b) a “tension build-up
dle, taste, or smell practically everything in the phase,” in which the batterer begins to display
immediate environment. —curious adj. irritability and anger toward the battered part-
current material information about a client’s ner; and (c) the violence phase, in which batter-
present feelings, interpersonal relationships, and ing occurs. The phases are then proposed to
life events that is used in understanding that per- recycle. As a battering relationship persists over
son’s psychodynamics, especially by contrast- time, the honeymoon phases shorten, and the
ing it with data from past experiences. tension-building and violence phases lengthen.
Also called cycle of abuse. [proposed in 1979
Cushing’s syndrome a group of signs and
by U.S. clinical and forensic psychologist Lenore
symptoms related to a chronic overproduction
Walker (1942– )]
of corticosteroid hormones, mainly cortisol,
by the adrenal cortex. The condition occurs cyclic adj. characterized by alternating phases.
most commonly in women and is usually associ- Also called cyclical.
ated with a tumor of the adrenal or pituitary cyclical vomiting syndrome recurrent, se-
gland. Cushing’s syndrome is characterized by a vere episodes of vomiting that may last for hours
“moon face” due to fat deposits, “buffalo hump” or days but are separated by intervals of com-
fat pads on the trunk, hypertension, glucose in- pletely normal health. Stress may be an impor-
tolerance, and psychiatric disturbances. [Harvey tant precipitant of cyclical vomiting, which
W. Cushing (1869–1939), U.S. surgeon] occurs frequently in children.
custodial care 1. care rendered to a patient cyclic AMP (cAMP; cyclic adenosine mono-
with prolonged mental or physical disability phosphate) a second messenger that is in-
that includes assisted daily living (e.g., the regu- volved in the activities of dopamine,
lar feeding and washing of bedridden patients) norepinephrine, and serotonin in transmit-
but typically not mental health services them- ting signals at nerve synapses. Also called
selves. 2. confinement in such institutions as adenosine 3 ,5 -monophosphate.
prisons and military correctional facilities that cyclic illness 1. any disorder characterized by
place restrictions on individuals’ liberty under alternating phases. 2. bipolar I disorder (see bi-
the rules of law and that protect and monitor the polar disorder) in which both major depres-
individual or protect others from the individ- sive episodes and manic episodes occur
ual’s violent and harmful tendencies or poten- alternately.
tial. cyclobenzaprine n. a drug used for the treat-
custodial case a court case concerning who ment of acute skeletal muscle spasm (see muscle
153
cycloid psychosis
relaxant). Structurally related to the tricyclic and severity of these symptoms do not meet the
antidepressants, it has many features in com- full criteria for a major depressive episode or a
mon with them, including sedation and signifi- hypomanic episode. It often is considered to be a
cant anticholinergic effects. Low doses are mild bipolar disorder. Also called cyclo-
moderately effective in treating fibromyalgia thymia.
syndrome. Because of its resemblance to the Cylert n. a trade name for pemoline.
C tricyclic drugs, cyclobenzaprine should not be
taken concurrently with monoamine oxidase
cyproheptadine n. a drug that acts as a anti-
histamine and serotonin antagonist and is
inhibitors. U.S. trade name: Flexeril.
used for the the treatment of allergic symptoms
cycloid psychosis an atypical and contro- (e.g., runny nose and watery eyes), appetite stim-
versial psychiatric disorder with three forms: ulation, and relief of migraine headaches. U.S.
motility, confusional, and anxiety–happiness. trade name (among others): Periactin.
Symptoms, which resemble those of both a
schizoaffective disorder and a psychotic cystathionine synthetase deficiency see
disorder not otherwise specified, follow a homocystinuria.
phasically recurring course and may change rap- cystathioninuria n. an inherited disorder of
idly. [as modified in 1957 by German psychia- amino acid metabolism marked by deficiency of
trist Karl Leonhard (1904–1988) from the the enzyme cystathionase. The effects include
original 1924 conceptualization of German vascular, skeletal, and ocular abnormalities.
neuropsychiatrist Karl Kleist (1879–1960)] Mental retardation occurs in less than 50% of
cyclosporine (cyclosporin) n. an immuno- cases, often accompanied by behavioral disor-
suppressive agent used primarily to prevent re- ders. Also called gamma-cystathionase defi-
jection of organ transplants but also used in the ciency.
treatment of some autoimmune disorders, such cytochrome P450 (CYP) a group of proteins
as inflammatory bowel disease and severe atopic located in liver and other cells that, in combina-
dermatitis. It is extensively metabolized by the tion with other oxidative enzymes, is responsi-
cytochrome p450 3A4 enzyme, and accord- ble for the metabolism of various chemicals,
ingly has numerous potential interactions with including many psychotropic drugs. Approxi-
psychotropic drugs metabolized via the same en- mately 50 cytochrome P450 enzymes (so named
zyme (e.g., clonidine, nefazodone, St. John’s because their reduced forms show a spectro-
wort). Depression, anxiety, and other psycholog- scopic absorption peak at 450 nm) are currently
ical disturbances are rare side effects. U.S. trade identified as being active in humans, of which
name (among others): Sandimmune. cytochromes belonging to the CYP2D6 subclass,
cyclothymic disorder in DSM–IV–TR, a CYP2C variants, and CYP3A4/5 subclass pre-
mood disorder characterized by periods of dominate. Cytochromes are mainly active in
hypomanic symptoms and periods of depressive Phase I drug metabolism; by donating an atom
symptoms that occur over the course of at least 2 of oxygen, they tend to make parent drugs more
years (1 year in children and adolescents), dur- water soluble and therefore more easily excreted.
ing which any symptom-free periods must last Because numerous drugs are metabolized via the
no longer than 2 months. The symptoms are same cytochrome, these enzymes are important
those of a major depressive episode or a in drug interactions.
hypomanic episode, but the number, duration, Cytomel n. a trade name for liothyronine.
154
Dd
DA abbreviation for dopamine. 2010, Darvon was withdrawn from the U.S. mar-
ket.
Da Costa’s syndrome an anxiety state identi-
fied in soldiers during the American Civil War Dasein n. in the thought of German philosopher
(1861–1865) in which heart palpitations were Martin Heidegger (1889–1976), the particular
the most prominent symptom. It is now recog- kind of being manifest in humans. It is their
nized as a form of panic disorder observed in being as Dasein that allows humans access to the
soldiers during the stress of combat and marked larger question of being in general, since our ac-
by fatigue, heart palpitations, chest pain, and cess to the world is always through what our
breathing difficulty. Also called neurocircu- own being makes possible. The term is com-
latory asthenia; soldier’s heart. See also ef- monly used in existential psychology and re-
fort syndrome. [Jacob Méndes Da Costa (1833– lated therapeutic approaches. See being-in-the-
1900), U.S. surgeon] world. [German, literally: “being there”]
DAD abbreviation for device for automated Dasein analysis a method of existential psy-
desensitization. chotherapy emphasizing the need to recognize
DAH test abbreviation for Machover Draw-a- not only one’s being-in-the-world but also
House Test. See machover draw-a-person what one can become (see dasein). Through ex-
test. amination of such concepts as intentionality
and intuition, Dasein analysis attempts to help
Dalmane n. a trade name for flurazepam. clients not to adapt to others or eliminate anxi-
DALYs acronym for disability adjusted life ety (which tends to submerge individuality and
years. encourage outer conformity), but rather to ac-
dance therapy the use of various forms of cept themselves and realize their potential. [de-
rhythmic movement—classical, modern, folk, or veloped by Swiss psychiatrist Medard Boss
ballroom dancing; exercises to music; and the (1903–1990)]
like—as a therapeutic technique to help individ- DAT abbreviation for dementia of the Alzhei-
uals achieve greater body awareness and social mer’s type. See alzheimer’s disease; dementia.
interaction and enhance their psychological and
physical functioning. See also movement ther- data reduction the process of reducing a set of
apy. [pioneered in 1942 by U.S. dance profes- measurements or variables into a smaller, more
sional Marian Chace (1896–1970)] manageable, more reliable, or better theoreti-
cally justified set or form. For example, a re-
dancing mania see choreomania. searcher may conduct a factor analysis on a
dangerousness n. the state in which individu- set of 50 items on well-being and satisfaction to
als become likely to do harm either to them- determine whether the information could be
selves or to others, representing a threat to their summarized more efficiently on underlying di-
own or other people’s safety. —dangerous adj. mensions of relationship satisfaction, degree of
meaning in life, job satisfaction, and general
dantrolene n. a muscle relaxant whose pri-
health.
mary action is directly on skeletal muscles; it also
indirectly affects the central nervous system as a date rape sexual assault by an acquaintance,
secondary action. Dantrolene is used in the date, or other person known to the victim, often
treatment of muscular spasm associated with involving alcohol or date-rape drugs that may
spinal cord injury, stroke, cerebral palsy, and hinder the victim’s ability to withhold consent.
multiple sclerosis, as well as with neuroleptic Also called acquaintance rape.
malignant syndrome. U.S. trade name: Dan-
date-rape drug a drug that is surreptitiously
trium.
administered to impair consciousness or mem-
DAP test abbreviation for machover draw-a- ory for the purpose of sexual exploitation of the
person test. victim. Such drugs are commonly introduced
darkness fear see fear of darkness. into alcoholic beverages in social settings. Com-
mon date-rape drugs include barbiturates, high-
Darvocet n. a trade name for the analgesic com- potency benzodiazepines (flunitrazepam, tri-
bination propoxyphene and acetaminophen. azolam), and the illicit substance ghb (gamma-
In 2010, Darvocet was withdrawn from the U.S. hydroxybutyrate). The U.S. Congress passed the
market. Drug-Induced Rape Prevention and Punishment
Darvon n. a trade name for propoxyphene. In Act in 1996, making it a federal crime to give an
155
Daubert test
unaware person a controlled substance with the based service provided for a person with men-
intent of committing a violent crime. tal retardation or a related condition. This ser-
Daubert test a test used in U.S. federal courts to vice provides productive daily schedules of activ-
determine if expert scientific testimony is admis- ity based on individualized service and support
sible under Federal Rules of Evidence 702. It gen- planning, including clinical services, compan-
erally takes place during a Daubert hearing, at ion services, socialization, recreation, vocational
which judges evaluate whether the testimony development, and lifestyle enrichment. In prac-
is both relevant and reliable, considering such tice, these services may be delivered on a person-
D factors as testability, error rate, evidence of peer by-person basis or in small groups in any loca-
review, and general acceptance within the scien- tion during daytime hours.
tific community. day hospital a nonresidential facility where in-
Daubert v. Merrell Dow Pharmaceuti- dividuals with mental disorders receive a full
cals Inc. a case resulting in an influential 1993 range of treatment and support services during
U.S. Supreme Court ruling that Federal Rules of the day and return to their homes at night. Spe-
Evidence should be the standard to determine cific service offerings vary across facilities but
whether expert scientific testimony is admissi- generally include psychological evaluation, indi-
ble. The court noted that judges should evaluate vidual and group psychotherapy, social and
the validity of the scientific testimony according occupational rehabilitation, and somatic ther-
to whether the research reported (a) is peer- apy. Staff members are multidisciplinary, com-
reviewed, (b) is testable (i.e., capable of being fal- prising psychiatrists, psychologists, social workers,
sified), (c) has known error rates, and (d) is gener- vocational counselors, and others.
ally accepted within the scientific community. daymare n. an attack of acute anxiety, distress,
Dauerschlaf n. a type of therapy in which pro- or terror, which is similar to a nightmare but
longed sleep is induced with drugs (e.g., barbitu- occurs in a period of wakefulness and is precipi-
rates). Dauerschlaf (German, “perpetual sleep”) tated by waking-state fantasies.
has been used in the treatment of substance de- day treatment a program of coordinated inter-
pendence, status epilepticus, and acute psy- disciplinary assessment, treatment, and rehabili-
chotic episodes. Its efficacy and use have been tation services provided by professionals and
the subject of extreme controversy, and it is now paraprofessionals for people with disabilities,
rarely encountered clinically. mental or physical disorders, or substance abuse
day camp a facility that provides recreational, problems, usually at a single location for 6 or
educational, or therapeutic services to children more hours. Services also address skill and voca-
on a short-term, day-by-day basis as opposed to tional development and may include adjust-
long-term camps that require overnight accom- ment programs or sheltered workshops.
modation. dc (d/c) in pharmacology, abbreviation for dis-
day care center 1. a nonresidential facility that continue.
provides health and social services in a commu- D-cognition n. see being cognition.
nity setting for adults who are unable to perform DDAVP n. a trade name for desmopressin.
many ordinary tasks without supervision or as-
sistance. See adult day care. 2. see child care deadly catatonia see lethal catatonia.
facilities. deadly nightshade see belladonna alka-
daydream n. a waking fantasy, or reverie, in loids.
which wishes, expectations, and other potential- deaf-blind adj. lacking or having severely com-
ities are played out in imagination. Part of the promised vision and hearing concomitantly.
stream of thoughts and images that occupy most People with deaf-blind impairment encounter
of a person’s waking hours, daydreams may be significant—sometimes lifelong—challenges in
unbidden and apparently purposeless or simply communication, development, and education.
fanciful thoughts, whether spontaneous or in- Solutions involving tactile devices are often ap-
tentional. Researchers have identified at least propriate (e.g., braille). There is a large number
three ways in which individuals’ daydreaming of known causes, including meningitis, con-
styles differ: positive-constructive daydreaming, genital rubella syndrome, and usher syn-
guilty and fearful daydreaming, and poor drome. —deaf-blindness n.
attentional control. These styles are posited to deafness n. the partial or complete absence or
reflect the daydreamer’s overall tendencies to- loss of the sense of hearing. The condition may
ward positive emotion, negative emotion, and be hereditary or acquired by injury or disease at
other personality traits. Among the important any stage of life, including in utero. The major
positive functions that daydreams may serve are kinds are conduction deafness, due to a disrup-
the release of strong affect, the gaining of self- tion in sound vibrations before they reach the
insight when reviewing past experiences or re- nerve endings of the inner ear; and sensorineural
hearsing for future situations, the generation of deafness, caused by a failure of the nerves or
creative solutions, and the production of greater brain centers associated with the sense of hear-
empathy for others. ing to transmit or interpret properly the im-
day habilitation a home and community- pulses from the inner ear. Some individuals
156
deception clue
experience both conduction and sensorineural structive instinct. See also destrudo; mor-
deafness, a form called mixed deafness. —deaf tido; nirvana principle.
adj. death phobia see thanatophobia.
deaggressivization n. in psychoanalytic the- death wish 1. in psychoanalytic theory, a con-
ory, the neutralization of the aggressive drive scious or unconscious wish that another person,
so that its energy can be diverted to various tasks particularly a parent, will die. According to
and wishes of the ego. See also sublimation. Sigmund freud, such wishes are a major source
death n. 1. the permanent cessation of physical of guilt, desire for self-punishment, and depres-
and mental processes in an organism. In the sion. 2. an unconscious desire for one’s own
D
United States in the early 1980s, the American death, as manifested in self-destructive or dan-
Medical Association and the American Bar Asso- gerous behaviors. See also death instinct.
ciation drafted and approved the Uniform Deter- Debré–Sémélaigne syndrome see kocher–
mination of Death Act, in which death is defined debré–sémélaigne syndrome.
as either the irreversible cessation of core physio-
debriefing n. the process of giving participants
logical functioning (i.e., spontaneous circulatory
in a completed research project a fuller explana-
and respiratory functions) or the irreversible loss
tion of the study in which they participated than
of cerebral functioning (i.e., brain death).
was possible before or during the research.
Given the emergence of sophisticated technolo-
gies for cardiopulmonary support, brain death is debt counseling counseling specifically aimed
more often considered the essential determining at helping individuals with financial problems.
factor, particularly within the legal profession. The help and advice given includes budgeting,
See also assisted death; dying process; credit-card usage, debt consolidation, and
thanatology. 2. the degeneration or disinte- awareness of difficulties in managing money.
gration of a biological cell. See necrosis. Debt counseling may be part of the counseling
or therapy for other problems or it may be car-
death anxiety emotional distress and insecu- ried out by financial planners and accountants.
rity aroused by reminders of mortality, including
one’s own memories and thoughts. Classical Decadron n. a trade name for dexamethasone.
psychoanalytic theory asserted that the uncon- decarceration n. 1. the process of removing of-
scious cannot believe in its own death, therefore fenders from correctional facilities, often to
thanatophobia was a disguise for some deeper community facilities. 2. see deinstitution-
fear. Existentialists later proposed that death alization.
anxiety is at the root of all fears, though often decatastrophizing n. a technique, used in
disguised. A mass of research using self-report treating people with irrational or exaggerated
scales (see death-anxiety scales) suggests that fears, that explores the reality of the situation
most people have a low to moderate level of rather than imagined or anticipated events.
death anxiety. See also edge theory; terror
management theory. decathexis n. in psychoanalytic theory, the
withdrawal of libido from objects (i.e., other
death-anxiety scales questionnaires that people) in the external world. Compare cath-
yield scores for the level of self-reported concern exis.
about death. Some scales distinguish between
decentering n. 1. any of a variety of techniques
several types of concern, such as fear of pain or
aimed at changing centered thinking to open-
fear of nonbeing. See also thanatophobia.
minded thinking. A person with centered think-
death education learning activities or pro- ing is focused on only one salient feature at a
grams designed to educate people about death, time, to the total exclusion of other important
dying, coping with grief, and the various emo- characteristics. 2. dissolution of unity between
tional effects of bereavement. Death education is self and identity. —decenter vb.
typically provided by certified thanatologists
decentralization n. the trend to relocate pa-
from a wide array of mental and medical health
tients with chronic mental illness from long-
personnel, educators, clergy, and volunteers. In-
term institutionalization, usually at government
dividual or group sessions provide information,
hospitals, to outpatient care in community-
discussion, guided experiences, and exploration
based, residential facilities. —decentralize vb.
of attitudes and feelings.
deception by commission see active decep-
death instinct in psychoanalytic theory, a tion.
drive whose aim is the reduction of psychical
tension to the lowest possible point, that is, deception by omission see passive decep-
death. It is first directed inward as a self- tion.
destructive tendency and is later turned outward deception clue a behavioral indication that an
in the form of the aggressive instinct. In the individual is not telling the truth. Deception
dual instinct theory of Sigmund freud, the clues include inconsistencies between voluntary
death instinct, or thanatos, stands opposed to and involuntary behavior and unusual or exag-
the life instinct, or eros, and is believed to be gerated physiological or expressive responses to
the drive underlying such behaviors as aggres- knowledge that only a guilty person possesses.
siveness, sadism, and masochism. Also called de- To date, behavioral scientists have discovered no
157
decisional competence
behavioral or physiological response that, by it- deconditioning n. a technique in behavior

self, shows a 1:1 relation to deception. therapy in which learned responses, such as
decisional competence the ability of a defen- phobias, are “unlearned” (deconditioned). For
dant to make the decisions normally faced by de- example, a person with a phobic reaction to fly-
fendants in a criminal defense (e.g., deciding ing might be deconditioned initially by practic-
among various plea agreements). See also coming going to the airport when not actually taking
petency evaluation; competency to stand a flight and using breathing techniques to con-
trial; dusky standard. trol anxiety. See also desensitization.
D decision making the cognitive process of decontextualization n. 1. the process of ex-
choosing between two or more alternatives, amining, considering, or interpreting something
ranging from the relatively clear cut (e.g., order- separately from the context within which it is
ing a meal at a restaurant) to the complex (e.g., embedded. Decontextualization may occur con-
selecting a mate). Psychologists have adopted sciously (e.g., with the aim of subjecting a con-
two converging strategies to understand deci- stituent element of some phenomenon or
sion making: (a) statistical analysis of multiple process to closer, individual study) or uncon-
decisions involving complex tasks and (b) exper- sciously. Either mode may result on the one
imental manipulation of simple decisions, look- hand in greater clarity but on the other in over-
ing at elements that recur within these decisions. simplification and inaccuracies in comprehen-
decision-making model of counseling an sion. 2. in perception, the process of turning
approach that envisions counseling as a process implicit or contextual events into objects of con-
with three stages: the problem definition phase, scious perception or belief. —decontextualize
the work phase, and the action phase. The prob- vb.
lem definition phase includes considering al- dedifferentiation n. loss of specialization or of
ternative definitions of the problem and com- advanced organizational and functional abili-
mitting to one of these. During the work phase ties. This may occur, for example, when mature
the problem is examined from different perspec- cells within an organism regress to a more gen-
tives to identify facts as well as the thoughts and eral, simplified state, as is sometimes seen in the
feelings of the client. The counselor helps the cli- progression of certain cancers, or as a form of
ent to look at issues, answers, and solutions in thought disorganization seen in schizophrenia.
new ways. The action phase deals with finding deductive reasoning the form of logical rea-
alternative solutions and choosing one to test in soning in which a conclusion is shown to follow
the home environment. necessarily from a sequence of premises, the first
decision–redecision method a technique of which stands for a self-evident truth or
used in transactional analysis that allows agreed-upon data. In the empirical sciences, de-
clients to reexperience decision moments in ductive reasoning underlies the process of deriv-
their childhood and choose to redecide. These ing predictions from general laws or theories.
decision moments resulted from such self- Compare inductive reasoning. See also
injunctions as “Don’t be you,” “Don’t feel,” logic; top-down analysis.
“Don’t be a child,” and so forth, and have associ- deep depression a severe major depressive
ated habitual patterns of emotion. episode characterized by psychomotor retar-
decisive moment in psychotherapy, that modation, guilt, suicidal ideation, and psy-
ment at which a client makes a momentous deci- chotic features. rumination is frequent, and
sion, such as revealing a secret or deciding to risk of suicide is high.
make a major change in his or her life.
deep dyslexia a form of acquired dyslexia (see
declarative memory the ability to retain in- alexia) characterized by semantic errors (e.g.,
formation about facts or events over a significant reading parrot as canary), difficulties in reading
period of time and to consciously recall such de- abstract words (e.g., idea, usual) and function
clarative knowledge, typically in response to a words (e.g., the, and), and an inability to read
specific request to remember. It is one of two pronounceable nonwords. See also phonologi-
major divisions in memory proposed in 1980 by cal dyslexia; surface dyslexia. [first de-
U.S. neuroscientist and biological psychologist scribed in 1973 by British neuropsychologists
Larry R. Squire (1941– ), and generally is di- John C. Marshall and Freda Newcombe (1925–
vided into two subtypes: episodic memory and 2001)]
semantic memory. This form of memory is se-
deep processing cognitive processing of a stim-
lectively impaired in amnesia and is known as
ulus that focuses on its meaningful properties
explicit memory in other theoretical classifica-
rather than its perceptual characteristics. It is
tions. Compare nondeclarative memory.
considered that processing at this semantic level,
de Clérambault’s syndrome see cléram- which usually involves a degree of elabora-
bault’s syndrome. tion, produces stronger, longer-lasting memo-
decompensation n. a breakdown in an individ- ries than shallow processing. See also seman-
ual’s defense mechanisms, resulting in progres- tic encoding. [proposed in 1972 by Canadian
sive loss of normal functioning or worsening of psychologists Fergus I. M. Craik (1935– ) and
psychiatric symptoms. Robert S. Lockhart]
158
deficiency love
deep sleep the stage of the sleep cycle in which defense mechanism in classical psychoana-
arousal thresholds are highest and consciousness lytic theory, an unconscious reaction pattern
is taken to be least likely. In deep sleep, delta employed by the ego to protect itself from the
waves are prominent in the electroencephalo- anxiety that arises from psychic conflict. Such
gram. See slow-wave sleep. mechanisms range from mature to immature,
deep trance in hypnosis and shamanistic prac- depending on how much they distort reality: de-
tices, a state in which participants are minimally nial is very immature because it negates reality,
responsive to environmental cues except for sug- whereas sublimation is one of the most mature
gestions consistent with their beliefs. See trance. forms of defense because it allows indirect satis- D
faction of a true wish. In more recent psycholog-
Deese paradigm a laboratory memory task used ical theories, defense mechanisms are seen as
to study false recall. It is based on the report in normal means of coping with everyday prob-
1959 that, after presentation of a list of related lems, but excessive use of any one, or the use of
words (e.g., snore, rest, dream, awake), participants immature defenses (e.g., displacement or re-
mistakenly recalled an unpresented but strongly pression), is still considered pathological. Also
associated item (e.g., sleep). Following renewed called escape mechanism. See also avoid-
research into the technique, it is now generally ance; denial; projection; regression; subli-
referred to as the Deese–Roediger–McDermott mation; substitution. [proposed in 1894 by
paradigm. [James Deese (1921–1999), U.S. psy- Sigmund freud]
chologist; Henry L. Roediger III (1947– ) and
Kathleen B. McDermott (1968– ), U.S. cogni- defense reflex a sudden response elicited by a
tive psychologists] painful or unexpected stimulus. The term is ap-
plied to a variety of responses, ranging from an
defect n. a fault or error in something that pre- acceleration in heart rate in reaction to a star-
vents it from functioning correctly. —defective tling auditory stimulus, through flight, fight, or
adj. freezing elicited by perceived threat, to complex
defective delinquent an outdated legal name psychological responses. Also called defense re-
for an individual who engages in repeated crimi- sponse.
nal behavior and is considered to be below aver- defensive behavior 1. aggressive or submis-
age in intelligence. sive behavior in response to real or imagined
defectology n. in Russian psychology, the area threats of bodily or psychic (particularly emo-
of abnormal psychology and learning disabili- tional) harm. A cat, for example, may exhibit de-
ties. More specifically, defectology is concerned fensive aggression by spitting and hissing,
with the education of children with sensory, arching its back, and raising the hair along the
physical, cognitive, or neurological impairment. back of the neck in anticipation of a physical
Russian defectology offers services to roughly threat. A human might unconsciously fend off
the same population as special education and criticism by putting forth self-justifying excuses
school psychology in the United States. It is or by expressing an emotional reaction (e.g., cry-
based on the view that the primary problem of a ing) to limit another’s disapproval or anger. 2. in
disability is not the organic impairment itself psychoanalytic theory, behavior characterized
but its social implications. [originally defined by by the use or overuse of defense mechanisms
Lev vygotsky] operating at an unconscious level.
defect orientation 1. in interdisciplinary defensive identification the process by
team or other individual service-planning pro- which a victim of abuse psychologically identi-
cesses, an emphasis that focuses on the impair- fies with the perpetrator of abuse, or with the
ments, limitations, deficits, or defects in group with which the perpetrator is identified, as
functioning of individuals with disabilities, but a defensive strategy against continuing feelings
that excludes corresponding assessment of and of vulnerability to further victimization.
emphasis on their skills, abilities, and strengths.
defensiveness n. a tendency to be sensitive to
2. see defect theory. Compare developmen-
criticism or comment about one’s deficiencies
tal orientation.
and to counter or deny such criticisms. —defen-
defect theory the proposition that the cogni- sive adj.
tive processes and behavioral development of
deficiency n. a lack or shortage of something. A
people with mental retardation are qualitatively
deficiency may, for example, be a relative or ab-
different from those of their peers without men-
solute lack of a skill, of a biological substrate or
tal retardation. Also called defect orientation;
process, or of resources that enable specific func-
difference hypothesis. Compare develop-
tions or actions to be performed.
mental theory.
defense interpretation in psychoanalysis, an deficiency cognition see being cognition.
interpretation of the ways in which the patient deficiency love (D-love) in Abraham mas-
protects himself or herself from anxiety. Such an low’s humanistic psychology, a type of love
interpretation aims to make the patient aware of that is fulfillment-oriented (e.g., based on a need
his or her defenses and to uncover the source of for belonging, self-esteem, security, or power)
the anxiety in intrapsychic conflict. and characterized by dependency, possessive-
159
deficiency motivation
ness, lack of mutuality, and little concern for the quota. Early symptoms are apathy, irritability,
other’s true welfare. Compare being love. drowsiness, inability to concentrate, and anxi-
deficiency motivation in Abraham mas- ety. Dehydration reactions may progress to delir-
low’s humanistic psychology, the type of moti- ium, spasticity, blindness, deafness, stupor, and
vation operating on the lower four levels of his death if more than 10% of body weight is lost.
hierarchy of needs (see maslow’s motivational dehypnosis n. in hypnosis, the process of elimi-
hierarchy). Deficiency motivation is character- nating the belief that hypnotic fantasies are ac-
ized by the striving to correct a deficit that may tual.
D be physiological or psychological in nature. deindividuation n. an experiential state char-
Compare metamotivation. acterized by loss of self-awareness, altered per-
deficiency need any need created by lack of a ceptions, and a reduction of inner restraints that
substance required for survival (e.g., food, water) results in the performance of unusual, atypical
or of a state required for well-being (e.g., secu- behavior. It can be caused by a number of fac-
rity, love). tors, such as a sense of anonymity or of submer-
deficit n. a lack of an essential element in some- sion in a group (see group identification).
thing that prevents it from functioning cor- deinstitutionalization n. the joint process of
rectly. moving people with developmental or psychiat-
defusion n. in psychoanalytic theory, the sepa- ric disabilities from structured institutional facil-
ration of instincts that usually operate to- ities to their home communities and developing
gether. Defusion is posited to lead to various comprehensive community-based residential,
neuroses. Compare fusion. —defused adj. day, vocational, clinical, and supportive services
to address their needs. See community care.
degeneracy n. 1. a state in which a person has —deinstitutionalize vb.
declined or reverted to a much earlier state of de-
velopment in physical, mental, or moral quali- déjà raconté the feeling that a long-forgotten
ties. 2. the state of possessing few if any of the event, now recalled, has been told before
moral standards considered normal in one’s so- (French, “already told”). Some theorists believe
ciety. Degeneracy is often popularly used with that the illusion arises from the need for reassur-
special reference to sexual offenses. 3. in biol- ance that a threatening experience was previ-
ogy, reversion to a less highly organized and sim- ously mastered and can therefore be mastered
pler stage of development. —degenerate adj. again. See also false memory.
degeneration n. 1. deterioration or decline of déjà vu the feeling that a new event has already
organs or tissues, especially of neural tissue, to a been experienced or that the same scene has
less functional form. 2. deterioration or decline been witnessed before (French, “already seen”).
of moral values. —degenerate vb. The feeling of familiarity may be due to a neuro-
logical anomaly, to resemblance between the
degrees of freedom (symbol: df; ν) the number present and the past scenes, or to the fact that a
of elements that are allowed to vary in a statisti- similar scene has been pictured in a daydream or
cal calculation, or the number of scores minus night dream. See false memory.
the number of mathematical restrictions. If the
mean of a set of scores is fixed, then the number de Lange’s syndrome a congenital disorder
of degrees of freedom is one less than the num- that occurs in two forms, both of which include
ber of scores. For example, if four individuals moderate to severe mental retardation and are
have a mean IQ of 100, then there are three de- associated with autosomal dominant inheri-
grees of freedom, because knowing three of the tance or duplication of the long arm of chromo-
IQs determines the fourth IQ. See also chi- some 3. One form, the Bruck–de Lange type,
square distribution. features a short, broad neck, broad shoulders,
short and thick extremities, and muscular hy-
dehumanization n. any process or practice pertrophy, which gives the child the appea-
that is thought to reduce human beings to the rance of a small professional wrestler. The other,
level of nonhuman animals or mechanisms, es- Brachmann–de Lange type, is also known as am-
pecially by denying them autonomy, individual- sterdam dwarf disease or Amsterdam type of
ity, and a sense of dignity. —dehumanize vb. retardation, because the disorder was identi-
dehydration n. lack of water in the body tis- fied among patients in the Amsterdam area.
sues. Dehydration may be absolute, as measured Also called Cornelia de Lange’s syndrome.
in terms of the difference from normal body- [Cornelia de Lange (1871–1950), Dutch physi-
water content, or relative, as considered in terms cian]
of fluid needed to maintain effective osmotic delayed auditory feedback (DAF) a tech-
pressure. The physiological lag between water nique of feedback in which speakers listen
loss through excretion and the development of through headphones to their own speech, which
thirst sensations that stimulate replacement of is heard a short time after it is spoken. It is one of
the water is called voluntary dehydration. several techniques that may be used to induce
dehydration reactions metabolic and psy- greater fluency and clearer articulation in those
chological disturbances occurring when the with various speech and language disorders, par-
body’s water supply falls far below its normal ticularly in those who stutter. Paradoxically,
160
delusional disorder
however, the delay in DAF has also been found mors, substance intoxication and withdrawal,
to cause dysfluency in normally fluent speak- head trauma, and seizures.
ers. delirium of persecution delirium in which
delayed development slower than expected the predominant symptoms include intense
developmental increases in physical, emotional, mistrust and hallucinations that one is being
social, or cognitive abilities or capacities. A child threatened.
with delayed development may hold attitudes, delirium tremens (DTs) a potentially fatal al-
exhibit habits, or engage in behaviors consistent cohol withdrawal syndrome involving extreme
with an earlier developmental level. agitation and anxiety, fearfulness, paranoia, vi- D
delayed effect an effect that is not observed for sual and tactile hallucinations, tremors, sweat-
some period of time after the event or factor that ing, and increased heart rate, body temperature,
is held to have caused it. Usually the precipitat- and blood pressure.
ing event exerts an indirect influence by starting delta alcoholism one of the five types of alco-
a process or chain of events that ultimately has a holism defined by U.S. physician Elvin M.
demonstrable effect. See causal latency; re- Jellinek (1890–1963), the others being alpha
mote cause. alcoholism, beta alcoholism, gamma al-
delayed posttraumatic stress disorder a coholism, and epsilon alcoholism. It is
form of posttraumatic stress disorder that characterized by physical and psychological de-
is diagnosed when the symptoms first appear pendence, tolerance, inability to abstain, and
more than 6 months after exposure to the trau- withdrawal symptoms if use is suspended. Delta
matic stressor. alcoholism is similar to gamma alcoholism but
delayed speech the failure of speech to develop distinguished by the person’s inability to ab-
at the expected age. It may be due to develop- stain, as opposed to his or her complete loss of
mental delay, hearing loss, brain injury, men- control over drinking.
tal retardation or other psychological disorders, delta receptor see opioid receptor.
or emotional disturbance. delta-9-tetrahydrocannabinol n. see can-
delay of gratification forgoing immediate re- nabis.
ward in order to obtain a larger, more desired, or delta wave the lowest frequency brain wave re-
more pleasurable reward in the future. Compare corded in electroencephalography. Delta waves
immediate gratification. are large, regular-shaped waves that have a fre-
deliberate psychological education (DPE) quency of 1–3 Hz. They are associated with deep,
a curriculum that is designed to affect personal, often dreamless, sleep (delta-wave sleep) and in-
ethical, aesthetic, and philosophical develop- dicate a synchronization of cells of the cerebral
ment in adolescents and young adults, through a cortex. Also called delta rhythm; slow wave.
balance of real and role-taking experiences and See nrem sleep; stage 3 sleep; stage 4 sleep.
reflective inquiry. Counselors act as psychologi- delusion n. an improbable, often highly per-
cal educators or developmental instructors. sonal, idea or belief system, not endorsed by
delibidinization n. see desexualization. one’s culture or subculture, that is maintained
délire de négation see cotard’s syndrome. with conviction in spite of irrationality or evi-
dence to the contrary. Delusions may be tran-
délire du toucher the compulsion to touch ob- sient and fragmentary, as in delirium, or highly
jects, which may be associated with obsessive- systematized and elaborate, as in delusional
compulsive disorder or may be a complex tic disorders, though most of them fall between
in tourette’s disorder. these two extremes. Common types include de-
deliriant n. a substance capable of inducing a lusional jealousy, delusions of being con-
state of acute delirium, commonly associated trolled, delusions of grandeur, delusions
with restlessness or agitation. An acute delirium of persecution, delusions of reference, ni-
may result from excess ingestion of anticholin- hilistic delusions (see nihilism), and somatic
ergic drugs (see central anticholinergic syn- delusions. Data suggest delusions are not pri-
drome) or withdrawal from alcohol and certain marily logical errors but are derived from emo-
other substances. tional material. Delusions have come to
delirium n. a state of disturbed consciousness in represent one of the most important factors in
which attention cannot be sustained, the envi- systems for classifying diagnostic categories.
ronment is misperceived, and the stream of Some researchers believe that delusions may be
thought is disordered. The individual may expe- the most important symptom of schizophrenia.
rience changes in cognition (which can include See also bizarre delusion; encapsulated de-
disorientation, memory impairment, or distur- lusion; fragmentary delusion; system-
bance in language), perceptual disturbances, hal- atized delusion.
lucinations, illusions, and misinterpretation of delusional disorder in DSM–IV–TR, any one
sounds or sights. The episode develops quickly of a group of psychotic disorders with the essen-
and can fluctuate over a short period. Delirium tial feature of one or more nonbizarre delu-
may be caused by a variety of conditions includ- sions that persist for at least 1 month but are not
ing, but not limited to, infections, cerebral tu- due to schizophrenia. The delusions are non-
161
delusional jealousy
bizarre in that they feature situations that could that the actions of others and events occurring
conceivably occur in real life (e.g., being fol- in the external world have some special meaning
lowed, poisoned, infected, deceived by one’s or significance (typically negative) in relation to
government, etc.). Seven types of delusional dis- oneself. See also idea of reference.
order are specified, according to the theme of the delusion of sin a delusion in which the individ-
delusion: erotomanic type, grandiose type, jeal- ual is convinced of having committed unpar-
ous type, persecutory type, somatic type, mixed donable sins, for example, being to blame for
type, and unspecified type. In DSM–III, delu- wars, droughts, and other catastrophes. Such a
D sional disorder was called paranoid disorder. delusion is frequently accompanied by intense
delusional jealousy a fixed delusion that a fear of punishment.
spouse or partner is unfaithful. The individual is
delusion system see delusional system.
constantly on the watch for indications that this
false belief is justified, manufactures evidence if demand n. a requirement or urgent need, partic-
it is not to be found, and completely disregards ularly any internal or external condition that
facts that contravene the conviction. This type arouses a drive in an organism.
of delusion was formerly called amorous (or con- demand characteristics in an experiment or
jugal) paranoia. Also called morbid jealousy; research project, cues that may influence or bias
Othello syndrome or delusion; pathologi- participants’ behavior, for example, by suggest-
cal jealousy. ing the outcome or response that the experi-
delusional mania a manic episode character- menter expects or desires. Such cues can distort
ized by delusions. Delusional mania is now more the findings of a study.
often described as a manic episode with psy- demandingness n. insistence upon attention,
chotic features. help, or advice from others. It is commonly as-
delusional misidentification see misiden- sociated with depression. See also dependence.
tification. —demanding adj.
delusional misidentification syndrome demandment n. any self-constructed and often
see misidentification syndrome. self-defeating and unconscious imperative that
delusional system a more or less logically in- converts important desires and goals into abso-
terconnected group of delusions held by the lute demands: “Because I am not performing
same person. Delusions that are tightly logical, well, as I absolutely must, I am a terrible person.”
but based on a false premise, are characteristic of See rational emotive behavior therapy. [de-
persecutory type delusional disorder. Also fined by U.S. psychotherapist Albert Ellis (1913–
called delusion system. 2007)]
delusion of being controlled the false belief démence précoce see dementia praecox.
that external forces, such as machines or other dementia n. a generalized, pervasive deteriora-
people, are controlling one’s thoughts, feelings, tion of cognitive functions, such as memory,
or actions. language, and executive functions, due to
delusion of grandeur the false attribution to any of various causes. The loss of intellectual
the self of great ability, knowledge, importance abilities is severe enough to interfere with an in-
or worth, identity, prestige, power, accomplish- dividual’s daily functioning and social and occu-
ment, or the like. Also called grandiose delu- pational activity. In DSM–IV–TR, dementias are
sion. See also megalomania. categorized according to the cause, which may
delusion of influence 1. the false supposition be Alzheimer’s disease, cerebrovascular disease
that other people or external agents are covertly (see vascular dementia), Pick’s disease (mainly
exerting powers over oneself. Idea of influence is affecting the frontal and temporal lobes), Parkin-
used synonymously, but with the implication son’s disease (see also lewy body dementia),
that the condition is less definite, of shorter du- Huntington’s disease, HIV infection (see aids
ration, or less severe. 2. the false belief that one’s dementia complex), Creutzfeldt–Jakob disease,
intentions or actions directly control external head injury, alcoholism (see alcohol-induced
events or the thoughts and behavior of other persisting dementia), or substance abuse (see
people. substance-induced persisting dementia).
delusion of negation see nihilism. Brain tumor, hypothyroidism, hematoma, or
other conditions, which may be treatable, can
delusion of observation the false belief that also cause dementia. The age of onset varies with
one is being watched by others. Also called ob- the cause but is usually late in life. When occur-
servation delusion. ring after the age of 65 it is termed senile demen-
delusion of persecution the false conviction tia and when appearing before 65 it is called
that others are threatening or conspiring against presenile dementia. However, dementia should
one. Also called persecutory delusion. not be confused with age-associated memory
delusion of poverty a false belief in which the impairment, which has a much less deleterious
individual insists that he or she is, or will soon impact on day-to-day functioning.
be, entirely destitute. dementia of the Alzheimer’s type (DAT)
delusion of reference the false conviction see alzheimer’s disease.
162
dependence
dementia praecox the original, now obsolete, belief that one is possessed by or under the con-
name for schizophrenia, first used in 1896 by trol of an evil spirit or demon.
German psychiatrist Emil Kraepelin (1856– demoralization n. a breakdown of values, stan-
1926). It is derived from démence précoce dards, and mores in an individual or group, such
(French, “early deterioration of the mind”), as may occur in periods of rapid social change,
coined in 1857 by Austrian-born French psychia- extended crises (e.g., war, economic depression),
trist Bénédict A. Morel (1809–1873), this name or personal traumas. A demoralized person may
reflecting the belief that the symptoms of the be disorganized and feel lost, bewildered, and in-
disorder arose in adolescence or before and insecure. —demoralize vb. D
volved incurable degeneration. Swiss psychia-
trist Eugen Bleuler (1857–1939) questioned both
demoralization hypothesis the idea that ef-
fective psychotherapy depends on the therapist
of these views and in 1911 renamed the disorder
overcoming the client’s state of demoralization,
schizophrenia.
which can be achieved by encouraging the client
Dementia Rating Scale (DRS) a neuro- to confide, explaining his or her symptoms, and
psychological assessment instrument used to providing a therapeutic ritual through which
measure cognitive status in adults with cognitive these may be resolved. Such an approach is held
impairments due to brain pathologies. It com- to be a common factor underlying the success of
prises 36 tasks of varying difficulty (e.g., repeat- various therapies. [proposed by U.S. psycholo-
ing a series of numbers, naming objects present gist Jerome D. Frank (1909–2005)]
in the immediate environment, copying designs
from stimulus cards onto blank pieces of paper) demotivation n. negative imagery or self-talk
that are presented to participants in a fixed that emphasizes why one cannot do well in a
order. The scale evaluates performance on five task and thus discourages any attempt to per-
subscales: attention, initiation–perseveration, form it.
construction, conceptualization, and memory. demyelination n. the loss of the myelin
Originally developed in 1973 by U.S. neuro- sheath that covers nerve fibers.
psychologist Steven Mattis and published com- dendrite n. a branching, threadlike extension of
mercially in 1988, the DRS subsequently was the cell body that increases the receptive sur-
revised in 2001 (DRS–2). face of a neuron. —dendritic adj.
dementia syndrome of depression see dendrophilia n. a paraphilia characterized by
pseudodementia. sexual attraction to trees. The person may have
Demerol n. a trade name for meperidine. actual sexual contact with trees, may venerate
democratic parenting a parenting style, de- them as phallic symbols, or both. Also called
rived from the ideas of Alfred adler, in which dendrophily.
the parent guides the child’s development in an denervation n. removal or interruption of the
accepting but steady manner and fosters a cli- nerves that supply a part of the body.
mate in which cooperation, fairness, equality, denial n. a defense mechanism in which un-
and mutual respect between parent and child are pleasant thoughts, feelings, wishes, or events are
assumed. ignored or excluded from conscious awareness.
demographic pattern a significant pattern re- It may take such forms as refusal to acknowledge
vealed by a statistical study of population vari- the reality of a terminal illness, a financial prob-
ables, such as marriages, births, infant mortality, lem, an addiction, or a partner’s infidelity. De-
income, or geographical distribution of the use nial is an unconscious process that functions to
of medical or mental health services. resolve emotional conflict or reduce anxiety.
demography n. the statistical study of human Also called disavowal. —deny vb.
populations in regard to various factors and dental phobia a persistent and irrational fear of
characteristics, including geographical distribu- dentists or of dental treatment, resulting in the
tion, sex and age distribution, size, structure, avoidance of dental care or marked distress and
and growth trends. Such analyses are used in anxiety during dental visits. It may be related to
many types of study, including epidemiological a prior negative dental experience, fear of pain,
studies. —demographer n. —demographic perceived lack of control, or feelings of helpless-
adj. ness or embarrassment.
demonic possession the supposed invasion of deoxyribonucleic acid see dna.
the body by an evil spirit or devil that gains con- Depacon n. a trade name for valproate sodium.
trol of the mind or soul, producing mental disor- See valproic acid.
der, illness, or criminal behavior. Many forms of
physical and psychological illness were formerly Depakene n. a trade name for valproic acid.
attributed to such possession, notably epilepsy, Depakote n. a trade name for divalproex so-
schizophrenia, and tourette’s disorder. dium.
The traditional remedy for possession was ritual dependence n. 1. the state of having some reli-
exorcism. ance on or association with another entity or
demonomania n. a morbid preoccupation with event. For example, in statistics two variables are
demons and demonic possession, including the said to have “linear dependence” if one variable
163
Dependency Court
is formed from another variable in an analysis, as disorder characterized by one or more episodes
would occur if including IQ, formed from men- of depersonalization severe enough to impair
tal age over actual age, in an analysis that already social and occupational functioning. Onset of
has age as a variable. 2. a state in which assis- depersonalization is rapid and usually mani-
tance from others is intuitively expected or ac- fested in a sensation of self-estrangement, a feel-
tively sought for emotional or financial support, ing that one’s extremities are changed in size, a
protection, security, or daily care. The depend- sense of being mechanical, perceiving oneself at
ent person leans on others for guidance, decision a distance, and, in some cases, a feeling that the
D making, and nurturance. Whereas some degree external world is unreal (derealization).
of dependence is natural in interpersonal rela-
depersonification n. 1. treatment of another
tions, excessive, inappropriate, or misdirected
person as something other than the unique indi-
reliance on others is often a focus of psychologi-
vidual that he or she really is. For example, par-
cal treatment. Personality, social, and behavioral
ents may treat their child as an extension of
psychology, as well as psychoanalytic theory,
themselves, which leads to the child having a
all contribute different perspectives to the
distorted sense of self. 2. in psychoanalytic the-
study and treatment of pathological depend-
ory, a stage in the maturation of the superego
ence. 3. see substance dependence. —de-
that follows introjection of parental imagoes
pendent adj.
and leads to integration of parental values as ab-
Dependency Court in the United States, a stract ideas. —depersonify vb.
court dealing with all issues concerned with
child abuse and neglect; such issues are brought deployment psychology a branch of mili-
to the attention of the court by a government tary psychology devoted to understanding
agency (typically Child Protective Services), that and addressing the unique mental and behav-
intervenes on behalf of the child by filing a peti- ioral health needs of members of the armed
tion alleging abuse or neglect. forces and their families during and after mem-
bers’ posting to combat zones and other opera-
dependency need any personal need that must tional environments. Although relatively scarce
be satisfied by others, including the need for af- to date, research in this area focuses on (a) the
fection, love, shelter, physical care, food, psychosocial effects on military personnel and
warmth, protection, and security. Such needs are their families of combat exposure and of injuries
considered universal and normal for both sexes sustained in combat, including disfigurement,
and at all ages. It is also recognized that depend- amputation, sensory loss, traumatic brain in-
ence can be maladaptive (e.g., excessive and jury, and other severe wounds; (b) barriers to ac-
overencouraged) and generate a variety of issues cessing mental health care in the military and
surrounding attachment. See also codepen- the efficacy of existing prevention and interven-
dency; morbid dependency. tion programs; (c) the psychology of trauma and
dependent personality disorder in DSM– promotion of resilience among military per-
IV–TR, a personality disorder manifested in a sonnel and their families; and (d) the process of
long-term pattern of passively allowing others to readjusting to family, community, and general
take responsibility for major areas of life and of civilian life for returning military personnel.
subordinating personal needs to the needs of Similarly, clinical services focus on (a) treating
others, due to lack of self-confidence and self- posttraumatic stress disorder, anxiety disorder,
dependence. It was formerly known as passive- adjustment disorder, depression, substance
dependent personality. abuse, and other mental health disorders com-
dependent variable (DV) the outcome that is mon among returning military personnel; (b)
observed to occur or change after the occurrence mitigating the negative effects of these disorders
or variation of the independent variable in an on the families of those affected; (c) mitigating
experiment, or the effect that one wants to pre- the stress experienced by families while military
dict or explain in correlational research. De- personnel are deployed; (d) teaching effective
pendent variables may or may not be related coping skills—such as anger management, con-
causally to the independent variable. Also called flict resolution, and communication tech-
criterion variable; outcome variable; re- niques—to returning soldiers and their families
sponse variable. to better prepare them to handle interpersonal
difficulties that may arise; and (e) utilizing
depersonalization n. a state of mind in which stress-inoculation training and other strate-
the self appears unreal. Individuals feel es- gies during deployment to enhance the psycho-
tranged from themselves and usually from the logical well-being of soldiers and thus prevent
external world, and thoughts and experiences the subsequent development of serious prob-
have a distant, dreamlike character. In its persis- lems.
tent form, depersonalization is observed in such
disorders as depression, hypochondriasis, Depo-Provera n. a trade name for medroxy-
dissociative states, temporal-lobe epilepsy, and progesterone acetate, an antiandrogen used in
early schizophrenia. The extreme form is called the treatment of sex offenders. See chemical
depersonalization syndrome. castration.
depersonalization disorder a dissociative deprenyl n. see selegiline.
164
derealization
depressant n. any agent that diminishes or re- tion. 2. in conditioning, reduction of access
tards any function or activity of a body system or to or intake of a reinforcer. —deprive vb.
organ, especially a cns depressant. deprivation dwarfism stunting of physical
depression n. 1. a fluctuation in normal mood growth in infancy and early childhood due to
ranging from unhappiness and discontent to an such nonorganic factors as maternal separation
extreme feeling of sadness, pessimism, and de- or emotional neglect. See also failure to
spondency. 2. in psychiatry, any of the depres- thrive.
sive disorders. —depressed adj. deprogramming n. the process by which peo-
depression after delivery a less common ple who have adopted profoundly new sets of
D
name for postpartum depression. attitudes, beliefs, and values have their orig-
depressive anxiety in psychoanalytic theory, inal attitudes, beliefs, and values restored. De-
anxiety provoked by fear of one’s own hostile programming techniques are typically used on
feelings toward others. It is based on the theory people who have left or been removed from
that depression is hostility turned inward. highly coercive social groups, such as religious
depressive disorder in DSM–IV–TR, any of the cults. See also brainwashing.
mood disorders that typically have sadness as depth interview an interview designed to re-
one of their symptoms. They include dysthymic veal deep-seated feelings, attitudes, opinions,
disorder, major depressive disorder, and de- and motives by encouraging the individual to
pressive disorder not otherwise specified. express himself or herself freely without fear of
See unipolar depression. disapproval or concern about the interviewer’s
depressive disorder not otherwise speci- reactions. Such interviews may be conducted,
fied in DSM–IV–TR, a mood disorder with de- for example, in counseling and as part of qualita-
pressive symptoms that does not meet the tive market research. They tend to be relatively
criteria for either of the specific depressive dis- lengthy, unstructured, one-on-one conversa-
orders (i.e., major depressive disorder or dys- tions.
thymic disorder). This category includes minor depth-oriented brief therapy a form of
depressive disorder and premenstrual brief psychotherapy that applies principles of
dysphoric disorder. constructivist psychotherapy in a time-
depressive episode see major depressive epi- limited fashion.
sode. depth psychology a general approach to psy-
depressive neurosis a former name for chology and psychotherapy that focuses on un-
dysthymic disorder. conscious mental processes as the source of
emotional disturbance and symptoms, as well as
depressive personality disorder a personal-
personality, attitudes, creativity, and lifestyle. A
ity disorder (in the appendix of DSM–IV–TR)
typical example is classical psychoanalysis,
characterized by glumness, pessimism, a lack of
but others include Carl jung’s analytic psy-
joy, the inability to experience pleasure, and
chology and Alfred adler’s individual psy-
motor retardation. Feelings of loss, a sense of giv-
chology.
ing up, and an orientation to pain are notable.
There are vegetative signs, despair regarding the depth therapy any form of psychotherapy,
future, and a disheartened outlook. brief or extended, that involves identifying and
working through unconscious conflicts and ex-
depressive position in the object relations
periences that underlie and interfere with behav-
theory of Melanie klein, the stage of infant de-
ior and adjustment. Compare surface therapy.
velopment that reaches its peak at about 6
months of age. In the depressive position the in- Deracyn n. a trade name for adinazolam.
fant begins to perceive the good object and derailment n. a symptom of thought disorder,
bad object as a single whole and feels guilt for often occurring in individuals with schizophre-
having attacked the good object during the pre- nia, marked by frequent interruptions in
ceding paranoid-schizoid position. In this— thought and jumping from one idea to another
Klein’s most mature—phase of primary psycho- unrelated or indirectly related idea. It is usually
logical organization, the infant fears that he or manifested in speech (speech derailment) but
she will lose or destroy the good object and at- can also be observed in writing. Derailment is es-
tempts to make reparation for earlier hostility. sentially equivalent to loosening of associa-
depressive reaction see reactive depres- tions. See cognitive derailment; thought
sion. derailment.
depressive spectrum the range of severity and derangement n. 1. disturbance in the regular
disparate symptoms that characterize depres- order or normal functioning of something. 2.
sive disorders. The underlying concept is that loosely, mental illness or mental disturbance.
depression is a range of related disorders, rather derealization n. a state characterized by a sense
than a single diagnostic entity. of unreality; that is, an alteration in the percep-
deprivation n. 1. the removal, denial, or un- tion of external reality so that it seems strange or
availability of something needed or desired. See unreal (“This can’t be happening”), often due to
cultural deprivation; maternal depriva- trauma or stress. It may also occur as a feature of
165
dereflection
schizophrenia or of certain dissociative dis- origin, catharsis, or deconditioning tech-

orders. See also depersonalization. niques. See also covert desensitization; in
dereflection n. a common technique used to vivo desensitization; systematic desensiti-
allay anxiety or stop inappropriate behavior by zation.
diverting attention to a different topic and away desertion n. see abandonment.
from the self. It is used to reduce excessive self- desexualization n. in psychoanalytic theory,
concern, shyness, and worry about the self and is the elimination or neutralization of a sexual
a central component in morita therapy. aim. Also called delibidinization. See also
D dereism n. mental activity that is not in accord sublimation. —desexualize vb.
with reality, experience, or logic. It is similar
designer drug any of various synthetic opioids,
to autistic thinking. Also called dereistic
usually with heroin-like effects, designed with
thinking.
chemical structures that circumvent existing
derivative insight an insight into a problem legal definitions of controlled substances and
that is achieved by the client without interpreta- hence avoid restrictions on their use. These
tion by the therapist. drugs tend to be abused by young middle-class
derived need a need developed through associ- people. See also club drugs.
ation with or generalization from a primary design fluency test any of a group of tests in
need. which participants must generate (within a
dermatoglyphics n. the study of the patterns given time) a series of figures that have specific
of lines on the skin of the fingers, palms, and criteria. The tests were developed to provide clin-
soles. The technique is used in the diagnosis of ical information regarding nonverbal capacity
certain kinds of chromosomal abnormalities for flexibility and planning similar to verbal
based on observations that some patterns are fluency tests. For example, participants may
associated with certain types of birth defects or be required to produce figures made from five
disorders. For example, people with Down syn- lines and must devise new ways to put the lines
drome have a single crease across the palm and a together in an organized manner to make new
single crease on the skin of the little (fifth) fin- figures or designs. Also called figural fluency
ger. test.
dermatological disorder any disorder or dis- desipramine n. a tricyclic antidepressant
ease of the skin. See also psychocutaneous dis- and the principal metabolic product of imi-
order. pramine, produced in the body by the
DES 1. abbreviation for diethylstilbestrol. 2. demethylation of imipramine in the liver.
abbreviation for dysexecutive syndrome. Desipramine is a stronger inhibitor of norepi-
descriptive approach see topographic nephrine reuptake than of serotonin reuptake
model. relative to imipramine. In general, it is less sedat-
ing and has fewer anticholinergic effects
descriptive behaviorism an approach to the than imipramine and was frequently used to
study of behavior espoused by B. F. skinner, treat behavior disorders and insomnia in chil-
who felt that psychology should limit itself to a dren. However, like all tricyclic antidepressants,
description of behaviors of organisms, the con- it has fallen into relative disuse as safer medica-
ditions under which they occur, and their effects tions have become available. U.S. trade name:
on the environment. It requires that theoretical Norpramin.
explanations in terms of underlying biological
or hypothetical psychological processes be desmopressin n. a synthetic analog of the pitu-
avoided. See behaviorism; radical behavior- itary hormone vasopressin that, among other
ism. functions, stimulates water retention and raises
blood pressure. Desmopressin is used in the form
descriptive statistic a numerical index used
of a nasal spray to treat nocturnal enuresis (bed-
to describe (summarize) a particular feature of
wetting) and diabetes insipidus. It possesses
the data, such as a mean or standard devia-
more antidiuretic activity (i.e., prevents exces-
tion.
sive water loss from the body) and less potential
descriptive study a research method in which to raise blood pressure than vasopressin. U.S.
the primary goal is to reveal patterns and illus- trade name (among others): DDAVP.
trate connections in the phenomena under in-
vestigation, without manipulating variables or desocialization n. gradual withdrawal from so-
seeking to establish cause and effect. For exam- cial contacts and interpersonal communication,
ple, a survey undertaken to ascertain the politi- with absorption in private thought processes
cal party preferences of a group of voters would and adoption of idiosyncratic and often bizarre
be a descriptive study because it is intended sim- behavior.
ply to identify attitudes rather than systemati- Desoxyn n. a trade name for methamphet-
cally infer or analyze influencing factors. amine.
desensitization n. a reduction in emotional or despair n. 1. the emotion or feeling of hopeless-
physical reactivity to stimuli that is achieved by ness, that is, that things are profoundly wrong
such means as gaining insight into its nature or and will not change for the better. Despair is one
166
detoxification
of the most negative and destructive of human view during which the therapist gains an under-
affects and behaviors, and as such is a primary standing of the patient by asking direct ques-
area for psychotherapeutic intervention. 2. in tions on many diverse topics, ranging from
erikson’s eight stages of development, see mundane questions about everyday life to
integrity versus despair. highly detailed questions, for example, about
despondency n. a state characterized by both particular reactions to specific events.
apathy and depressed mood. —despondent deterioration n. progressive impairment or loss
adj. of basic functions, such as emotional, judgmen-
destiny neurosis see fate neurosis. tal, intellectual, muscular, and memory func- D
tions.
destructive behavior the expression of anger,
hostility, or aggression by damaging or destroy- deterioration effect an adverse effect or nega-
ing external objects or oneself (see self- tive outcome from participating in psychother-
destructiveness). apy.
destructive instinct see death instinct. deterioration index a pattern of subtest
scores on the wechsler adult intelligence
destructiveness n. a tendency toward the ex- scale viewed as suggestive of neurological defi-
pression of aggressive behavior by destroying, cit and used in measuring the degree of reduced
damaging, or defacing objects. See also self- performance that can be attributed to aging.
destructiveness. Also called deterioration quotient. See also
destrudo n. the energy associated with don’t-hold functions; hold functions.
thanatos, the death instinct. Destrudo con- deterioration of attention inconstant and
trasts with libido, the energy of eros, the life shifting attention and impaired ability to con-
instinct. See also mortido. [defined by Aus- centrate on external reality.
trian-Italian psychoanalyst Edoardo Weiss
determination n. 1. a mental attitude charac-
(1889–1970)]
terized by a strong commitment to achieving a
desurgency n. a personality trait characterized particular goal despite barriers and hardships. 2.
by anxiety, brooding, and seclusion. [defined by the act or process of making a decision, reaching
British-born U.S. personality psychologist Ray- a conclusion, or ascertaining the characteristics
mond Bernard Cattell (1905–1998)] or exact nature of something, or the end result of
desymbolization n. the process of depriving such a process.
symbols, especially words, of their accepted determinism n. the philosophical position that
meanings and substituting distorted, neolo- all events, physical or mental, including human
gistic, autistic, or concrete ideas for them. behavior, are the necessary results of antecedent
desynchronization n. in electroencephalogra- causes or other entities or forces. Determinism,
phy, the replacement of alpha waves by fast, which requires that both the past and the future
low-amplitude, irregular waveforms, often be- are fixed, manifests itself in psychology as the
cause of an external stimulus, usually one that position that all human behaviors result from
alerts the individual. See alpha blocking. specific efficient causal antecedents, such as bio-
Desyrel n. a trade name for trazodone. logical structures or processes, environmental
conditions, or past experience. The relationships
DET diethyltryptamine: a synthetic hallucino- between these antecedents and the behaviors
gen belonging to the indolealkylamine family, they produce can be described by generalizations
to which lsd, psilocin, and dmt also belong. much like the laws that describe regularities in
detached character a personality character- nature. Determinism contrasts with belief in free
ized by extreme self-sufficiency and lack of feel- will, which implies that individuals can choose
ing for others. German-born U.S. psychoanalyst to act in some ways independent of antecedent
Karen D. Horney (1885–1952) identified the de- events and conditions. Those who advocate free-
velopment of such a character as one of three will positions often adopt a position of “soft de-
basic neurotic trends used as a defense against terminism,” which holds that free will and re-
basic anxiety. Compare aggressive charac- sponsibility are compatible with determinism.
ter; compliant character. Others hold that free will is illusory, a position
detachment n. 1. a feeling of emotional free- known as “hard determinism.” Of contempor-
dom resulting from a lack of involvement in a ary psychological theories, behaviorism takes
problem or with another situation or person. 2. most clearly a hard determinist position. See also
objectivity: that is, the ability to consider a prob- genetic determinism. —determinist adj., n.
lem on its merits alone. Also called intellectual —deterministic adj.
detachment. 3. in developmental psychology, deterrent therapy see aversion therapy.
the child’s desire to have new experiences and detoxification n. a therapeutic procedure, pop-
develop new skills. This occurs at about 2 years ularly known as detox, that reduces or elimi-
of age, as the child begins to outgrow the period nates toxic substances in the body. These
of total attachment to and dependence on the procedures may be metabolic (by converting the
parent or caregiver. toxic substance to a less harmful agent that is
detailed inquiry a phase of a clinical inter- more easily excreted) or they may require in-
167
detoxification center
duced vomiting, gastric lavage (washing), or di- developmental dyslexia a form of dyslexia
alysis, depending upon the nature of the poison that is apparent during an early developmental
and other factors. Examples are the use of meth- age or phase and manifested as difficulty in
adone in opioid intoxication, tranquilizers to learning to read and spell single words.
ease alcohol withdrawal, and lavage and artifi- developmental dysphasia language diffi-
cial respiration in barbiturate poisoning. culty or delayed language acquisition believed to
detoxification center a clinic, hospital unit, be associated with brain damage or cerebral mat-
or other facility devoted to the alleviation of the uration lag. It is characterized by defects in ex-
D toxic effects of drug or alcohol overdose and to pressive language and articulation (expressive
the management of acute withdrawal symp- dysphasia) and in more severe cases by defects in
toms. These centers may focus on either medical comprehension of language (receptive dyspha-
or nonmedical procedures, depending on the se- sia). Also called developmental aphasia.
verity of the syndromes handled. See alcohol developmental dyspraxia dyspraxia pres-
withdrawal; substance withdrawal. ent since birth and manifested during an early
detoxification effects see substance with- developmental age or phase as difficulty in per-
drawal. forming coordinated movements. In DSM–IV–
Detussin n. a trade name for a combination of TR this condition is equivalent to developmen-
hydrocodone and pseudoephedrine. tal coordination disorder. Compare ac-
quired dyspraxia.
devaluation n. a defense mechanism that in-
volves denying the importance of something or developmental expressive writing disor-
someone, including the self. —devalue vb. der see disorder of written expression.
developmental assessment the evaluation of developmental hyperactivity a condition
shown by children who are within or above the
a child’s level of physical, cognitive, emotional,
average range intellectually but display high ac-
and social development, as assessed by specific
tivity levels as an integral part of their behavior.
developmental scales.
developmental immaturity the status of a
developmental-behavioral pediatrics see
child who exhibits a delay (usually temporary)
behavioral pediatrics.
in reaching developmental landmarks without
developmental coordination disorder in clinical or historical evidence of damage to the
DSM–IV–TR, a motor skills disorder character- central nervous system. The child may appear
ized by marked impairment in the development younger than his or her chronological age in
of motor coordination. Performance in activities physical development, gross and fine motor abil-
that require motor coordination is substantially ities, language development, social awareness, or
below that expected given the child’s chronolog- any combination of these. See also develop-
ical age and measured intelligence. Significant mental delay; developmental retardation.
impairment of academic performance or daily
developmental language disorder in
living activities is also observed. However, the
DSM–III, a diagnostic category comprising two
difficulties are not due to mental retardation or
types of disorder in which the development of
pervasive developmental disorders. See also
language skills is impaired: an expressive type
developmental dyspraxia.
and a receptive type. The equivalent DSM–IV–TR
developmental delay delay in the age at classifications for these types are expressive
which developmental milestones are achieved language disorder and mixed receptive-
by a child or delay in the development of com- expressive language disorder, respectively.
munication, social, and daily living skills. It
developmental levels the stages into which
most typically refers to delays in infants, tod-
the human life span is typically divided: (a) neo-
dlers, and preschool children that are meaning-
natal period; (b) infancy; (c) early, middle, and
ful but do not constitute substantial handicap.
late childhood; (d) adolescence; and (e) early,
Children with developmental delays are often el-
middle, and late adulthood.
igible for early intervention or preschool services
to ameliorate these delays. developmental orientation 1. in interdisci-
plinary team or other individual service-
developmental disability a developmental planning processes, an emphasis on the skills,
level or status that is attributable to a cognitive abilities, and strengths of people with disabilities
or physical impairment, or both, originating be- in relation to expected developmental attain-
fore the age of 22. Such an impairment is likely ments and performance of children or young
to continue indefinitely and results in substan- people without disabilities. 2. see developmen-
tial functional or adaptive limitations. Examples tal theory. Compare defect orientation.
of developmental disabilities include, but are
not limited to, mental retardation, pervasive de- developmental pharmacokinetics the
velopmental disorders, learning disorders, devel- study of how pharmacological agents are pro-
opmental coordination disorder, communication cessed (see pharmacokinetics) in infants and
disorders, cerebral palsy, epilepsy, blindness, children.
deafness, mutism, and muscular dystrophy. Also developmental psychopathology the sci-
called developmental disorder. entific study of the origins and progression of
168
device for automated desensitization
psychological disorders as related to the typical plex trauma, have a pervasive and long-range in-
processes of human growth and maturation. fluence on children’s emotional, cognitive, be-
Central to this field is the belief that studying de- havioral, and psychobiological functioning
partures from developmental norms will en- that many clinicians believe is not adequately
hance understanding of those norms, which will captured by posttraumatic stress disorder
in turn enhance the conceptualization and treat- or any other existing diagnosis. Six domains
ment of mental illness. of potential impairment related to complex
developmental retardation abnormally trauma exposure have been delineated: (a) affect
slow growth in any or all areas—intellectual, regulation; (b) information processing; (c) self- D
motor, perceptual, linguistic, or social. See also concept; (d) behavioral control; (e) interpersonal
developmental delay; developmental im- relationships; and (f) biological processes. This
maturity. multifaceted dysregulation can disrupt typical
maturation, potentially leading to wide-ranging
Developmental Test of Visual–Motor In- developmental delays and to persistently altered
tegration (VMI) a measure of visuomotor de- attributions and expectancies about the self, re-
velopment that requires the participant to copy lationships, and others.
onto blank pieces of paper geometric designs
increasing in difficulty from a straight line to deviance n. 1. any behavior that differs signifi-
complex figures. The VMI is used to identify cantly from what is considered appropriate or
problems with visual perception, motor coordi- typical for a social group. Also called deviancy.
nation, and visual–motor integration. It is avail- 2. in statistics, a measure of the goodness of fit
able in two versions: the Short Format, con- between a smaller nested model and a fuller
taining 15 designs and appropriate for children model that has all of the same parameters plus
aged 2 to 8 years, and the Full Format, contain- more. The difference or deviance between these
ing 24 designs and appropriate for children models follows a chi-square distribution,
through age 18. [originally developed in 1967 by with the degrees of freedom equal to the num-
U.S. psychologists Keith E. Beery (1932–2010) ber of parameters that are added by the fuller
and Norman A. Buktenica (1930– )] model. If the deviance reveals a significant dif-
ference, then the larger model is needed. If the
developmental theory 1. any theory based
deviance is not significant, then the smaller,
on the continuity of human development and
more parsimonious model is retained as more
the importance of early experiences in shaping
appropriate.
the personality. Examples are the psychoana-
lytic theory of psychosexual development, deviant sexuality see sexual deviance.
erikson’s eight stages of development,
deviant verbalization see schizophrenic
learning theories that stress early conditioning,
thinking.
and role theories that focus on the gradual acqui-
sition of different roles in life. 2. the proposition deviation n. a significant departure or differ-
that mental retardation is due to slower than ence. This conceptually broad term has a variety
normal development of cognitive processes and of applications in psychology and related fields
is not qualitatively different from the cognitive but most commonly refers to behavior that is
processes of other people. Also called develop- significantly different from the accepted stan-
mental orientation. Compare defect the- dard or norm, or to the arithmetical difference
ory. between one of a set of values and some fixed
developmental therapy a method of treat- amount, generally the mean of the set or the
ment for children and adolescents with emo- value predicted by a model. See standard devi-
tional, social, or behavioral problems. A series of ation.
graded experiences is used to help clients to deviation IQ the absolute measure of how far
function better in various areas, such as interact- an individual differs from the mean on an indi-
ing with others or managing anger. vidually administered iq test. This is the ap-
developmental toxicology the study of the proach now most commonly used in standard
effects of toxic (poisonous) substances on the IQ tests. A reported deviation IQ is a standard
normal development of infants and children: score on an IQ test that has a mean of 100 and a
specifically, the study of the adverse effects of standard deviation specific to that of the test ad-
certain drugs administered to them or to which ministered, usually 15 or 16 for intelligence
they may have been exposed in the uterus. tests. The test scores represent a deviation from
the mean score rather than a quotient, as was
developmental trauma disorder (DTD) a
typical in the early days of IQ testing.
new diagnosis, proposed for inclusion in the up-
coming fifth edition of the Diagnostic and Statis- device for automated desensitization
tical Manual of Mental Disorders, for children who (DAD) a computerized system for applying de-
have been exposed in early life to multiple ad- sensitization therapy to the treatment of
verse interpersonal events, such as sexual or focused phobic behavior. The device administers
physical abuse, parental substance abuse, do- visual or audio instructions for muscle re-
mestic or community violence, neglect, and laxation and visualization of feared stimuli
abandonment. These experiences, termed com- arranged in a hierarchical order. See also co-
169
devil’s trumpet
vert desensitization; systematic desensiti- and attention-deficit/hyperactivity disorder.

zation. Like all amphetamines, it is prone to abuse and
devil’s trumpet see jimsonweed. dependence. Also called dexamphetamine.
U.S. trade names (among others): Dexedrine;
Dewey, John (1859–1952) U.S. philosopher, ed- Adderall (in combination with amphetamine).
ucator, and psychologist. After receiving his doc-
torate in 1884 under George S. Morris (1840– dextromethorphan n. a synthetic opioid
1889) at Johns Hopkins University, Dewey used clinically as a cough suppressant. Its mech-
taught for a decade each at the universities of anism of action is unknown, but it is known to
D Michigan and Chicago before moving to Colum- bind to nmda receptors. Dextromethorphan is
bia University, where he spent the rest of his ca- a common ingredient in over-the-counter cough
reer. Dewey wrote the first scientific text on and cold preparations and is increasingly used as
psychology in the United States (Psychology, a drug of abuse, particularly among adolescents.
1886) and went on to develop the functionalist, Because it is metabolized extensively by the
or instrumentalist, approach, in conjunction cytochrome p450 (CYP) 2D6 liver enzyme, it is
with William james, James Rowland angell, used in pharmacology as a comparison when
and others. Dewey’s 1896 essay, “The Reflex Arc calculating the degree to which certain drugs in-
Concept in Psychology,” is considered to be hibit CYP enzymes. It should not be taken by in-
the debut of functionalism in psychology. dividuals who are taking monoamine oxidase
Dewey’s work also had a great impact in the inhibitors, and it should be used with caution
fields of education and philosophy. In keeping by those taking inhibitors of the CYP2D6 en-
with his functionalist views, he held that educa- zyme (i.e., fluoxetine, paroxetine) because unex-
tion must relate to the child’s own experience, pectedly high plasma concentrations of either
involve the child’s participation, and develop a drug may occur (see enzyme inhibition). Exam-
spirit of inquiry leading to the solution of real ples of some common U.S. proprietary products
rather than merely academic problems. In phi- that include dextromethorphan are Coricidin,
losophy, Dewey is famous as one of the founders NyQuil, Robitussin, Tylenol PM, and Vicks 44.
of the American school of pragmatism, to- dhat n. in DSM–IV–TR, a culture-bound syn-
gether with William James, Charles S. Peirce drome specific to India. Dhat involves severe
(1839–1914), and George Herbert Mead (1863– anxiety and hypochondriacal concerns about
1931). See also instrumentalism; progressive the discharge of semen, whitish discoloration of
education. the urine, and feelings of weakness and exhaus-
dexamethasone n. a synthetic analog of tion. It is similar to shen-k’uei.
cortisol, with similar biological action. It is DHE 45 n. a trade name for dihydroergot-
used to treat nausea and vomiting and as an anti- amine.
inflammatory agent. U.S. trade name (among
diabetes insipidus a metabolic disorder
others): Decadron.
marked by a deficiency of vasopressin
dexamethasone suppression test (DST) a (antidiuretic hormone), which promotes the re-
test of the ability of dexamethasone, a synthetic absorption of water from the kidney tubules. The
analogue of cortisol, to inhibit the secretion of patient experiences excessive thirst and excretes
corticotropin and hence suppress levels of large amounts of urine, but without the high
cortisol in the blood. In the test, dexamethasone level of sugar found in the urine of people with
is administered and, after a waiting period, diabetes mellitus. See also nephrogenic diabe-
cortisol levels are assessed. In normal individuals tes insipidus.
cortisol levels will be suppressed by dexametha-
diabetes mellitus a metabolic disorder caused
sone. If cortisol is still elevated, the individual is
by ineffective production or utilization of the
categorized as a nonsuppressor. The test is used
hormone insulin. Because of the insulin disrup-
primarily to aid in the diagnosis of Cushing’s
tion, the patient is unable to oxidize and utilize
syndrome. Dexamethasone nonsuppression was
carbohydrates in food. Glucose accumulates in
thought at one time to be a good indication that
the blood, causing weakness, fatigue, and the ap-
the individual has, or is likely to develop, major
pearance of sugar in the urine. Fat metabolism is
depressive disorder, but it does not reliably
also disrupted so that end products of fat metab-
predict this condition. Because of this, and the
olism (ketones) accumulate in the blood.
development of less invasive and less costly diag-
nostics, the DST has been generally abandoned diacetylmorphine n. the chemical name for
as a clinical maneuver in depression. heroin. A synthetic analog of morphine (pro-
dexamphetamine n. see dextroampheta- duced by substituting acetyl groups for hydroxyl
mine. groups at two positions on the morphine mol-
ecule), it is, like morphine and codeine, a
Dexedrine n. a trade name for dextroam- pure opioid agonist, activating receptors for
phetamine. endorphins and enkephalins (see endogenous
dextroamphetamine n. a sympathomimetic opioid). Diacetylmorphine is characterized by a
agent and cns stimulant that is the rapid onset of action and a duration of action
dextrorotated form of the amphetamine mole- similar to that of morphine; however, it is three
cule. It is used in the treatment of narcolepsy times more potent than morphine. In Great Brit-
170
dialogue
ain and Canada it is used clinically in the man- structured interview assessing an individ-
agement of severe pain, for example, in ual’s current and past symptoms of a variety of
terminally ill patients, but it is not legally avail- psychiatric disorders, including depression,
able in the United States due to concerns about schizophrenia, and alcohol and substance de-
its potential for abuse. Also called diamor- pendence. Designed to be an objective diagnos-
phine. See opioid analgesic. tic instrument requiring a minimum of clinical
diadochokinesis n. the ability to rapidly per- judgment, the DIS consists of a predetermined
form repetitive muscular movements, such as set of questions that are asked in a specific order.
finger tapping or pursing and retracting the lips. It was originally developed in the late 1970s by D
This ability is often examined during clinical as- the national institute of mental health for
sessments of motor behavior. use in the epidemiologic catchment area
survey. The Diagnostic Interview Schedule for
diagnosis (Dx) n. (pl. diagnoses) 1. the process Children (DISC) is also available.
of identifying and determining the nature of a
disease or disorder by its signs and symptoms, diagnosticity n. the informational value of an
through the use of assessment techniques (e.g., interaction, event, or feedback for someone
tests and examinations) and other available evi- seeking self-knowledge. Information with high
dence. 2. the classification of individuals on the diagnosticity has clear implications for the self-
basis of a disease, disorder, abnormality, or set of concept, whereas information with low
characteristics. Psychological diagnoses have diagnosticity may be unclear, ambiguous, or in-
been codified for professional use, notably in the accurate. The impulse to seek highly diagnostic
dsm–iv–tr. —diagnostic adj. information about the self is called the ap-
praisal motive.
diagnosis-related groups (DRGs) an inpa-
tient or hospital classification used as a financ- diagnostic overshadowing the failure, when
ing tool to reimburse health care providers. Each assessing an individual with multiple disabili-
of the DRGs (of which there are currently over ties, to discern the presence of one disability be-
500) has a preset price based on diagnosis, age cause its features are attributed to another,
and sex of patient, therapeutic procedure, and primary disability. In particular, it refers to the
length of stay. failure to recognize a psychiatric condition or
mental disorder in a person with mental retarda-
Diagnostic and Statistical Manual of tion, because characteristics of that condition
Mental Disorders see dsm–iv–tr. are erroneously attributed to the mental retarda-
diagnostic baseline the entry or pretreatment tion. See also dual diagnosis.
levels of condition- or disease-related symptoms diagnostic test any examination or assessment
used in identifying or treating diseases or disor- measure that may help reveal the nature and
ders. Such levels are often used to assign patients source of an individual’s physical, mental, or be-
or participants in a study to correlational groups. havioral problems or anomalies. In medical re-
See also baseline. search, for example, a diagnostic test would be
diagnostic center a facility equipped with expected to show sensitivity (i.e., correctly
skilled personnel and appropriate laboratory and identifying individuals with a certain illness)
other equipment for evaluating the condition of and specificity (i.e., correctly identifying those
a patient and determining the cause of his or her who do not have a specific illness).
physical or psychological disorder. The diagnos- dialectic n. 1. in general language, any investi-
tic center may be a part of a larger health care fa- gation of the truth of ideas through juxtaposi-
cility or a separate institution. tion of opposing or contradictory opinions. 2.
diagnostic formulation a comprehensive the conversational mode of argument attributed
evaluation of a patient, including a summary of to Greek philosopher Socrates (c. 470–399 bce),
his or her behavioral, emotional, and psycho- in which knowledge is sought through a process
physiological disturbances. Diagnostic formula- of question and answer. —dialectical adj.
tion includes the most significant features of the dialectical behavior therapy a flexible,
patient’s total history; the results of psychologi- stage-based therapy that combines principles of
cal and medical examinations; a tentative expla- behavior therapy, cognitive behavior ther-
nation of the origin and development of his or apy, and mindfulness. Dialectical behavior
her disorder; the diagnostic classification of the therapy concurrently promotes acceptance and
disorder; a therapeutic plan, including basic and change, especially with difficult-to-treat pa-
adjunctive treatments; and a prognostic evalua- tients. [developed by U.S. clinical psychologist
tion based on carrying out this plan. Marsha Linehan (1943– )]
diagnostic interview an interview in which a dialogue (dialog) n. 1. in general, an exchange
psychologist or other mental health professional of ideas between two or more people. 2. in ges-
explores a patient’s presenting problem, current talt therapy, a technique in which the client
situation, and background, with the aim of for- engages in an imaginary conversation (a) with a
mulating a diagnosis and prognosis as well as de- body part from which he or she feels alienated;
veloping a treatment program. (b) with a person, such as his or her mother or fa-
Diagnostic Interview Schedule (DIS) a ther, who is pictured sitting in an empty chair
171
dialysis dementia
(see empty-chair technique); or (c) with an dibenzodiazepine n. any member of a class of

object associated with a dream. The technique chemically related compounds that include
often elicits strong feelings. Also called dia- clozapine, the first atypical antipsychotic
logue technique. introduced into clinical medicine. This class is
dialysis dementia an aluminum-induced structurally similar to the dibenzoxazepines.
brain disease affecting patients undergoing long- dibenzothiazepine n. any member of a class of
term dialysis. Major symptoms are progressive chemically related compounds that include
mental deterioration, personality changes, and quetiapine, an atypical antipsychotic. This class
D speech impairment, with such neurological is structurally similar to the dibenzodiazepines
signs as seizures, dysarthria, dysnomia (diffi- and the dibenzoxazepines.
culty in naming objects), and dyspraxia.
dibenzoxazepine n. any member of a class of
diamorphine n. see diacetylmorphine. chemically related compounds that include
dianetics n. a controversial therapeutic tech- loxapine, one of the older antipsychotics that
nique claiming to treat, according to its founder, does not belong to the phenothiazine class. This
“all inorganic mental ills and all inorganic psy- class is structurally similar to the dibenzo-
chosomatic ills, with assurance of complete diazepines.
cure.” Dianetics has been largely discredited dichotomous thinking the tendency to
within the fields of psychology and psychiatry. think in terms of bipolar opposites, that is, in
[introduced in 1950 by L(afayette) Ron(ald) Hub- terms of the best and worst, without accepting
bard (1911–1986), U.S. writer and subsequent the possibilities that lie between these two ex-
founder of Scientology] tremes. This has been found to be especially
diaphragm n. 1. a muscular sheet that separates common among individuals with major de-
the thoracic and abdominal cavities. 2. a cup- pressive episodes, and is sometimes thought to
shaped contraceptive device made from a layer be a risk factor for major depressive disorder.
of thick latex rubber fitted over a round or spiral Also called polarized thinking.
spring. The diaphragm is filled with a contracep- dichotomous variable a variable that can
tive jelly and inserted in the vagina so that it have only two values (typically, 0 or 1) to desig-
forms a barrier between the cervix and any sper- nate membership in one of two possible catego-
matozoa that enter the vagina during coitus. The ries, for example, female versus male, Repub-
spring holds it in place. The diaphragm has been lican versus Democrat.
used by women since 1882. —diaphragmatic
adj. didactic analysis see training analysis.
diathesis n. a susceptibility to acquiring (not in- didactic group therapy an early form of
heriting) certain diseases or disorders (e.g., aller- group psychotherapy based on the theory that
gies, arthritic diathesis). Compare genetic institutionalized individuals will respond most
predisposition. effectively to the active guidance of a profes-
sional leader. In one form of didactic group ther-
diathesis–stress model the theory that men- apy the group members bring up their own
tal and physical disorders develop from a genetic
problems and the therapist leads the discussion,
or biological predisposition for that illness
often giving his or her own interpretations. In
(diathesis) combined with stressful conditions
another form, the therapist presents a short lec-
that play a precipitating or facilitating role. Also
ture based on printed material designed to stim-
called diathesis–stress hypothesis; diathesis–
ulate the members to break through their
stress paradigm; diathesis–stress theory.
resistances and express themselves. The didactic
See also stress–vulnerability model.
approach is also used in self-help groups.
diazepam n. a long-acting benzodiazepine that
didactic teaching 1. a technique in which be-
is used for the management of alcohol with-
havioral and therapeutic concepts and tech-
drawal and as an anticonvulsant, anxio-
niques are explained to clients, and instructions
lytic, and muscle relaxant. It is broken down
are given in both verbal and written form.
in the liver to produce a number of metabolites
Such instruction is common in many forms of
(metabolic products) of varying half-lives, in-
therapy, with the exception of long-term
cluding the active compounds desmethyl-
psychodynamic psychotherapy and psycho-
diazepam (nordiazepam) and oxazepam. Its
analysis. 2. a component of many courses in
complex metabolism and lengthy half-life make
undergraduate and graduate psychology courses
diazepam unsuitable for use in older adults and
and multidisciplinary psychotherapy training.
those with liver disease. U.S. trade name (among
others): Valium. diencephalic amnesia amnesia caused by le-
sions of the diencephalon. Causes include in-
diazepam-binding inhibitor (DBI) an en-
farction of the paramedian artery, trauma, di-
dogenous neuropeptide that binds to molecu-
encephalic tumors, and wernicke–korsakoff
lar receptors for benzodiazepines. It counters
syndrome.
the effectiveness of these drugs, thus increasing
anxiety, and may be involved in the develop- diencephalon n. the posterior part of the
ment of drug dependence. forebrain that includes the thalamus, epi-
172
dihydroindolone
thalamus, and hypothalamus. —diencephalic For example, one might reinforce lever presses
adj. that are more than 1 s in duration, but not rein-
dietary neophobia avoidance of new foods. A force those that are less than 1 s in duration.
nonpathological form is commonly seen in chil- differential reinforcement of alterna-
dren who display a reluctance to try unfamiliar tive behavior (DRA) the reinforcement of
food. Acceptance of novel diets may be facili- a particular behavior as a means of decreasing
tated through observation of others eating simi- another, targeted behavior. It combines extinc-
lar foods or, in some cases, by simply observing tion of the targeted response with competition
others eating familiar foods. from the reinforced alternative. D
diethylpropion n. a cns stimulant used as an differential reinforcement of other be-
appetite suppressant in the treatment of obesity. havior (DRO) a procedure in which rein-
See also analeptics. U.S. trade name: Tenuate. forcement occurs if a particular response does
diethylstilbestrol (DES) n. a synthetic, not occur for a fixed period of time. It is used to
nonsteroidal compound with the activity of es- decrease the rate of the targeted response. Also
trogen. It was formerly widely prescribed to preg- called omission training.
nant women to prevent miscarriages or differential validity 1. the accuracy of a bat-
premature deliveries, but such use was discon- tery of tests in discriminating between a person’s
tinued in the early 1970s due to the health risks subsequent success in two or more different cri-
associated with DES, including increased risk of terion tasks. 2. differences in validity coefficients
reproductive abnormalities and cancer in female across groups. For example, the correlation be-
offspring. It is still used clinically to treat se- tween test scores and job performance may differ
lected cases of breast cancer or prostate cancer, for males and females.
but this is very rare.
differentiation of self the ability to distin-
diethyltryptamine n. see det. guish and maintain personal thoughts, feelings,
dieting n. the deliberate restriction of the types goals, and identity in the presence of emotional
or amounts of food one eats, usually in an effort and societal pressures to do otherwise, especially
to lose weight or to improve one’s health. in family systems.
Dieting is viewed by some medical and mental Digit Span an attentional subtest in the wechs-
health professionals as a solution to obesity and ler adult intelligence scale that assesses the
by others as a primary pathology associated with ability of an individual to repeat a series of digits
eating disorders. of increasing length. Digit Span Forward assesses
difference hypothesis see defect theory. the number of digits an individual is able to re-
difference score (symbol: D) an index of dis- peat immediately following their presentation,
similarity or change between observations from in the exact order they were presented. Digit
the same individual across time, based on the Span Backward assesses the number of digits an
measurement of a construct or attribute on two individual is able to repeat immediately follow-
or more separate occasions. For example, it ing their presentation, but in reverse order. The
would be helpful to calculate a difference score former is regarded as a measure of immediate
for a person’s weight at the beginning of a diet memory; the latter provides a measure of work-
and exercise program and the final weight six ing memory.
months later. Also called change score; gain Digit Symbol a performance subtest in the
score. wechsler adult intelligence scale that mea-
differential diagnosis 1. the process of deter- sures the time taken to indicate digits associated
mining which of two or more diseases or disor- with abstract symbols using a substitution key. It
ders with overlapping symptoms a particular is a measure of fluid abilities (see cattell–horn
patient has. 2. the distinction between two or theory of intelligence) and performance and
more similar conditions by identifying critical is negatively correlated with adult age.
symptoms present in one but not the other. dihydrocodeine n. see opioid analgesic;
differential emotions theory a theory pro- opioid.
posing the existence of a large but limited set of dihydroergotamine n. a semisynthetic deriv-
specific emotions that appear without social ative of the ergot alkaloid ergotamine, used in
learning at the age when the emotions can first the treatment of acute migraine headache. It is a
play an adaptive role in the behavior of the potent vasoconstrictor due to its ability to
child. [associated with the work of U.S. psychol- antagonize alpha-adrenergic receptors in
ogist Carroll E. Izard (1923– )] blood-vessel walls as well as serotonin and dopa-
differential psychology the branch of psy- mine receptors. U.S. trade names: DHE 45;
chology that studies the nature, magnitude, Migranal.
causes, and consequences of psychological dif- dihydroindolone n. any member of a class of
ferences between individuals and groups, as well chemically related compounds whose molecular
as the methods for assessing these differences. structure incorporates an indole nucleus similar
differential reinforcement in conditioning, to that of serotonin. The group includes
the reinforcement of only selected behavior. molindone, a conventional antipsychotic.
173
dihydromorphine
dihydromorphine n. a semisynthetic opioid antihistamine at H1 receptors that are used

analgesic used primarily in research on opioid primarily as anxiolytics. They also prevent car-
receptors. It is also a metabolite (metabolic diac fibrillation and have local anesthetic effects.
product) of dihydrocodeine. See also opioid. The prototype is hydroxyzine.
Dilantin n. a trade name for phenytoin. diploid adj. denoting or possessing the normal
dildo n. an artificial penis, made usually of rub- number of chromosomes, which in humans is
ber or plastic but occasionally of wood or other 46: 22 homologous pairs of autosomes plus
materials. A dildo is used in autoerotic practices the male or female set of XY or XX sex chromo-
D and other sexual activities. Also called olisbos; somes. Compare haploid.
lingam; godemiche. See also vibrator. diplomate n. see board certified.
dimenhydrinate n. a nonprescription anti- dipsomania n. formerly, episodic binge drink-
histamine at H1 receptors that is commonly ing. See epsilon alcoholism. —dipsomaniac
taken to suppress symptoms of motion sickness. n.
U.S. trade name (among others): Dramamine. direct aggression aggressive behavior directed
dimensional theory of emotion any theory toward the source of the frustration or anger.
postulating that emotions have two or more fun- Compare displaced aggression.
damental dimensions. There is universal agree- direct-contact group see face-to-face
ment among theories on two fundamental group.
dimensions—pleasantness–unpleasantness (hed- direct coping active, focused confrontation
onic level) and arousal–relaxation (level of acti- and management or resolution of stressful or
vation)—but considerable differences in labeling otherwise problematic situations.
others.
direct dyslexia a form of acquired dyslexia (see
dimensions of consciousness dimensions alexia) characterized by an ability to read words
along which the overall quality of awareness can aloud but an inability to understand what is
vary, including mood, involvement with inner being read.
or outer events, changes in immediate memory,
sensation and perception, self-awareness, and
directed analysis see focused analysis.
identification with events outside of oneself. directed attention see selective attention.
dimethoxymethylamphetamine n. see directed facial action studies studies in
dom. which participants are instructed to contract
specific facial muscles to produce prototypical
dimethyltryptamine n. see dmt.
emotional facial expressions without any verbal
diminished capacity a legal defense in which reference being made to the emotions them-
a mental abnormality, due either to intoxication selves (e.g., “anger,” “frown”). These studies
or mental defect, is claimed to have limited the have reported that facial configurations of nega-
defendant’s ability to form the requisite criminal tive emotions produce distinctive patterns of au-
intent (see mens rea) for the crime with which tonomic physiological activity.
he or she is charged.
directed movement movement targeted to-
diminished responsibility a form of affir- ward achieving a specific goal.
mative defense in which evidence of mental directedness n. the sense of unified purpose
abnormality is presented to mitigate or reduce a that provides the mature individual with endur-
defendant’s accountability for an act. It is dis- ing motivation, continuity, and orientation to
tinct from an insanity defense, which takes an the future. [first described by G. W. allport]
all-or-none perspective with regard to criminal
responsibility. Also called limited responsi- directed reverie in individual and group ther-
bility. See also partial insanity. apy, a technique in which the therapist directs
the client to reexperience a dream or something
diminutive visual hallucination see lilli- that happened in early life by creating and then
putian hallucination. describing a mental image of that dream or
DIMS abbreviation for disorders of initiating event. See also guided affective imagery.
and maintaining sleep. directed thinking controlled, purposeful
diphenhydramine n. a sedating antihista- thinking that is focused on a specific goal, such
mine at H1 receptors that also possesses activity as the solution to a problem, and guided by the
at cholinergic and other receptor sites. It is used requirements of that goal. See also critical
generally to suppress allergic responses and, in thinking.
mental health, as a sedative and hypnotic or to directional test see one-tailed test.
suppress the parkinsonian symptoms induced
by conventional antipsychotic drugs. U.S. trade directive n. a command, suggestion, or order
name (among others): Benadryl. specifying the type of action that should be per-
formed. In therapeutic contexts, a directive is a
diphenylbutylpiperidine n. any member of specific statement by the therapist that enjoins
a class of chemically related compounds that in- the client to act, feel, or think in a particular way
clude the conventional antipsychotic pimozide. when he or she confronts a particular problem or
diphenylmethanes pl. n. a class of sedating situation. The use of directives in therapy de-
174
discharge
pends a great deal on the particular mode of DIS abbreviation for diagnostic interview
therapy; in some modes (e.g., psychoanalysis) schedule.
directives occur rarely if at all, whereas in others disability n. a lasting physical or mental impair-
(e.g., behavior therapy) they occur more fre- ment that significantly interferes with an indi-
quently. vidual’s ability to function in one or more
directive counseling an approach to counsel- central life activities, such as self-care, ambula-
ing and psychotherapy in which the therapeutic tion, communication, social interaction, sexual
process is directed along lines considered rele- expression, or employment. For example, an in-
vant by the counselor or therapist. Directive dividual who cannot see has visual disability. See D
counseling is based on the assumption that the also handicap. —disabled adj.
professional training and experience of the disability adjusted life years (DALYs) a
counselor or therapist equip him or her to man- measure of the impact of disease or injury on the
age the therapeutic process and to guide the cli- length and quality of a person’s life. It takes into
ent’s behavior. Therapy is considered to progress account the potential loss of years due to prema-
along primarily intellectual lines in contrast to ture mortality and the value of years lived with
the approaches of psychodynamic psycho- disability. One DALY represents one lost year of
therapy, which emphasizes unconscious moti- “healthy” life.
vation and affective dynamics. Also called
disability evaluation an evaluation of the ef-
directive psychotherapy.
fect of an impairment (i.e., a loss of function) on
directive group psychotherapy a type of an individual’s capabilities, particularly in terms
group psychotherapy designed to help members of his or her capacity for gainful employment.
adjust to their environment through educa-
Disability Rating Scale (DRS) a rating scale,
tional tasks, group guidance, group counseling,
used primarily in rehabilitation facilities to mon-
and therapeutic recreation. [developed by 20th-
itor the rehabilitative progress of individuals
century Russian-born U.S. psychotherapist Sam-
with moderate to severe brain damage, that mea-
uel Richard Slavson]
sures arousal and awareness, cognitive ability,
directive play therapy a controlled approach dependence on others, and psychosocial adapt-
to play therapy in which the therapist is ac- ability. Each of the 8 items on the scale (eye
tively involved, structuring a child’s activities by opening, communication ability, motor re-
providing selected play materials and encourag- sponse, feeding, toileting, grooming, level of
ing the child to use them in the enactment of functioning in self-care, and employability) is as-
“pretend” situations and the expression of feel- signed a value from 0 to either 3, 4, or 5. These
ings. Compare nondirective play therapy. values are then added together to obtain a total
directive therapy an approach to psychother- score, which may range from 0 (no disability) to
apy in which the therapeutic process is directed 29 (extreme vegetative state). [originally devel-
along lines considered relevant by the therapist. oped in 1982 by psychiatrist Maurice Rappaport
Directive therapy is based on the assumption (1926–2008) and colleagues]
that the professional training and experience of disadvantaged adj. denoting individuals, fami-
the therapist equip him or her to manage the lies, or communities deprived of equal access to
therapeutic process and to guide the client’s be- society’s resources, especially the necessities of
havior. Therapy is considered to progress along life or the advantages of education and employ-
primarily intellectual lines in contrast to the ap- ment.
proaches of psychodynamic psychotherapy, disaster counseling counseling offered to vic-
which emphasizes unconscious motivation and tims and their families, emergency workers, and
affective dynamics. witnesses during or immediately following a
director n. in a psychodrama, the therapist traumatic event. Individual therapists and coun-
who establishes the scenario or role play and selors and mental health teams are specially
manages the interactions therein. trained (e.g., by the American Red Cross) to re-
direct suggestion 1. a technique in support- spond in disaster situations. Disaster counseling
ive psychotherapy in which attempts are made may include defusing, debriefing (e.g., critical-
to alleviate emotional distress and disturbance incident stress debriefing), and other coun-
in an individual through reassurance, encour- seling techniques to help traumatized people
agement, and direct instructions. 2. a technique cope with stress. One aim of the counseling
in hypnotherapy in which a client under hyp- might be to reduce the potential for post-
nosis is directed to follow instructions of the traumatic stress disorder, which may de-
therapist either in the session or in his or her velop after the event.
daily life. disavowal n. see denial.
dirt phobia a persistent and irrational fear of discharge n. 1. in clinical psychology, the
dirt, often accompanied by a fear of contami- abrupt reduction in psychic tension that occurs
nation and a hand-washing compulsion. Fear in symptomatic acts, dreams, or fantasies. 2. in
of dirt is a common obsession associated with neurophysiology, the firing or activity of a neu-
obsessive-compulsive disorder. Also (rarely) ron or group of neurons, resulting in an action
called rupophobia. potential. 3. in hospitals and other mental and
175
discharge of affect
physical health facilities, the dismissal of a pa- ues, which may be ordered or not ordered. See
tient from treatment or other services. categorical data; discrete variable.
discharge of affect the reduction of an emo- discrete measure a measure of a discrete (i.e.,
tion by giving it active expression, for example, discontinuous, distinct, and limited) value, for
by crying. [described by Sigmund freud] example, the grade level of a student.
discharge procedure the process of releasing discrete variable a random variable that is
a patient from a mental hospital or psychiatric not continuous but takes on only a relatively
unit. Common steps in the process include a small number of distinct values. Also called dis-
D crete random variable. Compare continu-
final clinical interview and evaluation, instruc-
tions regarding prescribed medication (if rele- ous variable.
vant), and discussion of follow-up treatment and discriminability n. the quality that enables an
services. object or person to be readily distinguished from
discharge rate the ratio of the number of pa- something or someone else.
tients discharged from a hospital or other insti- discriminant analysis a multivariate statis-
tution in a given period to the number admitted. tical method that combines information from a
Also called improvement rate; recovery set of predictor variables in order to allow maxi-
ratio. mal discrimination among a set of predefined
dischronation n. an aspect of disorientation groups.
in which there is confusion about time. Also discriminant function any of a range of sta-
called chronotaxis. tistical techniques to situate an item that could
discipline n. 1. training that is designed to es- belong to any of two or more variables in the cor-
tablish desired habits of mind and behavior. 2. rect set, with minimal probability of error.
control of conduct, usually a child’s, by means of discriminant validity a form of construct
punishment or reward. 3. a field of study. validity demonstrated by showing that mea-
sures of constructs that are conceptually unre-
discomfort anxiety tension and consequent
lated do not correlate in the data. See also
low frustration tolerance that arise from irratio-
convergent validity.
nal beliefs about perceived threats to well-being.
For example, one may experience discomfort discriminating power a measure of the abil-
anxiety when one has the awfulizing belief “I ity of a test to distinguish between two groups
can’t stand it when things don’t go my way.” being measured.
[proposed in 1979 by U.S. psychologist Albert discrimination index see index of discrimi-
Ellis (1913–2007)] nation.
discomfort disturbance a low tolerance to ei- discrimination learning a conditioning or
ther discomfort or frustration that may make learning experience in which an individual must
people overreact to unpleasant life experiences, learn to make choices between seemingly identi-
frustration, or their own negative feelings. [pro- cal or similar alternatives in order to reach a goal.
posed by U.S. psychologist Albert Ellis (1913– Also called discriminative learning.
2007)] discussion group any group set up to explore
discomfort–relief quotient see distress– problems and questions in a variety of voca-
relief quotient. tional, educational, guidance, therapeutic, and
discontinuity hypothesis in gestalt psy- community settings. In schools, a discussion
chology, the viewpoint that emphasizes the group is usually an instructional technique; in
role of sudden insight and perceptual reorgani- psychiatric and other therapeutic settings, the
zation in successful discrimination learning focus is emotional and interpersonal; in voca-
and problem solving. According to this view, a tional, guidance, and community settings, the
correct answer is only recognized when its rela- objective may be to stimulate decision-making
tion to the issue as a whole is discovered. Also processes and to channel recommendations to a
called discontinuity theory. Compare conti- study or action group.
nuity hypothesis. See also aha experience; disease n. a definite pathological process with or-
eureka task. ganic origins, marked by a characteristic set of
symptoms that may affect the entire body or a
discordance n. 1. the state or condition of being
part of the body and that impairs functioning.
at variance. Affective discordance may be ob-
served, for example, during psychotherapy disease course the progress of a pathological
when a client relates a particularly disturbing ex- condition or process from inception, manifesta-
perience without any facial or vocal indication tion, and diagnosis through treatment and res-
of distress. 2. in twin studies, dissimilarity be- olution.
tween a pair of twins with respect to a particular disease model 1. any of several theories con-
trait or disease. Compare concordance. —discerning the causes and course of a pathological
cordant adj. condition or process. 2. see medical model.
discrete data data that are not on a continuous disease of adaptation any of a group of ill-
scale but are limited to specific categories or val- nesses, including high blood pressure and heart
176
disorder
attacks, that are associated with or partly caused image, loss of self-esteem, feelings of inferiority,
by long-term defective physiological or psycho- self-consciousness, shame, resentment, hyper-
logical reactions to stress. [named and defined sensitivity, withdrawal, antisocial behavior, and
by Austrian physician Hans Selye (1907–1982)] paranoid reactions. See also facial disfigure-
disease phobia a persistent and irrational fear ment.
of disease in general or of a particular disease, disgust n. a strong aversion, for example, to the
formerly called nosophobia. Fear of disease may taste, smell, or touch of something deemed re-
be a specific phobia or a feature of hypo- volting, or toward a person or behavior deemed
chondriasis or obsessive-compulsive disor- morally repugnant. —disgusting adj. D
der. Also called pathophobia. dishabituation n. the reappearance or en-
disenfranchised grief grief that society (or hancement of a habituated response (i.e., one
some element of it) limits, does not expect, or that has been weakened following repeated ex-
may not allow a person to express. Examples in- posure to the evoking stimulus) due to the pre-
clude the grief of parents for stillborn babies, of sentation of a new stimulus. Dishabituation can
teachers for the death of students, and of nurses be interpreted as a signal that a given stimulus
for the death of patients. People who have lost can be discriminated from another habituated
an animal companion are often expected to keep stimulus and is a useful method for investigating
their sorrow to themselves. Disenfranchised perception in nonverbal individuals or animals.
grief may isolate the bereaved individual from Compare habituation.
others and thus impede recovery. Also called
disinhibition n. 1. diminution or loss of the
hidden grief. See also grief counseling;
normal control exerted by the cerebral cortex,
griefwork; mourning.
resulting in poorly controlled or poorly re-
disengaged family a family whose members strained emotions or actions. Disinhibition may
are mutually withdrawn from each other psy- be due to the effects of alcohol, drugs, or brain
chologically and emotionally. injury, particularly to the frontal lobes. 2. in
disengagement theory a theory proposing conditioning experiments, the reappearance of
that old age involves a gradual withdrawal of the responding, which has stopped occurring as a re-
individual from society and of society from the sult of exposure to extinction, when a new
individual. According to this theory, those hap- stimulus is presented.
piest in old age have turned their attention in- disintegration n. a breakup or severe disorgani-
ward toward the self and away from zation of some structure or system of function-
involvement in the outside world. Empirical re- ing, for example, of psychic and behavioral
search has shown, however, that this mutual functions.
withdrawal is not an inevitable component of
disintegration of personality fragmenta-
old age and that a continuity theory of aging is
tion of the personality to such an extent that the
most likely, in which older people are happiest
individual no longer presents a unified, predict-
when they are able to maintain their preferred
able set of beliefs, attitudes, traits, and behav-
level of social involvement. Compare activity
ioral responses. The most extreme examples of
theory. [developed by 20th century U.S. psy-
disintegrated, disorganized personality are
chologist Elaine Cumming and William E.
found in the schizophrenias.
Henry]
disequilibrium n. 1. a loss of physical balance, disjunctive motivation striving for substi-
as in parkinson’s disease and ataxias due to tute or temporary (rather than true and lasting)
cerebellar disorder or injury. 2. emotional imbal- satisfaction. Compare conjunctive motiva-
ance, as in individuals with extreme mood tion. [defined by U.S. psychiatrist Harry Stack
swings or labile affect. 3. in developmental Sullivan (1892–1949)]
psychology, a state of tension between cognitive dismissive attachment an adult attachment
processes competing against each other. In con- style that combines a positive internal work-
trast to Jean piaget, some theorists believe that ing model of attachment of oneself, charac-
disequilibrium is the optimal state for significant terized by a view of oneself as competent and
cognitive advances to occur. worthy of love, and a negative internal working
disfigurement n. a blemish or deformity that model of attachment of others, characterized by
mars the appearance of the face or body. Disfig- one’s view that others are untrustworthy or un-
urement can result from severe burn scars; muti- dependable. Individuals with dismissive attach-
lations due to wounds, accidents, or radical ment are presumed to discount the importance
surgery; and a wide variety of congenital anoma- of close relationships and to maintain rigid self-
lies, some of which are at least partially repara- sufficiency. Compare fearful attachment; pre-
ble. The psychological effects of disfigurement occupied attachment; secure attachment.
are often devastating, especially since they are disorder n. a group of symptoms involving ab-
due in part to the negative and often humi- normal behaviors or physiological conditions,
liaating reactions of others in a society that persistent or intense distress, or a disruption of
places a high value on physical attractiveness. physiological functioning. See also mental dis-
Among these effects are damage to the self- order.
177
disorder of written expression
disorder of written expression in DSM–IV– sleep time, sleep efficiency, breathing patterns,
TR, a learning disorder in which writing skills body temperature, minutes of rem sleep, and
are substantially below those expected, given the REM sleep latency are measured.
person’s chronological age, formal education ex- disorganization n. loss or disruption of orderly
perience, and measured intelligence. The writing or systematic structure or functioning. For exam-
difficulties, which may involve errors in gram- ple, thought disorganization is an inability to
mar, punctuation, and paragraph organization, integrate thought processes; behavior disorgani-
often combined with extremely poor handwrit- zation is a disruption of behavior.
D ing and spelling errors, significantly interfere
with academic achievement and activities of disorganized attachment in the strange
daily living that require writing skills. Also called situation, a form of insecure attachment in
developmental expressive writing disor- which infants show no coherent or consistent
der. behavior during separation from and reunion
with their parent. Also called disoriented at-
disorders of excessive somnolence (DOES) tachment.
one of four basic types of sleep disorders, dif-
ferentiated from the other types by the presence disorganized behavior behavior that is self-
of excessive sleepiness for at least 1 month. The contradictory or inconsistent. It may include
equivalent classification in DSM–IV–TR is pri- childlike silliness, unpurposeful or aimless
mary hypersomnia. Diagnosis can involve ob- behavior, unpredictable agitation, or extreme
servation in a sleep laboratory, in which such emotional reaction (e.g., laughing after a catas-
criteria as nocturnal awakenings, sleep time, trophe). A typical example is dressing in clothing
sleep continuity, sleep latency, percentage of inappropriate for the weather (e.g., wearing sev-
time in stage 2 sleep, and percentage of time in eral layers on a warm summer day). Disorganized
stage 3 sleep and stage 4 sleep are measured. behavior is commonly seen in individuals with
schizophrenia.
disorders of infancy, childhood, or ado-
lescence not otherwise specified in DSM– disorganized development disruption in the
IV–TR, disorders with an onset during infancy, normal course of attachment in children in
childhood, or adolescence that do not meet which the child does not learn how to deal with
DSM–IV–TR criteria for any specific disorder. separation from or reunion with a parent. As in-
fants, these children react to their parents with
disorders of initiating and maintaining
fear or apprehension and do not know how to
sleep (DIMS) one of four basic types of sleep
seek them out when stressed (see disorganized
disorders, differentiated from the other types
attachment).
by the presence of insomnia, that is, persistent
inability to fall asleep or stay asleep. The equiva- disorganized schizophrenia in DSM–IV–TR,
lent classification in DSM–IV–TR is primary in- a subtype of schizophrenia characterized primar-
somnia. Diagnosis can involve observation in a ily by random and fragmented speech and be-
sleep laboratory, in which such criteria as havior and by flat or inappropriate affect,
nocturnal awakenings, sleep time, sleep effi- frequently associated with grimaces, manner-
ciency, breathing patterns, percentage of time in isms, laughter, and extreme social withdrawal. It
stage 2 sleep, percentage of time in stage 3 tends to be the most severe of the schizophrenia
sleep and stage 4 sleep, minutes of rem sleep, subtypes and is often associated with poor
and REM sleep latency are measured. premorbid personality and early and insidious
onset. In DSM–III, it was called disorganized
disorders of the self in self psychology,
type schizophrenic disorder; historically, and in
narcissistic problems resulting from insufficient
other classifications, this subtype is known as
response by others (such as parents) to one’s
hebephrenia or hebephrenic schizophrenia.
needs. According to this view, an individual’s
self-cohesion, self-esteem, and vitality derive disorganized speech incoherent speech. This
from and are maintained by the empathic re- may be speech in which ideas shift from one sub-
sponsiveness of others; lack of this response can ject to another, seemingly unrelated, subject,
lead to deficiencies or inabilities in loving other sometimes described as loosening of associa-
people and a focus on oneself. [defined by Aus- tions. Other types of disorganized speech in-
trian psychoanalyst Heinz Kohut (1913–1981)] clude responding to questions in an irrelevant
way, reaching illogical conclusions, and making
disorders of the sleep–wake cycle sched-
up words. See metonymic distortion; neolo-
ule one of four basic types of sleep disorders,
gism; paralogia.
differentiated from the other types in that it re-
sults from a mismatch between one’s internal disorientation n. a state of impaired ability to
circadian rhythm and one’s actual sleep identify oneself or to locate oneself in relation to
schedule. The equivalent classification in DSM– time, place, or other aspects of one’s surround-
IV–TR is circadian rhythm sleep disorder. ings. Long-term disorientation can be character-
Rotating work-shift schedules and jet lag are two istic of organic neurological and psychological
common causes of this disorder. Diagnosis can disorders; temporary disorientation can be
involve observation in a sleep laboratory, in caused by alcohol or drugs or can occur in sit-
which such criteria as nocturnal awakening, uations of acute stress, such as fires or earth-
178
dissociative barriers
quakes. See also confusion; time disorienta- TR criteria, children exhibiting disruptive
tion. —disoriented adj. behavior are diagnosed with one of the disrup-
disoriented attachment see disorganized tive behavior disorders, whereas those older
attachment. than 18 years of age are diagnosed with antiso-
cial personality disorder.
dispersion n. the degree to which a batch of
scores deviate from the mean. Also called disruptive behavior disorder a psychiatric
spread. disorder in which the primary symptom in-
volves disruptive behavior (e.g., violation of
displaced aggression the direction of hostil- social rules and rights of others, defiance, hostile D
ity away from the source of frustration or anger behavior) that is severe enough to produce sig-
and toward either the self or a different person or nificant impairment in social or occupational
object. Displaced aggression may occur, for ex- functioning. In DSM–IV–TR, disruptive behavior
ample, when circumstances preclude direct con- disorders include conduct disorder, oppo-
frontation with the responsible person or sitional defiant disorder, and disruptive
institution because that person or institution is behavior disorder not otherwise specified.
perceived as too powerful to attack without fear
of reprisal. See displacement. Compare direct disruptive behavior disorder not other-
aggression. wise specified in DSM–IV–TR, a pattern of be-
havior involving violation of social rules or the
displacement n. the transfer of feelings or be- basic rights of others, aggression, or defiance
havior from their original object to another per- that results in clinically significant impairment
son or thing. In psychoanalytic theory, but does not conform to the full DSM–IV–TR cri-
displacement is considered to be a defense teria of other, specific disruptive behavior disor-
mechanism in which the individual discharges ders.
tensions associated with, for example, hostility
and fear by taking them out on a neutral, dissociated state a reaction to a traumatic
nonthreatening or less threatening target. Thus, event in which the individual splits the compo-
an angry child might hurt a sibling instead of at- nents of the event into those that can be faced in
tacking the father; a frustrated employee might the present and those that are too harmful to
criticize his or her spouse instead of the boss; or a process. The latter components are repressed and
person who fears his or her own hostile impulses can be recalled later in life if triggered by a simi-
might transfer that fear to knives, guns, or other larly traumatic event, introspection, or psycho-
objects that might be used as a weapon. See also therapy. In the healthily functioning psyche,
displaced aggression; drive displacement; consciousness, memory, identity, and per-
scapegoating. —displace vb. ception of the self and the environment are
integrated rather than split into separate compo-
displacement behavior a behavior in which nents. See also dissociative disorders.
an individual substitutes one type of action for
another when the first action is unsuccessful or dissociation n. 1. an unconscious defense
when two competing motivations are present mechanism in which conflicting impulses are
that lead to incompatible actions. Also called kept apart or threatening ideas and feelings are
displacement activity. separated from the rest of the psyche. See
compartmentalization; dissociative disor-
displacement of affect see transposition ders. 2. in research, a method used to differenti-
of affect. ate processes, components, or variables. For
disposition n. a recurrent behavioral or affective instance, it might involve discovering a variable
tendency that distinguishes an individual from that influences short-term memory but not
others. See also personal disposition. long-term memory. See double dissociation.
dispositional attribution the ascription of dissociative amnesia in DSM–IV–TR, a
one’s own or another’s actions, an event, or an dissociative disorder characterized by failure
outcome to internal or psychological causes spe- to recall important information about one’s per-
cific to the person concerned, such as moods, at- sonal experiences, usually of a traumatic or
titudes, decisions and judgments, abilities, or stressful nature, that is too extensive to be ex-
effort. Also called internal attribution; per- plained by normal forgetfulness. Recovery of
sonal attribution. Compare situational at- memory often occurs spontaneously within a
tribution. few hours and is usually connected with removal
dispositional hearing a proceeding held in from the traumatic circumstances with which
juvenile court cases after the court finds that an the amnesia was associated. In DSM–III this dis-
offense has been committed. It is similar to the order was called psychogenic amnesia.
sentencing hearing or penalty phase in an adult dissociative anesthetic an anesthetic agent
criminal court. capable of producing amnesia, analgesia, and se-
disruptive behavior behavior that chroni- dation without inducing loss of consciousness.
cally threatens and intimidates others or violates dissociative barriers in dissociative disorders,
social norms. The term is typically applied to the the barriers to full conscious access by individu-
behavior of children, but it can also be used to als to their recollections of a traumatic event.
describe adult behavior. According to DSM–IV– The trauma is presumed to be implicated in
179
dissociative disorder not otherwise specified
the development of the disorder, and the dis- or sexual abuse, wartime experience, or involve-
sociative barriers are theorized to serve a protec- ment in an accident in which someone else died.
tive function, allowing the traumatized person See also dissociative disorders.
to avoid knowledge of horrific life events. dissociative stupor a profound decrease in or
dissociative disorder not otherwise spec- absence of voluntary movement and responsive-
ified in DSM–IV–TR, a residual category of dis- ness to external stimuli, apparently resulting
orders that do not meet the diagnostic criteria from acute stress.
for any of the specific dissociative disorders. dissociative trance disorder a dissociative
D It includes dissociative trance disorder, disorder characterized by involuntary alter-
derealization without depersonalization, dis- ations in consciousness, identity, awareness or
sociated states resulting from brainwashing memory, and motor functioning that result in
or other forms of coercion, and ganser syn- significant distress or impairment. The two sub-
drome. types of the disorder are distinguished by the in-
dissociative disorders in DSM–IV–TR, any of dividual’s identity state. In possession trance,
a group of disorders characterized by a sudden, the individual’s usual identity is replaced by a
gradual, transient, or chronic disruption in the new identity perceived to be an external force,
normal integrative functions of consciousness, such as a ghost, another person, or a divine
memory, or perception of the environment. being, and there is loss of memory for the epi-
Such disruption may last for minutes or years, sode of trance. In trance disorder, individuals re-
depending on the type of disorder. Included in tain their usual identity but have an altered
this category are dissociative amnesia, perception of their milieu. These types of
dissociative fugue, dissociative identity dissociative experiences are common in various
disorder, depersonalization disorder, and cultures and may be part of customary religious
dissociative disorder not otherwise speci- practice; they should not be regarded as patho-
fied. logical unless considered abnormal within the
dissociative fugue in DSM–IV–TR, a dis- context of that cultural or religious group. Also
sociative disorder in which the individual called possession trance disorder; trance
suddenly and unexpectedly travels away from and possession disorder (TPD). See dis-
home or a customary place of daily activities and sociative disorder not otherwise specified.
is unable to recall some or all of his or her past. See also amok; ataque de nervios; latah;
Symptoms also include either confusion about piblokto.
personal identity or assumption of a new iden- dissonance n. see cognitive dissonance.
tity. No other signs of mental disorder are pres- dissonance reduction the process by which a
ent, and the fugue state can last from hours to person reduces the uncomfortable psychological
months. Travel can be brief or extended in dura- state that results from inconsistency among ele-
tion, and there may be no memory of travel once ments of a cognitive system (see cognitive dis-
the individual is brought back to the prefugue sonance). Dissonance can be reduced by
state. In DSM–III this disorder was called psycho- making one or more inconsistent elements con-
genic fugue. sistent with other elements in the system, by de-
dissociative hysteria a former name for a creasing the perceived importance of an
dissociative disorder. inconsistent element, or by adding new consis-
dissociative identity disorder in DSM–IV– tent elements to the system. Finally, self-
TR, a dissociative disorder characterized by affirmation theory postulates that merely af-
the presence in one individual of two or more firming some valued aspect of the self, even if it
distinct identities or personality states that each is not directly relevant to the inconsistency, can
recurrently take control of the individual’s be- reduce dissonance.
havior. It is typically associated with severe distance therapy any type of psychotherapy
physical and sexual abuse, especially during in which sessions are not conducted face-to-face
childhood. An increase in reported cases has because of problems of mobility, geographical
been seen in the United States in recent years, isolation, or other limiting factors. Distance
and research suggests that there may be a heredi- therapy includes interventions by telephone,
tary component. In DSM–III this disorder was audioconference, or videoconference (known
called multiple personality disorder. collectively as telepsychotherapy) and the
dissociative pattern a pattern of behavior Internet (see e-therapy).
consistent with dissociative disorders, as evi- distorting-mirror procedure a method of
denced by disruption in the normal integrative documenting accuracy of body-size perception
functions of consciousness, memory, or percep- by using a mirror distorted to represent an ap-
tion of the environment. pearance that is either smaller or larger than
dissociative process a process of disruption of one’s actual dimensions. Accuracy of image per-
the normal integrative functions of conscious- ception is determined by comparison with ob-
ness, memory, or perception of the environ- jective size level.
ment. It typically occurs as a result of a traumatic distorting-photograph procedure a proce-
or profoundly disturbing event, such as physical dure for documenting accuracy of body-size per-
180
diuretic
ception by using a photograph distorted to be simply an empirical description of that

provide an image of an individual that is smaller relationship or a mathematical (probabilistic)
or larger than actual size. Discrepancy between specification of the relationship.
the size of the selected image and that of an ac-
distributive analysis and synthesis an ap-
curate image is used as an index of perceptual ac-
proach to psychotherapy, developed within
curacy of body size.
psychobiology. In the first stage, a systematic
distorting-video procedure a method of analysis is made from information gained from
documenting accuracy of body-size perception the client about past and present experience and
by using a video image modified to be smaller or distributed into such categories as symptoms D
larger than one’s actual size. and complaints, assets and liabilities, and patho-
distortion n. 1. either the unconscious process logical or immature reactions. In the second
of altering emotions and thoughts that are unac- stage this study is used as a prelude to a construc-
ceptable in the individual’s psyche or the con- tive synthesis built on the client’s own strengths,
scious misrepresentation of facts, which often goals, and abilities. [developed by Swiss-born
serves the same underlying purpose of disguising U.S. psychiatrist Adolf Meyer (1866–1950)]
that which is unacceptable to or in the self. 2. in
disturbance in executive functioning see
psychoanalytic theory, the outcome of the
executive dysfunction.
dream-work that modifies forbidden thoughts
and wishes to make them more acceptable to the disturbance of association interruption of a
ego. Such distortion of the dream wish through logical chain of culturally accepted thought,
the use of substitutes and symbols means that leading to apparently confused and haphazard
only an act of interpretation can uncover the thinking that is difficult for others to compre-
true meaning of the dream. hend. It is one of the fundamental symptoms
distractibility n. difficulty in maintaining at- of schizophrenia described by Swiss psychiatrist
tention or a tendency to be easily diverted from Eugen Bleuler (1857–1939). See also schizo-
the matter at hand. Excessive distractibility is phrenic thinking; thought disorder.
frequently found in children with learning dis- disulfiram n. a drug used as an aversive agent in
orders or attention-deficit/hyperactivity managing alcohol abuse or dependence.
disorder and in people experiencing manic ep- Disulfiram inhibits the activity of acetaldehyde
isodes or hypomanic episodes. dehydrogenase, an enzyme responsible for the
distractible speech a speech pattern in which metabolism of alcohol (ethanol) in the liver.
the individual shifts rapidly from topic to topic Consumption of alcohol following administra-
in response to external or internal stimuli. It is a tion of disulfiram results in accumulation of
common symptom in mania. See also flight of acetaldehyde, a toxic metabolic product of etha-
ideas. nol, with such unpleasant effects as nausea,
distraction n. 1. the process of interrupting at- vomiting, sweating, headache, a fast heart rate,
tention. 2. a stimulus or task that draws atten- and palpitations. Because of the serious nature of
tion away from the task of primary interest. some of these effects (which can include damage
to the liver and heart), careful informed con-
distress n. 1. the negative stress response, involv-
sent is required before use of disulfiram.
ing excessive levels of stimulation: a type of
Disulfiram by itself is rarely effective in manag-
stress that results from being overwhelmed by
ing alcoholism and should be administered only
demands, losses, or perceived threats. It has a
in concert with a carefully designed behavioral
detrimental effect by generating physical and
regimen. U.S. trade name: Antabuse.
psychological maladaptation and posing serious
health risks for individuals. This generally is the disuse theory of aging the theory that some
intended meaning of the word stress. Compare decline in psychological abilities with aging may
eustress. 2. a negative emotional state in which be due to the lack of use of those abilities. Ac-
the specific quality of the emotion is unspecified cording to this theory, as adults grow older, they
or unidentifiable. For example, stranger anxi- engage their minds less and less with the types of
ety in infants is more properly designated tasks that are found on most psychological tests.
stranger distress because the infant’s negative
diuretic n. a substance that increases the flow of
behavior, typically crying, allows no more spe-
urine. Diuretics may be endogenous agents (e.g.,
cific identification of the emotion. —distress-
dopamine) or prescription or nonprescription
ing adj.
drugs (e.g., thiazide diuretics). Many diuretics
distress–relief quotient the ratio of verbal ex- (including thiazides) work by inhibiting or
pressions of distress to those of relief, used as blocking the reabsorption of sodium and potas-
an index of improvement in counseling and sium ions from the kidney filtrate, so that less
psychotherapy. Also called discomfort–relief water is reabsorbed across the kidney tubules.
quotient; relief–discomfort quotient; re- Others, called osmotic diuretics, increase the
lief–distress quotient. osmolality of the filtrate. Both mechanisms re-
distribution n. the relation between the values sult in increased urine volume. Some diuretics
that a variable may take and the relative number may produce adverse effects with psychological
of cases taking on each value. A distribution may implications, for example, lassitude, weakness,
181
diurnal enuresis
vertigo, sexual impotence, headaches, poly- To the extent that the activities require con-
dipsia (intense thirst), irritability, or excitability. sciousness and attention, they will tend to
diurnal enuresis see enuresis. degrade each other. See also dual-task compe-
tition.
diurnal mood variation a feature of some bi-
polar disorders and depressive disorders in divorce n. the legal dissolution of marriage, leav-
which daily, predictable fluctuations in mood ing the partners free to remarry. See also emo-
occur. Typically, this pattern consists of an ele- tional divorce. —divorcee n.
vation of mood during the daytime and evening divorce counseling counseling provided to in-
D hours and a depression of mood during the over- dividuals and their family members to help
night and morning hours. See also seasonal af- them cope with the problems resulting from di-
fective disorder. vorce. The counseling can be conducted with the
divagation n. rambling, digressive speech, writ- entire family or with one parent and children to
ing, or thought. See also disorganized speech. provide group support and encourage a sense of
belonging and identity during the transitional
divalproex sodium an anticonvulsant
period. In either a family or individual context,
drug, derived from valproic acid, originally
family members may be encouraged to let go of
used in the treatment of absence seizures and
the past and learn to deal with their present
now used primarily for the stabilization of mania
emotions. Spouses seen either individually or to-
and for prophylaxis in individuals with bipolar
gether may explore what their own contribu-
disorder. It has also been used in the treatment
tions to the breakup may have been so as to
of various other conditions, including autism,
decrease blame and increase probability of future
migrainous and other forms of head pain, other
relationship success.
chronic pain syndromes, and mood symptoms
associated with borderline personality disorder. divorce mediation counseling aimed at re-
Liver damage and reduction in blood platelets solving issues for couples facing separation or
(thrombocytopenia) may occur with use of the divorce. The mediator remains neutral and im-
drug, and monitoring of blood count and liver partial while assisting in negotiations to come to
function should be carried out, particularly in an agreed settlement over such issues as finan-
the early course of treatment and particularly in cial arrangements, child custody and visitation,
children, as most fatalities due to liver failure and child support. Divorce mediation attempts
have occurred in children. Because of its pos- to avoid confrontation and undue litigation
sible association with neural tube defects, prior to final settlement.
divalproex sodium should not be prescribed dur- dizygotic twins (DZ twins) twins, of the same
ing pregnancy. The drug has significant interac- or different sexes, that have developed from two
tions with antidepressants, antipsychotics, separate ova fertilized by two separate sperm. DZ
anxiolytics, and numerous other classes of medi- twins are genetically as much alike as ordinary
cation. U.S. trade name: Depakote. full siblings born as singletons, with each indi-
divergent production the capacity to pro- vidual inheriting a random half of each parent’s
duce novel solutions to a problem. It is one of genes. On average, DZ twins are approximately
the abilities recognized in Joy P. guilford’s the- half as genetically similar to one another as
ory of intelligence (see guilford dimensions monozygotic twins. For every 1,000 pregnan-
of intelligence). Compare convergent pro- cies there are, on average, 7–12 DZ twins. Also
duction. called fraternal twins. See also twin study.
divergent thinking creative thinking in D-love n. see deficiency love.
which an individual solves a problem or reaches DLPFC abbreviation for dorsolateral pre-
a decision using strategies that deviate from frontal cortex.
commonly used or previously taught strategies. DMT dimethyltryptamine: a hallucinogen be-
This term is often used synonymously with lat- longing to the indolealkylamine family, to
eral thinking. Compare convergent think- which lsd, psilocin, and det also belong.
ing.
DNA deoxyribonucleic acid: one of the two types
diversion program a program that may be of nucleic acid found in living organisms, which
available in some circumstances for individuals is the principal carrier of genetic information in
who have been arrested but have not been tried chromosomes and, to a much lesser extent, in
and sentenced. After the defendant has been for- mitochondria (an organelle that is the main site
mally charged with a crime and has entered a of energy production in cells). Certain segments
plea, he or she may be sent to a diversion proof the DNA molecules constitute the organism’s
gram (e.g., for drug treatment) instead of pro- genes. Structurally, DNA consists of two inter-
ceeding to trial; the charges are dropped if the twined, helically coiled strands of nucleotides—
individual successfully completes the program. the double helix. The nucleotides each contain
Also called deferred prosecution. one of four bases: adenine, guanine, cytosine, or
divided consciousness a state in which two or thymine. Each base forms hydrogen bonds with
more mental activities appear to be carried out at the adjacent base on the other, sister strand, pro-
the same time, for example, listening, planning ducing consecutive base pairs arranged rather
questions, and taking notes during an interview. like the “rungs” on a helical ladder. Adenine (A)
182
dominatrix
is always paired with thymine (T), and guanine his or her family unit. For example, it can
(G) with cytosine (C). DNA can undergo self- involve battering of one partner by another, vio-
replication in such a way that each strand serves lence against children by a parent, or violence
as the template for the assembly of a comple- against elders by younger family members. See
mentary matching strand, resulting in two mole- also battered women; child abuse; elder
cules exactly like the original helix in terms of abuse.
base pairing. The sequence of bases in the DNA dominance n. 1. the exercise of major influence
of genes contains information according to the or control over others. 2. the tendency for one
genetic code. Each gene specifies the manufac- hemisphere of the brain to exert greater influ- D
ture of a particular protein or ribosome. Because ence than the other over certain functions, such
of DNA’s ability to conserve its base sequence as language or handedness. The two hemi-
when replicating, the genetic instructions it car- spheres contribute differently to many func-
ries are also conserved, both during cell division tions; researchers therefore use the terms
within a single organism and for that organism’s hemispheric specialization or hemispheric
offspring following reproduction. Compare rna. lateralization in preference to dominance (or
See also recombinant dna. hemispheric dominance). 3. in genetics, the abil-
DNR abbreviation for do not resuscitate. See in- ity of one allele to determine the phenotype of a
formed consent. heterozygous individual. See dominant al-
doctor n. an individual, usually an MD, PhD, or lele; dominant trait. —dominant adj.
PsyD, trained and licensed to deliver medical or dominance hierarchy 1. any ordering of mo-
mental health care services. tives, needs, or other psychological or physical
DOES abbreviation for disorders of excessive responses based on priority or importance. An
somnolence. example is maslow’s motivational hierar-
chy. 2. in social psychology, a system of stable
dogmatism n. 1. the tendency to act in a blindly linear variations in prestige, status, and author-
certain, assertive, and authoritative manner in ity among group members.
accord with a strongly held set of beliefs. 2. a per-
sonality trait characterized by the tendency to dominance need the need to dominate, lead,
act in a blindly certain, assertive, and authorita- or otherwise control others. It is motivated by
tive manner in accord with a strongly held set of the desire for power, knowledge, prestige, or cre-
beliefs that are presumed to be resistant to ative achievement. [proposed by U.S. psycholo-
change. These belief systems contain elements gist Henry Alexander Murray (1893–1988)]
that are isolated from one another and thus may dominance–submission a key dimension of
contradict one another. Dogmatic people tend interpersonal behavior, identified through fac-
to be intolerant of those who hold different be- tor analysis, in which behavior is differenti-
liefs. See rokeach dogmatism scale. [first pro- ated along a continuum ranging from extreme
posed by U.S. psychologist Milton Rokeach dominance (active, talkative, extraverted, asser-
(1918–1988)] —dogmatic adj. tive, controlling, powerful) to extreme subordi-
doll play in play therapy, the use of dolls and nation (passive, quiet, introverted, submissive,
figurines, which may represent individuals fa- weak). Also called ascendance–submission.
miliar to the child, to facilitate the expression of dominant allele the version of a gene (see al-
feelings, to enact stories that express emotional lele) whose effects are manifest in preference to
needs, or to reveal significant family relation- another version of the same gene (the recessive
ships. Also called projective doll play. allele) when both are present in the same cell.
Dolophine n. a trade name for methadone. Hence, the trait determined by a dominant allele
(the dominant trait) is apparent even when the
DOM dimethoxymethylamphetamine: a syn-
allele is carried on only one of a pair of homolo-
thetic hallucinogen that is also called STP—
gous chromosomes. The term autosomal domi-
serenity, tranquillity, and peace, which the sub-
nant is used to describe such patterns of
stance is said to induce. It is a member of the
inheritance in which characteristics are con-
phenylisopropylamine family, to which mda
veyed by dominant alleles. For example, Hun-
and mdma also belong.
tington’s disease is an autosomal dominant
domestic partnership two people who live disorder.
together in a stable, intimate relationship and
share the responsibilities of a household in the dominant complex an emotional disturbance
same way that a married couple would. Some that dominates or controls one’s conduct.
states and companies in the United States and dominant trait in genetics, a trait, such as a
some other countries provide legal and eco- particular eye color, that is manifest in prefer-
nomic rights to domestic partners (e.g., insur- ence to an alternative version of the same trait
ance and death benefits) that are similar to those (i.e., the recessive trait) when the individual
granted to married couples. See common-law concerned carries both dominant and recessive
marriage; same-sex marriage. versions of the gene determining the trait. See
domestic violence any action by a person that dominant allele.
causes physical harm to one or more members of dominatrix n. a woman who takes the domi-
183
donepezil
nant role in sexual activity, often associated with ferase—to epinephrine. Also called aromatic
bondage and discipline or sadomasochism. L-amino acid decarboxylase.
donepezil n. an acetylcholinesterase inhibi- dopamine (DA) n. a catecholamine neuro-
tor used as a nootropic in the management of transmitter that has an important role in motor
mild to moderate dementia. By inhibiting the behavior and is implicated in numerous mental
degradation of acetylcholine in the synaptic conditions (see catecholamine hypothesis;
cleft, donepezil increases available levels of ace- dopamine hypothesis). It is found in
tylcholine in the basal nucleus of Meynert, dopaminergic neurons in the brain and else-
D thought to be associated with improved memory where. Dopamine is synthesized from the di-
and other aspects of cognitive functioning. U.S. etary amino acid tyrosine, which in the first,
trade name: Aricept. rate-limiting stage of the reaction is converted to
dong quai an herbal agent derived from the L-dopa (3,4-dihydroxy-L-phenylalanine; see levo-
plant Angelica sinensis, native to mountainous dopa) by the enzyme tyrosine hydroxylase.
regions of China, Korea, and Japan, with exten- L-Dopa is then transformed into dopamine by
sive folk use in Asia, America, and western Eu- the enzyme dopa decarboxylase. In non-
rope for a variety of conditions but particularly dopaminergic neurons and the adrenal medulla,
as a remedy for amenorrhea, dysmenorrhea, dopamine is further metabolized to form
and other menstrual irregularities. It also is re- norepinephrine and epinephrine, respectively.
puted to ameliorate the physical and psychologi- Destruction of the dopaminergic neurons in the
cal symptoms associated with premenstrual substantia nigra is responsible for the symp-
syndrome and menopause. The limited research toms of Parkinson’s disease (e.g., rigidity,
that has been done on dong quai is inconclusive, tremor). Blockade of the actions of dopamine in
providing conflicting results on its effectiveness other brain regions accounts for the therapeutic
for any of these uses. Side effects include abdom- activities of antischizophrenic drugs.
inal bloating, diarrhea and other gastrointestinal dopamine hypothesis the influential theory
disturbances, fever, photosensitivity, and in- that schizophrenia is caused by an excess of do-
creased bleeding. Additionally, the plant con- pamine in the brain, due either to an overpro-
tains numerous phytoestrogens (see estrogen) duction of dopamine or a deficiency of the
and coumarin-like compounds and may there- enzyme needed to convert dopamine to
fore interact with pharmaceutical estrogenic norepinephrine (adrenaline). There is some sup-
compounds and prescribed blood thinners. porting pharmacological and biochemical evi-
dence for this hypothesis, and it is still widely
Don Juan a man who ruthlessly seduces women,
discussed and promoted, particularly in a revised
concerned only with sexual conquest, after
form that postulates the involvement in schizo-
which he abruptly loses interest in them (Don
phrenia of both an increased mesolimbic and a
Juanism). The original Don Juan was a legendary
decreased prefrontal dopaminergic activity. See
Spanish libertine, the subject of literature and
also glutamate hypothesis.
Mozart’s opera Don Giovanni. In contrast to men
with a casanova complex, who adore women, dopamine receptor a receptor molecule that is
a Don Juan may think of women as prey. See also sensitive to dopamine and chemically related
satyriasis; erotomania. compounds. Dopamine receptors are located in
parts of the nervous system, such as the basal
don’t-hold functions cognitive abilities, such ganglia, and also in blood vessels of the kid-
as those involved in digit–symbol association neys and mesentery, where binding of dopa-
(see digit symbol), that often deteriorate with mine to its receptors results in widening
adult aging as observed on intellectual or cogni- (dilation) of the arteries. There are several sub-
tive tests (e.g., the wechsler adult intelli- types of dopamine receptors, designated D1, D2,
gence scale). and so on.
dopa (DOPA) n. 3,4-dihydroxyphenylalanine: an dopamine-receptor agonists drugs or other
amino acid that is a precursor to dopamine and agents that bind to and directly activate dopa-
other catecholamines. See also levodopa. mine receptors, producing physiological ef-
dopa decarboxylase the intermediate enzyme fects that mimic those of the neurotransmitter
in the metabolism of catecholamines from the dopamine. bromocriptine is an example. Be-
dietary amino acid tyrosine. Tyrosine is trans- cause parkinsonism is associated with a defi-
formed to L-dopa by tyrosine hydroxylase. ciency of dopamine in the brain, drugs that help
L-Dopa is in turn converted to dopamine by to maintain adequate levels of dopamine are
dopa decarboxylase, which also transforms a valuable in treating the disorder. Dopamine-
number of other aromatic amino acids. Dopa- receptor agonists are used to manage some of the
mine is the final product in dopaminergic neu- drug-induced parkinsonian symptoms associ-
rons; in adrenergic neurons, dopamine is ated with use of antipsychotic drugs; they are
transformed by the enzyme dopamine beta- also used in the treatment of Parkinson’s disease,
hydroxylase to norepinephrine and subse- galactorrhea, and prolactin-secreting tumors
quently—in specialized cells in the adrenal me- of the pituitary gland. Also called dopamin-
dulla and other sites, via the action of the ergic agents. Compare dopamine-receptor
enzyme phenylethanolamine N-methyltrans- antagonists.
184
double dissociation
dopamine-receptor antagonists substances in working memory and attentional control.

that reduce the effects of the neurotransmitter Damage to this region in humans results in an
dopamine by competitively binding to, and inability to select task-relevant information and
thus blocking, dopamine receptors. Clas- to shift attention based on external cues.
sically, the clinical use of dopamine antagonists dose–response relationship a principle relat-
in mental health has been to modulate the ing the potency of a drug to the efficacy of that
symptoms of schizophrenia and other psychotic drug in affecting a target symptom or organ sys-
conditions. Most conventional (typical or first- tem. Potency refers to the amount of a drug nec-
generation) antipsychotic drugs are thought essary to produce the desired effect; efficacy D
to act via antagonism of the postsynaptic do- refers to the drug’s ability to act at a target recep-
pamine D2 receptor. Most second-generation tor or organ to produce the desired effect. Dose–
(atypical) antipsychotics possess some degree response curves may be graded, suggesting a
of antagonistic activity at that receptor. Other continuous relationship between dose and ef-
dopamine-receptor antagonists are used to fect, or quantal, where the desired effect is an ei-
prevent or treat nausea and vomiting. Compare ther–or phenomenon, such as prevention of
dopamine-receptor agonists. arrhythmias. There is considerable variability
dopaminergic adj. responding to, releasing, or among individuals in response to a given dose of
otherwise involving dopamine. For example, a a particular drug.
dopaminergic neuron is any neuron in the brain dotting test a pencil-and-paper motor test in
or other parts of the central nervous system for which the participant makes as many dots as
which dopamine serves as the principal neuro- possible in a given time period, either randomly
transmitter. Three major tracts of dopamine- (tapping test) or within small circles (aiming
containing neurons are classically described: test).
the mesolimbic–mesocortical tract (see meso-
double n. in psychodrama, an individual, one
cortical system; mesolimbic system), in
of the auxiliary egos, who speaks or acts out
which excess dopamine activity is hypothesized
the presumed inner thoughts of the protago-
to be associated with positive and negative
nist (i.e., the person presenting the problem to
symptoms of schizophrenia; the nigrostriatal
be explored). The technique is known as dou-
tract, which is involved in motor functions
bling.
and Parkinson’s disease; and the tuberoinfun-
dibular pathway, a local circuit in the hypothala- double-agentry n. the situation in which the
mus that is involved in the regulation of the therapist’s allegiance to the patient is in conflict
pituitary hormone prolactin. with demands from the institution or from other
professionals. See conflict of interest.
dopaminergic agents see dopamine-
receptor agonists. double approach–avoidance conflict a
complex conflict situation arising when a person
Dopar n. a trade name for levodopa. is confronted with two goals or options that each
Doppelganger phenomenon the delusion have significant attractive and unattractive fea-
that one has a double or twin, who looks and tures. See also approach–avoidance con-
acts the same as oneself (German, “double flict.
walker”). See also autoscopy. double-approach conflict see approach–
Dora case one of Sigmund freud’s earliest and approach conflict.
most celebrated cases, reported in Fragment of an double-avoidance conflict see avoidance–
Analysis of a Case of Hysteria (1905). The study of avoidance conflict.
this woman’s multiple symptoms (headaches,
double bind a situation in which an individual
loss of speech, suicidal thoughts, amnesic epi-
receives contradictory messages from another
sodes) contributed to his theory of repression
person or from two different people. For exam-
and the use of dream analysis as an analytic
ple, a parent may respond negatively when his
tool.
or her child approaches or attempts to engage in
Doral n. a trade name for quazepam. affectionate behavior, but then, when the child
Doriden n. a trade name for glutethimide. turns away or tries to leave, reaches out to en-
courage the child to return. Double-binding
dorsal stream a series of specialized visual re-
communication was once considered a causative
gions in the cerebral cortex of the brain that orig-
factor in schizophrenia. [proposed by British an-
inate in the striate cortex (primary visual cortex)
thropologist Gregory Bateson (1904–1980)]
of the occipital lobe and project forward and up-
ward into the parietal lobe. Known informally as double blind see blind.
the “where” or “how” pathway, it is involved in double consciousness a condition in which
processing object motion and location in space. two distinct, unrelated mental states coexist
Compare ventral stream. within the same person. This may occur, for ex-
dorsolateral prefrontal cortex (DLPFC) a ample, in an individual with a dissociative
region of the brain located near the front and to identity disorder. Also called dual con-
both sides of the prefrontal cortex (brod- sciousness.
mann’s areas 9 and 46) in mammals, involved double dissociation a research process for
185
double insanity
demonstrating the action of two separable psy- [described in 1866 by John Langdon Haydon
chological or biological systems, such as differ- Down (1828–1896), British physician]
entiating between types of memory or the downward drift hypothesis see drift hy-
function of brain areas. One experimental vari- pothesis.
able is found to affect one of the systems,
whereas a second variable affects the other. The doxepin n. a tricyclic antidepressant,
differentiating variables may be task-related, among the most sedating and most anticholin-
pharmacological, neurological, or individual dif- ergic of these agents. Although it currently has
D ferences. [described by German-born U.S. psy- little use as an antidepressant, it may be used in
chologist Hans-Lukas Teuber (1916–1977)] relatively low doses as a hypnotic or in the man-
agement of neuromuscular or musculoskeletal
double insanity see folie à deux. pain. It is also available as a topical treatment for
double technique in psychodrama, a proce- management of dermatologic conditions. U.S.
dure in which one of the participants, usually trade name (among others): Sinequan.
the therapist, sits behind a member of the group
doxylamine n. an ethanolamine antihistamine
and speaks for that member saying what he or
(see antihistamine) with significant sedative
she believes the person is thinking. Also called
properties, which is included in numerous non-
priming-the-pump technique.
prescription sleep aids. Like all antihistamines, it
doubling n. see double. may lose its efficacy with repeated use. Overdose
doubt n. 1. lack of confidence or uncertainty is characterized by symptoms of anticholinergic
about something or someone, including the self. toxicity, including raised temperature, a rapid
Doubt may center on everyday concerns (Can I heart rate, and delirium.
accomplish this task?), issues of daily living (Can DPE abbreviation for deliberate psychologi-
I change this ingrained habit?), or the very cal education.
meaning of life itself (see existential anxiety).
d prime (symbol: d′) a measure of an individual’s
It is a perception, typically with a strong affec-
ability to detect signals; more specifically, a mea-
tive component, that is frequently a focus dur-
sure of sensitivity or discriminability derived
ing psychotherapeutic intervention. 2. in erik-
from signal detection theory that is unaf-
son’s eight stages of development, see au-
fected by response biases. It is the difference (in
tonomy versus shame and doubt.
standard deviation units) between the means of
doubting mania extreme and obsessive feel- the noise and signal+noise distributions. The as-
ings of uncertainty about even the most obvious sumptions underlying the validity of d′ as a bias-
matters. Doubting mania is a common obsession free measure are that the probability distribu-
associated with obsessive-compulsive disor- tions upon which decisions are based are
der and often results in checking rituals (e.g., re- Gaussian (normal) and have equal variances. If
peatedly looking to see if the door is locked) as this is true, then d′ completely describes the re-
a means of reducing doubt-related anxiety. ceiver-operating characteristic curve, the rela-
[named by French psychiatrist Jean-Pierre Falret tionship between hit and false-alarm rates of yes
(1794–1870)] responses in a detection, discrimination, or rec-
downers pl. n. slang for sedative, hypnotic, ognition task. In practice, d′ has proved to be suf-
and anxiolytic drugs. ficiently bias-free to be the “best” measure of
Down syndrome a chromosomal disorder psychophysical performance. It is essentially a
characterized by an extra chromosome 21 (in standardized score and is computed as the
some cases, 22) and manifested by a round flat difference between the (Gaussian) standard
face and eyes that seem to slant (the disorder was scores for the false-alarm rate and the hit rate. A
formerly known as mongolism). Brain size and value of d′ = 3 is close to perfect performance; a
weight are below average; affected individuals value of d′ = 0 is chance (“guessing”) perfor-
usually have mild to severe mental retardation mance.
and have been characterized as having docile, Dramamine n. a trade name for dimen-
agreeable dispositions. Muscular movements hydrinate.
tend to be slow, clumsy, and uncoordinated. In drama therapy in group therapy, the use of
many cases growth is retarded, the tongue is theater techniques to gain self-awareness and in-
thick, and the fingers are stubby. Affected indi- crease self-expression. See also psychodrama.
viduals may have heart defects and respiratory
insufficiencies or anomalies that are often cor- dramatics n. 1. the use of drama as a rehabilita-
rected during infancy by surgery. However, life- tion technique, using published or original
span is reduced compared to the general scripts with patients as performers. See also psy-
population, and affected individuals typically chodrama. 2. see creative dramatics.
show early onset of alzheimer’s disease. Down dramatization n. 1. the use of attention-
syndrome is one of the most common organic getting behavior as a defense against anxiety.
causes of mental retardation. Also called An example of dramatization is the exaggeration
Down’s syndrome; Langdon Down’s dis- of the symptoms of an illness to make it appear
ease; congenital acromicria. See also more important than the occurrence of the same
autosomal trisomy of group g; trisomy 21. illness in another person. 2. in psychoanalytic
186
dream-work
theory, the expression of repressed wishes or im- aided by such techniques as free association.
pulses in dreams. —dramatize vb. Also called dream interpretation.
dread n. 1. intense fear or fearful anticipation. dream anxiety disorder see nightmare dis-
order.
Existential dread (see existentialism) refers to a
profound, deep-seated psychic or spiritual con- dream censorship in psychoanalytic theory,
dition of insecurity and despair in relation to the the disguising in dreams of unconscious wishes
human condition and the meaning of life. See that would be disturbing to the ego if allowed
also angst. 2. in psychoanalysis, anxiety elic- conscious expression. According to the classic
ited by a specific threat, such as going out on a psychoanalytic theory of Sigmund freud, the D
dark night, as contrasted with anxiety that does thoroughness of dream disguise varies directly
not have a specific object. with the strictness of the censorship. See cen-
sor.
dream n. a mental state that occurs in sleep and dream content the images, ideas, and impulses
is characterized by a rich array of sensory, motor, expressed in a dream. See latent content;
emotional, and cognitive experiences. Dreams manifest content.
occur most often, but not exclusively, during pe-
riods of rem sleep. They are characterized by (a) dream ego in the analytic psychology of
vivid imagery, especially visual imagery, and a Carl jung, a fragment of the conscious ego that
strong sense of movement; (b) intense emotion, is active during the dream state.
especially fear, elation, or anger; (c) delusional dream function the purpose or function of
acceptance of the dream as a waking reality; and dreaming. In the classical psychoanalytic theory
(d) discontinuity in time and space and incon- of Sigmund freud, the dream functions as a dis-
gruity of character and plot. Despite the vivid in- guised fulfillment of a repressed wish or as mas-
tensity of dreams, it can be difficult to remember tery of a traumatic experience. In the analytic
them to any extent unless promptly awakened psychology of Carl jung, it is a reflection of
from REM sleep, but even then much content fundamental personality tendencies.
cannot be accurately retrieved. Because the re- dream imagery endogenous visual experiences
ports of dream content have little apparent rela- during dreams, sometimes taken to represent
tion to the physical or mental stimuli impinging daytime experiences or dilemmas.
on the sleeper and few dream events seem ever dream incorporation the integration of an
to have occurred, as it were, in vivo, the research accidental stimulus in the content of a
tools of experimental psychology cannot be dream.
used effectively to study the phenomenon.
dream induction see dream suggestion.
Thus, assumptions about how a dream is pro-
duced and what it means are strongly dependent dream interpretation see dream analysis.
on theories about waking cognitive events and dream state (D-state) the state of sleep during
processes. Diverse theories have arisen from var- which dreaming takes place most often, charac-
ied sources throughout history, including cer- terized by rapid eye movements (see rem sleep)
tain cultural beliefs in communication with the and patterns on the electroencephalogram that
supernatural; the suggestion of Greek physician most closely resemble those of wakefulness. It
Hippocrates (c. 460–c. 377 bce) that dreams pro- usually occurs four or five times during the night
vide early evidence of disease; freud’s interpre- and is physiologically distinct from deep sleep
tation of dreams as a struggle in which the part and wakefulness. Studies indicate that about
of the mind representing social strictures (the 20% of sleeping time is spent in the dream state.
superego) plays out a conflict with the sexual The lower brainstem appears to be the area most
impulses (the libido) while the rational part of involved in originating the dream state, under
the mind (the ego) is at rest; jung’s view that the control of genetically and light-regulated di-
dreams provide evidence of the biological inher- urnal rhythms (see pgo spikes; pontine sleep).
itance of universal symbols (archetypes); and See also twilight state.
adler’s view that inferiority feelings are played dream stimulus any of the stimuli that may
out in dreams. The discovery in the early 1950s initiate a dream, such as external stimulation, in-
of REM sleep initiated the scientific study of ternal sensory stimulation, mental images, feel-
dreaming as a neurocognitive process, a recent ings, or memories. Compare accidental
product of which is the activation–synthesis stimulus.
hypothesis. See also dream censorship;
dream suggestion a specialized hypnotic tech-
dream state; dream-work; latent content;
nique in which the client is instructed to dream
manifest content; nightmare. —dreamlike
about a problem or its source, either during the
adj. —dreamy adj.
hypnotic state or posthypnotically, during natu-
dream analysis a technique, originally used in ral sleep. The technique is sometimes used as an
psychoanalysis but now also used in other aid in hypnotherapy. Also called dream in-
psychotherapies, in which the content of duction.
dreams is interpreted to reveal underlying moti- dream-work n. in psychoanalytic theory, the
vations or symbolic meanings and representa- transformation of the latent content of a
tions (i.e., latent content). Dream analysis is dream into the manifest content experienced
187
dreamy state
by the dreamer. This transformation is effected butyrophenone class that is used in pre-
by such processes as condensation, symbol- medication for surgery and to maintain surgical
ism, displacement, and dramatization. anesthesia. It is occasionally used for the emer-
dreamy state a brief altered state of conscious- gency treatment of acute psychotic agitation. Be-
ness similar to a dream, during which the indi- cause of its extremely rapid onset of action, it has
vidual experiences visual, olfactory, or auditory few other mental health applications. U.S. trade
hallucinations. name: Inapsine.
dressing behavior dressing in accordance with drop-in center a facility, often associated with
D social expectations for one’s gender, which is an a substance-abuse program, where professional
important factor in gender identity. Studies support and advice can be obtained without an
of transvestites and transsexuals indicate that advance appointment. A drop-in center also
they often cross-dressed (or were cross-dressed) serves as a gathering place providing social, edu-
in childhood and adolescence. See cross- cational, and recreational activities.
dressing. dropout n. 1. a student who leaves school before
DRGs abbreviation for diagnosis-related graduating. 2. a patient or client who terminates
groups. treatment before it is completed.
drift hypothesis a sociological concept pur- drowsiness n. a state of low alertness in which
porting to explain the higher incidence of the brain wave pattern found during waking al-
schizophrenia in urban poverty centers, suggest- ternates with delta waves. See also hyper-
ing that during the preclinical phase people tend somnia; somnolence.
to drift into poverty and social isolation. Also DRS 1. abbreviation for dementia rating scale.
called downward drift hypothesis. 2. abbreviation for disability rating scale.
drinking bouts see epsilon alcoholism. drug n. any substance, other than food, that in-
drive n. 1. a generalized state of readiness precipi- fluences motor, sensory, cognitive, or other
tating or motivating an activity or course of ac- bodily processes. Drugs generally are adminis-
tion. Drive is hypothetical in nature, usually tered for experimental, diagnostic, or treatment
created by deprivation of a needed substance purposes but also tend to be used recreationally
(e.g., food), the presence of negative stimuli to achieve particular effects.
(e.g., pain, cold), or the occurrence of negative drug abuse see substance abuse.
events. Drive is said to be necessary for the stim- drug abuse treatment see substance abuse
uli or events to serve as reinforcers. 2. in the treatment.
psychoanalytic theory of Sigmund freud, a con-
cept used to understand the relationship be- drug addiction see substance dependence.
tween the psyche and the soma (mind and drug culture the activities and way of life of
body); drive is conceived as a having a somatic those people who habitually use one or more
source but creating a psychic effect. Freud identi- kinds of drugs of abuse, usually illicit drugs such
fied two separate drives as emerging from so- as hashish, cocaine, heroin, LSD, or other sub-
matic sources: libido and aggression. See also stances that produce altered states of conscious-
motivation; object relations. ness.
drive discrimination the ability of an organ- drug dependence see substance depend-
ism to differentiate between various psychologi- ence.
cal, emotional, and physiological needs and to drug education the process of informing indi-
direct responses accordingly, for example, drink- viduals or groups about the effects of various
ing when thirsty, eating when hungry. [defined chemical agents on the human body, usually
by Edward C. tolman] with a special emphasis on the effects of mind-
drive displacement the activation of one altering substances.
drive when another drive is thwarted; for exam- drug holiday discontinuance of a therapeutic
ple, eating chocolate when one is prohibited drug for a limited period in order to control dos-
from smoking a cigarette. age and side effects and to evaluate the patient’s
drive theory see classical psychoanalysis. behavior with and without it. Formerly com-
dromomania n. an abnormal drive or desire to monly recommended for children taking
travel that involves spending beyond one’s methylphenidate, drug holidays on weekends
means and sacrificing job, partner, or security in or school vacations were thought to prevent
the lust for new experiences. People with growth suppression that was tentatively associ-
dromomania not only feel more alive when trav- ated with this agent. Drug holidays are infre-
eling but also start planning their next trip as quent in modern clinical practice.
soon as they arrive home. Fantasies about travel drug-induced lactation see galactorrhea.
occupy many of their waking thoughts and drug-induced parkinsonism see parkin-
some of their dreams. The condition was for- sonism.
merly referred to as vagabond neurosis.
drug-induced psychosis a psychotic state re-
dronabinol n. see tetrahydrocannabinol. sulting from use or abuse of a variety of thera-
droperidol n. an antipsychotic agent of the peutic or illicit substances. Well-described drug-
188
dual-leadership therapy
induced psychoses may result from excessive or dream state) or desynchronized sleep, that is,
chronic use of amphetamines, cocaine, or other rem sleep. Compare s sleep.
stimulants; cannabis; LSD, PCP (phencyclidine), DSM–IV–TR the text revision of the fourth edi-
or other hallucinogens; and other illicit sub- tion of the Diagnostic and Statistical Manual of
stances. A variety of medications may produce Mental Disorders, prepared by the Task Force on
psychotic symptoms, including anticholinergic DSM–IV of the American Psychiatric Association
drugs at therapeutic doses in susceptible individ- and published in 2000. The classification pres-
uals. In DSM–IV–TR, it is categorized as sub- ents descriptions of diagnostic categories (which
stance-induced psychotic disorder. appear as entries in this dictionary) without fa- D
drug interactions the effects of administering voring any particular theory of etiology. It is
two or more drugs concurrently, which alters the largely modeled on the international classi-
pharmacological action of one or more of them. fication of diseases (9th edition, 1978), devel-
Pharmacokinetic interactions alter the absorp- oped by the World Health Organization and
tion, distribution, metabolism, and excretion of modified for use in the United States (ICD–9–
the drugs; they may induce or inhibit the elimi- CM), but contains greater detail and a method of
nation of drugs, leading to unexpected increases coding on different axes (see axis; multiaxial
or decreases in their concentrations in the body. classification). Previous editions were pub-
Pharmacodynamic interactions affect the drugs’ lished in 1952 (DSM–I), 1968 (DSM–II), 1980
activities at target organs or receptor sites; they (DSM–III), and 1994 (DSM–IV). Over that period,
may be synergistic, enhancing the effectiveness the number of identified disorders has increased
of a drug at a target receptor or organ (see drug from about 100 to more than 300. An updated
synergism), or antagonistic, in which the pres- edition (DSM-V) is expected in 2013.
ence of one drug reduces the effectiveness of an- DST abbreviation for dexamethasone suppres-
other (see antagonist). sion test.
drug metabolism the process by which a drug D-state abbreviation for dream state, as op-
is transformed in the body (in the liver and other posed to the S-state (sleeping state) and the W-
organs), usually from a more lipid-soluble form, state (waking state).
which makes it more readily absorbed into the
DTD abbreviation for developmental trauma
body, to a more water-soluble form, which facili-
disorder.
tates its excretion. Two phases of drug metabo-
lism are recognized. In Phase I metabolism, the D trisomy see chromosome-13 trisomy.
drug is oxidized, reduced, or hydrolyzed—that DTs abbreviation for delirium tremens.
is, oxygen is added, oxygen is removed, or hy- dual-action antidepressants see mixed-
drogen is added, respectively (see cytochrome function antidepressants.
p450). In Phase II metabolism, functional groups
dual consciousness see double conscious-
(specific clusters of atoms) are added to drug
ness.
molecules (e.g., by glucuronidation).
dual diagnosis the identification of two dis-
drug screening instrument a brief inter-
tinct disorders that are present in the same per-
view, such as cage, or a brief self-report instru-
son at the same time, for example, the
ment, such as mast, that is designed to identify
coexistence of depression or anxiety disorder
individuals who should be assessed thoroughly
and a substance-abuse disorder (e.g., alcohol or
for the possibility of substance abuse.
drug dependence). See also comorbidity.
drug synergism an enhancement of efficacy
dual instinct theory in psychoanalytic the-
occurring when two or more drugs are adminis-
ory, the view that human life is governed by two
tered concurrently, so that their combined phar-
antagonistic forces: the life instinct, or eros,
macological or clinical effects are greater than
and the death instinct, or thanatos. This was
those occurring when the drugs are administered
a late theoretical formulation by Sigmund
individually. Drug synergism can be metabolic,
freud, who held that “the interaction of the two
when the administration of one agent interferes
basic instincts with or against each other gives
with the metabolism of another, or it can be
rise to the whole variegation of the phenomena
pharmacological, when the administration of
of life” (Beyond the Pleasure Principle, 1920).
two or more agents results in enhanced receptor
binding or other activity at target sites. The en- dualism n. the position that reality consists of
hanced antimicrobial activity of two antibiotics two separate substances, defined by French phi-
administered together is an example of positive losopher René Descartes (1596–1650) as think-
synergism; negative synergism can be seen when ing substance (mind) and extended substance
the administration of a nontoxic agent with a (matter). In the context of the mind–body prob-
toxic drug worsens the toxicity of the latter. lem, dualism is the position that the mind and
the body constitute two separate realms or sub-
drug therapy see pharmacotherapy.
stances. Dualistic positions raise the question of
drug tolerance see tolerance. how mind and body interact in thought and be-
drug withdrawal see substance with- havior. Compare monism. See also cartesian
drawal. dualism. —dualist adj., n. —dualistic adj.
D sleep abbreviation for dreaming sleep (see dual-leadership therapy see cotherapy.
189
dual personality
dual personality a condition in which the per- otherwise incapable of making decisions on his
sonality is divided into two relatively independ- or her own.
ent and generally contrasting systems. See Duragesic n. a trade name for fentanyl.
dissociative identity disorder. duration of untreated illness in schizo-
dual process theory 1. the theory that the re- phrenia, the length of time that the illness is
sponse made by an individual to a stimulus that present before antipsychotic drug treatment or
permits behavioral control involves two stages: other forms of therapy are initiated. Such peri-
(a) a decision as to whether or not to respond ods are studied to determine the effect of un-
D and (b) a choice between alternative responses. treated schizophrenia on symptom severity and
2. in theories of memory, the operation of two the likelihood that specific treatments will be ef-
different cognitive processes (for example, recol- fective.
lection and familiarity) in recognition memory. Durham rule a 1954 ruling by the U.S. Court of
dual relationship see multiple relation- Appeals in a case involving a defendant named
ship. Durham. It stated that “an accused is not crimi-
nally responsible if his unlawful act was the
dual-store model of memory the concept product of mental disease or mental defect.”
that memory is a two-stage process, comprising This rule has been replaced by the american
short-term memory, in which information is law institute model penal code insanity
retained for a few seconds, and long-term test. Also called Durham decision; Durham
memory, which permits the retention of infor- test; product rule.
mation for hours to many years. William james
Dusky standard an influential 1960 U.S. Su-
called these stages primary memory and sec-
preme Court ruling establishing that defen-
ondary memory, respectively. Also called dual
dants’ competency to stand trial must be
memory theory.
related to their ability to understand and appre-
dual-task competition a phenomenon ob- ciate the criminal proceedings against them and
served in experimental techniques examining to whether they can reasonably assist their own
performance in which participants are asked to counsel by making choices among available op-
do two tasks (e.g., speeded reaction time and tions (e.g., pleas).
mental arithmetic) simultaneously. Such tasks duty to protect the obligation of mental health
require effort (see effortfulness) and tend to professionals to protect third parties from harm
compete against each other, so that their perfor- or violence that may result from the actions of
mances degrade. The decrease in performance is their clients. This obligation may involve, but is
often taken as a measure of mental capacity lim- not necessarily restricted to, a duty to warn.
its (see central limited capacity). See tarasoff decision.
Duchenne smile a smile characterized by bi- duty to warn the obligation of mental health
laterally symmetrical upturning of the lips and professionals to warn third parties whom their
activation of the orbicularis oculi muscles sur- clients intend to harm. See also duty to pro-
rounding the eyes, which creates a crow’s-foot tect; tarasoff decision.
effect at the corners of the eyes. Duchenne Dx abbreviation for diagnosis.
smiles are believed to be authentic smiles, as op-
posed to posed, voluntary smiles that lack the dyad (diad) n. 1. a pair of individuals in an inter-
orbicularis oculi component. [Guillaume Ben- personal situation, such as mother and child,
jamin Armand Duchenne (1806–1875), French husband and wife, cotherapists, or patient and
neurologist] therapist. 2. two individuals who are closely in-
terdependent, particularly on an emotional level
dull normal see below average. (e.g., twins reared together, mother and infant,
dummy n. in double-blind drug trials (see or a very close married couple). —dyadic adj.
blind), an inert substance that appears identical dyadic relationship 1. any committed, inti-
in all aspects (e.g., dosage form, method of ad- mate two-person relationship. 2. in psychother-
ministration) to the active drug under investiga- apy and counseling, the working relationship
tion, thereby helping to preserve experimental between therapist and patient or counselor and
blinds for both patients and clinical investiga- client.
tors. Since a dummy is completely inert it has no dyadic session a meeting of a therapist with
pharmacological activity, unlike an active pla- only one particular client, as opposed to a couple
cebo, which may produce side effects. or a family.
dummy variable coding a method of assign- dyadic therapy see individual therapy.
ing numerical values (often 0 and 1) to a ca- dying phobia see thanatophobia.
tegorical variable in such a way that the vari-
dying process a progressive and nonreversible
able reflects class membership.
loss of vital functions that results in the end of
durable power of attorney a legal document life. The transition from health to death can be
that designates someone to make health care de- swift or extended, predictable or unpredictable,
cisions, financial decisions, or both for an indi- depending on the specific life-threatening con-
vidual if that person becomes incapacitated or dition, the vigor of the patient, and the treat-
190
dyscalculia
ment available (see also end of life). See also terms of constantly changing, self-organizing
stages of grief. interactions among multiple organismic and en-
dynamic adj. 1. pertaining to force. 2. continu- vironmental factors that operate on multiple
ously changing or in flux. 3. describing systems timescales and multiple levels of analysis.
of psychology that emphasize motivation, men- dynamic testing a psychometric approach
tal processes, and the complexities of force and that attempts to measure not only the products
interaction. See also psychodynamics. or processes of learning but also the potential to
dynamic assessment 1. an approach to clini- learn. It focuses on the difference between actual
cal assessment that follows the same basic ability and potential, that is, the extent to which D
principles as dynamic testing, including not developed abilities reflect latent capacity. It at-
only tests but also other forms of assessment, tempts to quantify the process of learning rather
such as projects, essays, and performances. 2. an than the products of that process. This is done by
assessment that has the goal of elaborating on presenting progressively more challenging tasks
the complex reasons for dysfunctions, especially and providing continuous feedback on perfor-
with regard to conflicts. mance in an atmosphere of teaching and guid-
ance toward the right answer. [introduced by
dynamic core a theoretical construct involving
Lev vygotsky]
a subset of neurons in the thalamocortical sys-
tem of the brain that support conscious experi- dynamic trait a personality trait that involves
ence. The specific subset of neurons involved motivation or putting the individual into action.
may vary dynamically from moment to mo- It is one of three classes of source traits in
ment, but the dynamic core always maximizes cattell’s personality trait theory, the oth-
high integration and differentiation of informa- ers being ability traits and temperament
tion. See complexity hypothesis. [proposed traits.
by U.S. neuroscientist Gerald M. Edelman dynamic unconscious see unconscious.
(1929– ) and Italian–U.S. psychologist Giulio Compare cognitive unconscious.
Tononi (1960– )]
dysaesthesia n. see dysesthesia.
dynamic effect law the theory that goal-
directed behaviors become habitualized as dysarthria n. any of a group of motor speech
they effectively attain the goal. [proposed by disorders caused by muscular impairment
British-born U.S. psychologist Raymond B. originating in the central or peripheral nervous
Cattell (1905–1998)] system. Respiration, articulation, phonation,
resonance, and prosody may be affected. There
dynamic formulation the ongoing attempt are four main types: dyskinetic, spastic, periph-
to organize the clinical material elicited about a eral, and mixed. Dyskinetic dysarthria includes
client’s behavior, traits, attitudes, and symptoms hypokinetic dysarthria, in which prosody is af-
into a structure that helps the therapist under- fected in terms of rate and rhythm, and
stand the client and plan his or her treatment hyperkinetic dysarthria, in which articulation is
more effectively. poor due to difficulties in controlling the rate
dynamic model in psychoanalytic theory, the and range of movement in ongoing speech. In
view that the psyche can be explained in terms spastic dysarthria, all speech parameters are af-
of underlying, unconscious drives and instincts fected, respiration is poor, intonation patterns
that mold the personality, motivate behavior, are restricted, and spasticity in the vocal cords
and produce emotional disorder. Compare eco- causes hoarseness. Peripheral dysarthria is char-
nomic model; topographic model. See also acterized by continual breathiness during
metapsychology. phonation, with audible inspiration, distortion
dynamic psychotherapy see psychodynamic of consonants, and, often, a need to speak in
psychotherapy. short phrases. Mixed dysarthria occurs in those
who have impairment in more than one motor
dynamic resignation see neurotic resigna-
system, possibly caused by tumors, degenerative
tion.
conditions, or trauma. —dysarthric adj.
dynamic system a system in which a change in
one part influences all interrelated parts. Such a
dysautonomia n. dysfunction of the auto-
nomic nervous system, including impairment,
system is described by a set of quantitative vari-
failure, or overactivity of sympathetic or para-
ables changing continuously and interdepen-
sympathetic functioning. The dysfunction may
dently in time in accordance with laws captured
be local or generalized, acute or chronic, and is
by some set of equations. The motion on a pen-
associated with a number of disorders. Also
dulum is a simple example. Dynamic system
called autonomic dysfunction; autonomic
models provide an important alternative to
neuropathy.
symbolic models as a way to understand many
psychological phenomena (e.g., coordinated dysbulia n. 1. difficulty in thinking, maintain-
movements, developmental phenomena, and ing attention, or maintaining a train of thought.
decision making). 2. lack of willpower or weakness of volition.
dynamic systems theory a theory that at- dyscalculia n. an impaired ability to perform
tempts to explain behavior and personality in simple arithmetic operations that results from a
191
dyscheiria
congenital deficit. It is a developmental condi- ing, spelling, and writing words and sometimes
tion, whereas acalculia is acquired. in arithmetic. Dyslexia is characterized by im-
dyscheiria (dyschiria) n. see acheiria. pairment in the ability to process sounds, that is,
to make connections between written letters and
dyscontrol n. an impaired ability to direct or their sounds; written work is often characterized
regulate one’s functioning in volition, emotion,
by letter or word reversals. It can be either ac-
behavior, cognition, or some other area, which
quired (see alexia) or developmental (see de-
often entails inability to resist impulses and
velopmental dyslexia), is independent of
leads to abnormal behaviors without significant
D provocation.
intellectual ability, and is unrelated to disorders
of speech and vision that may also be present. It
dysesthesia (disesthesia; dysaesthesia) n. is not the result of lack of motivation, sensory
abnormalities of any sense but particularly that impairment, inadequate instructional or envi-
of touch. ronmental opportunities, emotional distur-
dysexecutive syndrome (DES) a collection of bances, or other such factors. Investigators have
symptoms that involve impaired executive con- proposed various subtypes of dyslexia—deep
trol of actions (see executive dysfunction), dyslexia, surface dyslexia, word-form dys-
caused by damage to the frontal lobes of the lexia, phonological dyslexia, and neglect
brain. Individuals can perform routine tasks but dyslexia, among others—but there is no uni-
cannot deal with new tasks or situations. They versally accepted system of classification. See
have difficulty in initiating and switching ac- also reading disability; reading disorder.
tions; for example, they cannot prevent an inap- —dyslexic adj.
propriate but highly automated action from dyslogia n. see alogia.
occurring or change their actions to appropriate
ones. A questionnaire called the Dysexecutive dysmenorrhea n. difficult or painful menstrua-
Questionnaire (DEX) can be used to assess the se- tion. The cause may be an obstruction in the cer-
verity of the impairment. vix or vagina that traps menstrual blood, or the
condition may be secondary to an infection or
dysfluency n. any disturbance in the normal tumor. More than three fourths of cases are a pri-
flow or patterning of speech, marked by repeti- mary, or functional, form of the disorder for
tions, prolongations, and hesitations. See also which no organic cause can be found. Dys-
stuttering. menorrhea may be characterized by cramplike
dysfunction n. any impairment, disturbance, or pains in the lower abdomen, headache, irritabil-
deficiency in behavior or operation. —dysfunc- ity, depression, and fatigue. Kinds of dysmenor-
tional adj. rhea include congestive dysmenorrhea, marked
dysfunctional family a family in which rela- by congestion of the uterus; inflammatory dys-
tionships or communication are impaired and menorrhea, associated with inflammation;
members are unable to attain closeness and self- membranous dysmenorrhea, marked by loss of
expression. Members of a dysfunctional family membrane tissue from the uterus; obstructive
often develop symptomatic behaviors, and often dysmenorrhea, associated with mechanical in-
one individual in the family presents as the terference of menstrual flow; and essential dys-
identified patient. menorrhea, for which there is no obvious cause.
—dysmenorrheic adj.
dysfunctions associated with sleep, sleep
stages, or partial arousals one of four basic dysmnesia n. an impairment of memory, which
types of sleep disorders, differentiated from may occur as a discrete episode or persist as a
the other types by the presence of physiological chronic condition and may be caused by any of a
activations at inappropriate times during sleep number of problems, such as delirium, acute or
rather than abnormalities in the mechanisms in- chronic brain disorders, or brain injury. Also
volved in the timing of sleep and wakefulness. called dysmnesic syndrome. —dysmnesic
This type of sleep disorder includes nightmare adj.
disorder, sleep terror disorder, and sleep- dysmorphism n. an abnormality in the shape
walking disorder; in DSM–IV–TR these are or structure of some part of the body.
classified as parasomnias.
dysmorphophobia n. see body dysmorphic
dysgeusia n. abnormalities of the sense of taste. disorder.
These gustatory distortions may occur during
pregnancy, prior to an epileptic seizure, or as a
dysnomia–auditory retrieval disorder a
speech and language disorder marked by prob-
symptom of psychosis or an eating disorder. See
lems in object naming and word retrieval and
also hypogeusia.
deficits in auditory memory. Affected children
dyskinesia n. any involuntary (unintended) may have difficulty remembering meaningful
movement, such as a tic or spasm. The term also information (expressed, for example, as sen-
is used more imprecisely to denote distorted or tences or stories) in a sequential fashion, even
impaired voluntary movement. Also called though they may have good language skills and
dyskinesis. —dyskinetic adj. normal or high verbal output. The memory defi-
dyslexia n. a neurologically based learning dis- cit may mimic some forms of attention-
ability manifested as severe difficulties in read- deficit/hyperactivity disorder, but behavior
192
DZ twins
is rarely a problem (although frustration may be dysponesis n. in biofeedback, a state of habitual

seen). Although increasingly supported by the tension that generates hypertension, migraine
research literature, the disorder is not classified headaches, bruxism (teeth grinding), or related
in DSM–IV–TR. disorders.
dysorexia n. any distortion of normal appetite dyspraxia n. an impaired ability to perform
or disturbance in normal eating behavior. See skilled, coordinated movements that is neuro-
also eating disorder. logically based and not due to any muscular or
dysorthographia n. an impairment in the abil- sensory defect. See acquired dyspraxia; devel-
ity to spell. opmental dyspraxia. See also apraxia. —dys- D
dyspareunia n. painful sexual intercourse, par- praxic adj.
ticularly in women. The term is sometimes used dyssocial behavior a former name for be-
for inability to enjoy intercourse, but DSM–IV– havior associated with delinquent or criminal
TR treats lack of enjoyment of intercourse with- activities, such as gangsterism, racketeering,
out pain as female sexual arousal disorder prostitution, or illegal gambling. Also called
or male erectile disorder (see impotence). If sociopathic behavior, it was attributed to dis-
there are no medical causes for the pain, the di- torted moral and social influences, frequently
agnosis is functional dyspareunia. aggravated by a broken home or a deprived envi-
dyspepsia n. abdominal pain or discomfort that ronment. Such behavior is now regarded as an
may be caused by ulcers, gastroesophageal re- aspect of antisocial personality disorder.
flux (acid reflux) disease, gallstones, and, rarely, dyssocial personality an obsolete name for
stomach or pancreatic cancer, although in a ma- antisocial personality disorder.
jority of cases the cause is unknown. Functional
(or nonulcer) dyspepsia describes the condition dyssomnia n. any of various sleep disorders
when other medical illnesses with similar symp- marked by abnormalities in the amount, quality,
toms have been excluded; it may be experienced, or timing of sleep. In DSM–IV–TR dyssomnias in-
for example, after eating too much or too clude primary insomnia, primary hyper-
quickly or eating during stressful situations. In somnia, narcolepsy, circadian rhythm sleep
common parlance, dyspepsia is known as indi- disorder, breathing-related sleep disor-
gestion. der, and dyssomnia not otherwise specified,
dysphagia spastica a somatic or, more often, which may be due to excessive noise, light, or
psychological symptom in which the act of swal- other environmental factors, ongoing sleep de-
lowing is painful or difficult because of throat- privation, ekbom’s syndrome, or nocturnal
muscle spasms. In psychological cases, it is a myoclonus.
symptom of somatization disorder. dysthymia n. 1. see dysthymic disorder. 2.
dysphemia n. a disorder of phonation, articula- any depressed mood that is mild or moderate in
tion, or hearing associated with emotional or severity. —dysthymic adj.
mental disturbance and, frequently, a predispo- dysthymic disorder a depressive disorder
sition to a neurological disorder. —dysphemic characterized by a depressed mood for most of
adj. the day, occurring more days than not, that
dysphonia n. any dysfunction in the production persists for at least 2 years (1 year in children or
of sounds, especially speech sounds, which may adolescents). During this depressed mood, at
affect pitch, intensity, or resonance. See also least two of the following must also be present:
spasmodic dysphonia; voice disorder. increased or decreased appetite, insomnia or
dysphoria n. a mood characterized by general- hypersomnia, diminished energy, low self-
ized discontent and agitation. —dysphoric adj. esteem, difficulty in concentrating or making
dysphoria nervosa 1. a less common name for decisions, and hopelessness. It is distinguished
psychomotor agitation. 2. convulsive or from major depressive disorder in that the
spasmodic muscle contractions. symptoms are less severe but more enduring:
There are no major depressive episodes dur-
dyspnea n. shortness of breath or difficulty in
breathing. When not accounted for by high alti-
ing the first 2 years (or, in children or adoles-
tude, exertion, or any identifiable organic cause, cents, 1 year) of the disorder. Also called
the condition is referred to as functional dysthymia.
dyspnea. DZ twins abbreviation for dizygotic twins.
193
Ee
EAP abbreviation for employee assistance pro- and behaviors related to food. DSM–IV–TR cat-
gram. egorizes eating disorders as anorexia nervosa,
Early and Periodic Screening, Diagnosis, bulimia nervosa, or eating disorder not other-
and Treatment (EPSDT) surveillance or wise specified, which does not meet the diagnos-
search for indications or early manifestations of tic criteria for either of the specific eating
a disease or disorder, regularly carried out at spe- disorders and includes binge-eating disorder.
cific intervals. In the United States, an EPSDT Other eating-related disorders include pica and
program of preventive health care services (e.g., rumination disorder, which are usually diag-
for vision, hearing, and dental problems) and nosed in infancy or early childhood and in DSM–
mental health and behavioral screenings (e.g., IV–TR are classified as feeding and eating dis-
for such issues as substance abuse) is provided for orders of infancy or early childhood.
children and young adults insured through EBP abbreviation for evidence-based practice.
Medicaid.
EBV abbreviation for epstein–barr virus.
early experience experience acquired in the
first 5 years of life, which is believed to have a ECA Survey abbreviation for epidemiologic
significant influence on a child’s subsequent catchment area survey.
cognitive, social, and emotional development. ECF abbreviation for extended care facility. See
Whereas theorists in the early and middle part of extended care.
the 20th century believed that early experience
permanently determined a child’s development, echinacea n. an herbal agent derived from any
more recent research indicates that later experi- of nine related plant species native to the United
ence can modify the effects of early experience. States and southern Canada, with Echinacea
purpurea being the most commonly used and
early infantile autism see autistic disor- perhaps the most potent. Echinacea tradition-
der. ally has been used in the belief that it stimulates
early intervention a collection of specialized the immune system. It is approved by Commis-
services provided to children from birth to 3 sion E, a committee of 24 interdisciplinary health
years of age with identified conditions placing care professionals formed in 1978 by the Ger-
them at risk of developmental disability or with man Federal Institute for Drugs and Medical De-
evident signs of developmental delay. Services vices, for use in the treatment or prevention of
are designed to minimize the impact of the in- fevers and colds, cough and bronchitis, urinary
fant’s or toddler’s condition, and in addition to tract and other infections, inflammation of the
stimulatory, social, therapeutic, and treatment mouth and pharynx, and—as an external appli-
programs may include family training, screen- cation—to promote healing of wounds and
ing, assessment, or health care. burns. Some studies have shown, however, that
early intervention program see infant de- taking echinacea has no clinical or significant ef-
velopment program. fects on whether people become infected with a
early memory adult recollection of childhood cold or, in those who develop colds, on the se-
events, which typically goes back only to the age verity or duration of their symptoms. Although
of 3 or so, even though the capacity to learn is echinacea is generally considered safe and there
present at birth. The absence of earlier child- are no known reports of toxicity, some people
hood memories, referred to as childhood am- may experience hypersensitivity reactions to
nesia, has been noted since the time of Sigmund echinacea, such as rashes, increased asthma, and
freud. Explanations include neural immaturity, anaphylaxis.
absence of language or adult schemas to orga- écho des pensées an auditory hallucina-
nize event memory, or different coding dimen- tion in which an individual hears his or her own
sions in infancy. thoughts repeated in spoken form. Also called
eating compulsion an irresistible impulse thought echoing.
leading to abnormal eating behavior. This is a echoencephalography n. a method of map-
primary symptom of a number of eating disor- ping brain anatomy for diagnostic purposes by
ders, such as bulimia nervosa and food ad- using ultrasonic waves. The waves are transmit-
dictions. See also compulsive eating. ted through the skull using an instrument called
eating disorder any disorder characterized pri- an echoencephalograph, and echoes of the
marily by a pathological disturbance of attitudes waves from intracranial structures are recorded
194
ecstasy
to produce a visual image called an echoen- should contribute to the development of the en-
cephalogram. tire community.
echographia n. pathological writing that in- ecological studies research that evaluates the
volves copying words and phrases without un- influence of environmental factors on individ-
derstanding them. ual behavior and mental health.
echoic memory the retention of auditory infor- ecological systems theory an evolving body
mation for a brief period (2–3 s) after the end of of theory and research concerned with the pro-
the stimulus. Also called auditory sensory cesses and conditions that govern the course of
memory. human development in the actual environ-
echolalia n. mechanical repetition of words and ments in which human beings live. Generally,
phrases uttered by another individual. It is often ecological systems theory accords equal impor- E
a symptom of a neurological or developmental tance to the concept of environment as a con-
disorder, particular catatonic schizophrenia or text for development (in terms of nested systems
autism. Also called echophrasia. ranging from micro- to macro-) and to the role
of biopsychological characteristics of the indi-
echo phenomenon echolalia, echopraxia,
vidual person. The current, still evolving, para-
or both. [first described by German psychiatrist
digm is now referred to as the bioecological
Emil Kraepelin (1856–1926)]
model. See also ecosystemic approach. [origi-
echophrasia n. see echolalia. nally conceptualized by Russian-born U.S. devel-
echopraxia n. mechanical repetition of another opmental psychologist Urie Bronfenbrenner
person’s movements or gestures. It is often a (1917–2005)]
symptom of a neurological disorder, particularly ecomania n. a morbid preoccupation with and
catatonic schizophrenia. pathological attitude toward members of one’s
eclectic behaviorism an approach to behav- family, characterized by irritable and domineer-
ior therapy that does not adhere to one theo- ing behavior. It is often a factor in domestic vi-
retical model but applies, as needed, any of olence and the cycle of violence. Also called
several techniques, including pavlovian con- oikomania.
ditioning, modeling, operant condition- economic model in psychoanalytic theory, the
ing, self-control mechanisms, and cognitive view that the psyche can be explained in terms
restructuring. of the amounts and distributions of psychic en-
eclectic counseling any counseling theory ergy associated with particular mental states
or practice that incorporates and combines doc- and processes. Compare dynamic model; top-
trines, findings, and techniques selected from di- ographic model.
verse theoretical systems. ecopathology n. the identification of people as
eclectic psychotherapy any psychotherapy abnormal by other members of their commu-
that is based on a combination of theories or ap- nity. Behavior considered normal in some com-
proaches or uses concepts and techniques from a munities (i.e., conforming to the attitudes and
number of different sources, including the inte- beliefs of community members) may be regarded
grated professional experiences of the therapist. as eccentric or even psychotic in other commu-
The more formalized prescriptive eclectic psy- nities.
chotherapy involves the use of a combination of ecosystemic approach an approach to ther-
psychotherapy approaches that is specifically se- apy that emphasizes the interaction between the
quenced in terms of formats, methods, and pro- individual or family and larger social contexts,
cesses in order to improve outcome. such as schools, workplaces, and social agencies.
eclima n. increased appetite or insatiable hunger, The approach emphasizes interrelatedness and
often associated with bulimia nervosa. Also interdependency and derives from diverse fields,
called eclimia. See also hyperorexia; hyper- including psychology, sociology, anthropology,
phagia. economics, and political science. family ther-
ecobehavioral assessment an observational apy, in particular, has made use of this approach
research method used in applied behavior in designing interventions for complex families
analysis to measure moment-to-moment ef- and systems. See also ecological systems the-
fects of multiple environmental events on an in- ory. [developed in psychology by Russian-born
dividual’s specific behaviors. These events U.S. developmental psychologist Uri Bronfen-
include the behavior of others, task demands, brenner (1917–2005)]
time of day, and situational changes. ECS abbreviation for electroconvulsive shock. See
ecological perspective a concept of commu- electroconvulsive therapy.
nity psychology in which a community (or ecstasy n. a state of intense pleasure and elation,
any other social entity) is viewed in terms of the including some mystical states, orgasm, aes-
interrelations between people, roles, organiza- thetic experiences, and drug-induced states.
tions, local events, resources, and problems. It Such extreme euphoria also occasionally occurs
accounts for complex reciprocal interactions of in the context of a hypomanic episode or
individuals and their environment. The premise a manic episode. Also called ecstatic state.
of the ecological perspective is that intervention —ecstatic adj.
195
Ecstasy
Ecstasy n. the popular name for mdma. educable mentally retarded (EMR) for-
ECT abbreviation for electroconvulsive ther- merly, describing people with mild or high-
apy. moderate mental retardation (IQ 50 to 70 or 80),
who are capable of achieving approximately a
ECT-induced amnesia amnesia that is a by- fifth-grade academic level.
product of electroconvulsive therapy (ECT).
Although ECT is effective in the relief of depres- educational counseling the counseling
sion, memory deficits often arise, especially specialty concerned with providing advice and
when the current is applied to both sides of the assistance to students in the development of their
brain. Memory can be severely compromised in educational plans, choice of appropriate courses,
the hours or days following treatment, but new and choice of college or technical school. Coun-
E learning typically returns to normal by 6 months seling may also be applied to improve study
after treatment. Some impairment in the re- skills or provide assistance with school-related
trieval of events that occurred close to the time problems that interfere with performance, for
of treatment may remain. example, learning disabilities. Educational coun-
seling is closely associated with vocational
ectomorph n. a constitutional type (somato- counseling because of the relationship be-
type) in sheldon’s constitutional theory tween educational training and occupational
of personality characterized by a thin, long, choice. Also called educational guidance;
fragile physique, which—according to this the- student counseling. See also counseling
ory—is highly correlated with cerebrotonia. psychology.
Also called ectomorphic body type. —ecto-
morphic adj. —ectomorphy n. educational diagnosis 1. the process of ana-
lytically examining a learning problem, which
ectopic pregnancy a pregnancy that develops may involve identification of cognitive, percep-
outside the uterus, most commonly in a fallo- tual, emotional, and other factors that influence
pian tube (a tubal pregnancy). Also called ec- academic performance or school adjustment. 2.
cyesis; extrauterine pregnancy; paracyesis. the conclusion reached as a result of the analyti-
ED50 (ED-50) abbreviation for effective dose 50 cal examination of a learning problem.
(see effective dose). See also therapeutic educational retardation 1. slowness or
ratio. delay of student progress in acquiring knowl-
edema n. an excess accumulation of fluid in body edge due to a physical, emotional, intellectual,
cells, organs, or cavities. The cause may be a loss or mental disability. 2. a slowness or delay that is
of fluid through the walls of the blood vessels specific to a certain subject or educational set-
as a symptom of a circulatory disorder or the ting.
interruption of flow of cerebrospinal fluid due educational therapy individualized treat-
to blockage of a passageway or failure of tissues ment interventions for people with learning dis-
to absorb the excess. See also cerebral edema. abilities or emotional or behavioral problems
—edematous adj. that significantly interfere with learning. Educa-
edge theory a theory proposing that death tional therapy integrates educational techniques
anxiety has a survival function that emerges and therapeutic practices to promote academic
when individuals perceive themselves to be in achievement and the attainment of basic
life-threatening situations. Edge theory attempts skills while building self-esteem and confidence,
to resolve the apparent discrepancy between fostering independence, and aiding personal de-
other theoretical claims that death anxiety is a velopment. It is usually conducted by a profes-
major motivational force and empirical studies sionally trained educational therapist.
that reveal only low to moderate levels of death Edwards Personal Preference Schedule
anxiety in the general population. It suggests (EPPS) a personality inventory for college stu-
that death anxiety is the subjective or experien- dents and adults in which the strength of 15
tial side of a holistic preparation to deal with “manifest needs” is assessed on a forced-choice
danger (symbolic of standing at the edge of the basis. The needs are: achievement, order, defer-
void). Heightened arousal is turned on by anxi- ence, autonomy, exhibition, affection, succor-
ety surges in emergency situations; psychologi- ance, sympathy, change, endurance, hetero-
cal difficulties arise when the emergency sexuality, aggression, intraception, abasement,
response has permeated the individual’s every- and affiliation. [developed in the 1950s by Allen
day functioning. See also terror management L. Edwards (1914–1994), U.S. psychologist, based
theory. [introduced by U.S. psychologist Robert on the needs described in the personality theory
J. Kastenbaum (1932– )] of U.S. psychologist Henry A. Murray (1893–
edrophonium n. an anticholinesterase (see 1988)]
cholinergic drug) characterized by a rapid Edwards syndrome see trisomy 17–18. [John
onset and short duration of action. It is the drug Hilton Edwards (1928– ), British geneticist]
of choice in the diagnosis of myasthenia gravis,
and it may also be used in surgical anesthesia to EE abbreviation for expressed emotion.
reverse the effects of neuromuscular blocking EEG abbreviation for electroencephalogra-
agents. U.S. trade names: Enlon; Reversol. phy or electroencephalogram.
196
ego-boundary loss
effectance n. the state of having a causal effect with practice. Because the sense of effort lacks
on objects and events in the environment, com- conscious sensory qualities, it can be considered
monly used in the term effectance motivation. an experience of fringe consciousness. It is
effective dose (ED) the minimum amount of a believed to involve increased brain activity in
drug that is required to produce a specified ef- the dorsolateral prefrontal cortex. —ef-
fect. It is usually expressed in terms of median effortful adj.
fective dose, or effective dose 50 (ED50, ED-50), effortful processing mental activity that re-
the dose at which 50% of the nonhuman animal quires deliberation and control and involves a
test population has a positive response. In psy- sense of effort, or overcoming resistance. Com-
chotherapy, this criterion is also used to express pare automaticity.
the number of sessions that are needed for 50% effort syndrome the former name for an anxi- E
of patients to show a clinically significant ety reaction now classified as panic disorder:
change. See also therapeutic ratio. The symptoms are those of a panic attack. This
effectiveness evaluation the assessment of syndrome has been given many names, includ-
the degree of success of a program in achieving a ing cardiac neurosis, hyperkinetic heart syn-
project’s goals. The process requires the determi- drome, irritable heart, soldier’s heart, Da Costa’s
nation of evaluation objectives, methods, syndrome, neurocirculatory asthenia, and hy-
and criteria of evaluation and the presenta- perventilation syndrome.
tion of findings. See also impact analysis; pro- EFPPA abbreviation for european federation
gram outcome. of professional psychologists’ associa-
effect size the magnitude, often in standardized tions.
units, of an effect (influence of independent EFT abbreviation for embedded figures test.
variables) in a study. It is often an indicator of egersis n. intense or extreme wakefulness.
the strength of a relationship, the magnitude of
mean differences among several groups, or the ego n. 1. the self, particularly the conscious sense
like. See also statistical significance. of self (Latin, “I”). In its popular and quasi-
technical sense, ego refers to all the psychologi-
effect-size correlation (symbol: reffect size) the cal phenomena and processes that are related to
correlation between scores on the dependent the self and that comprise the individual’s atti-
variable and the contrast weights (i.e., pre- tudes, values, and concerns. 2. in psychoanalytic
dicted values) without removing any other theory, the component of the personality that
sources of variation in the data. deals with the external world and its practical de-
effeminacy n. female behavior or appearance in mands. The ego enables the individual to per-
a male, which is regarded as not fitting the male ceive, reason, solve problems, test reality, and
gender role expectations of society. —effemi- adjust the instinctual impulses of the id to the
nate adj. behests of the superego. See also antilibidinal
Effexor n. a trade name for venlafaxine. ego; body ego; supportive ego.
efficacy n. 1. competence in behavioral perfor- ego-alien adj. see ego-dystonic.
mance, especially with reference to a person’s ego analysis psychoanalytic techniques di-
perception of his or her performance capabili- rected toward discovering the strengths and
ties, or perceived self-efficacy. 2. in pharma- weaknesses of the ego and uncovering its de-
cology, see dose–response relationship. fenses against unacceptable impulses. Ego analy-
sis is a short form of psychoanalysis: It does not
efficiency n. 1. a measure of the ability of an or-
attempt to penetrate to the ultimate origin of im-
ganization, work unit, or individual employee to
pulses and repressions. See also ego strength;
produce the maximum output with a minimum
ego weakness.
investment of time, effort, and other inputs.
Given the same level of output, efficiency in- ego anxiety in psychoanalytic theory, anxiety
creases as the time, effort, and other inputs taken caused by the conflicting demands of the ego,
to produce that level decrease. Also called in- id, and superego. Thus, ego anxiety refers to in-
dustrial efficiency; organizational effi- ternal rather than external demands. Compare
ciency. 2. in statistics, the degree to which an id anxiety. See also signal anxiety.
estimator uses all the information in a sample ego boundary 1. the concept that individuals
to estimate a particular parameter. —efficient are able to distinguish between self and not-self.
adj. Someone who is said to lack clear ego boundaries
effortfulness n. a sense of effort, or conscious- blurs the distinction between himself or herself
ness of effort: a feature of many psychological and others by identifying with them too easily
tasks that can be judged reliably by participants. and too much. 2. in psychoanalysis, the bound-
Effortful tasks compete against each other under ary between the ego and the id (the internal
dual-task conditions (see dual-task competi- boundary) or between the ego and external re-
tion), indicating that effortfulness correlates ality (the external boundary).
with demands on mental resources. Novel skills ego-boundary loss a condition in which the
often begin in an effortful and conscious way person lacks a clear sense of where his or her own
and become less effortful and more automatic body, mind, and influence end and where these
197
ego cathexis
characteristics in other animate and inanimate into the ego as a result of environmental de-
objects begin. mands. It involves a preconscious stage, in
ego cathexis in psychoanalytic theory, the con- which the ego is partly developed, and a subse-
centration of psychic energy onto the self, tak- quent conscious stage, in which such ego func-
ing one’s own ego as a love object. Ego cathexis tions as reasoning, judging, and reality testing
is thus a form of narcissism. Also called ego li- come to fruition and help to protect the individ-
bido. See cathexis. Compare object cath- ual from internal and external threats. Also
exis. called ego formation. See also id-ego.
egocentric speech speech that is apparently ego-dystonic adj. in psychoanalytic theory, de-
not directed to others or in which there is no at- scribing impulses, wishes, or thoughts that are
E tempt to exchange thoughts or take into account unacceptable or repugnant to the ego or self.
another person’s point of view. According to Also called ego-alien. Compare ego-syntonic.
Jean piaget, a child’s use of egocentric speech ego-dystonic homosexuality the condition
prevails until the 7th or 8th year of age and then of being distressed about an inability to be
disappears as the child develops social speech aroused by the opposite sex. There is a sustained
geared to others’ needs. According to Lev pattern of same-sex arousal that the person ex-
vygotsky, however, egocentric speech is in part plicitly states has been unwanted and persis-
vocalized social speech geared to solving prob- tently distressing. The condition is frequently
lems and develops into inner language. Also accompanied by feelings of loneliness, shame,
called private speech. anxiety, and depression. In DSM–IV–TR it is cat-
egocentrism n. 1. the tendency to emphasize egorized as a sexual disorder not otherwise
one’s personal needs and focus on one’s individ- specified.
ual concerns rather than those of the social unit ego formation see ego development.
or group to which one belongs. Also called
ego functions in psychoanalytic theory, the
egocentricity. See also idiocentric. Compare
various activities of the ego, including per-
sociocentrism. 2. in Jean piaget’s theory of
ception of the external world, self-awareness,
cognitive development, the tendency to per-
problem solving, control of motor functions, ad-
ceive the situation from one’s own perspective,
aptation to reality, memory, and reconciliation
believing that others see things from the same
of conflicting impulses and ideas. The ego is fre-
point of view as oneself and that events will elicit
quently described as the executive agency of the
the same thoughts, feelings, and behavior in
personality, working in the interest of the real-
others as in oneself. —egocentric adj.
ity principle. See also secondary process.
ego control a personality characteristic consist-
ing of the tendency to inhibit the expression of
ego-ideal n. in psychoanalytic theory, the part of
the ego that is the repository of positive identifi-
emotional and motivational impulses, ranging
cations with parental goals and values that the
from undercontrol to overcontrol of such im-
individual genuinely admires and wishes to em-
pulses.
ulate, such as integrity and loyalty, and which
ego-coping skills adaptive techniques devel- acts as a model of how he or she wishes to be. As
oped by an individual to deal with personal new identifications are incorporated in later life,
problems and environmental stresses. the ego-ideal may develop and change. In his
ego defect in psychoanalytic theory, the ab- later theorizing, Sigmund freud incorporated
sence of limitation of an ego function. The the ego-ideal into the concept of the superego.
prime function of the ego is perception of reality Also called self-ideal.
and adjustment to it. An ego defect can be either ego identity 1. in psychoanalytic theory, the
the target of treatment or a deficiency that slows experience of the self as a recognizable, persis-
recovery. tent entity resulting from the integration of
ego defense in psychoanalytic theory, protec- one’s unique ego-ideal, life roles, and ways of
tion of the ego from anxiety arising from threat- adjusting to reality. 2. the gradual acquisition of
ening impulses and conflicts as well as external a sense of continuity, worth, and integration
threats through the use of defense mecha- that Erik erikson believed to be the essential
nisms. process in personality development. See erik-
ego depletion a state marked by reduction in son’s eight stages of development. See also
the self’s capacity for volition (initiative, choice, identity.
and self-regulation), especially in the context of ego instinct in psychoanalytic theory, in-
self-regulatory resources theory. Ego de- stincts, such as hunger, that are directed toward
pletion is typically temporary and is restored by self-preservation. In Sigmund freud’s early the-
rest, positive emotions, or other means. ory, the energy of the ego instincts is used by the
ego development 1. the infant’s emerging ego to defend against the sexual instincts.
consciousness of being a separate individual dis- ego integration in psychoanalytic theory, the
tinct from others, particularly the parents. 2. in process of organizing the various aspects of the
classical psychoanalysis, the process in personality, such as drives, attitudes, and aims,
which a part of the id is gradually transformed into a balanced whole.
198
ego weakness
ego integrity versus despair see integrity normal context, ego-splitting can be seen in the
versus despair. critical attitude of the self toward the self; in neu-
egoism n. a personality characteristic marked by roses, contrary attitudes toward particular be-
selfishness and behavior based on self-interest haviors are fundamental; and in psychoses, ego-
with disregard for the needs of others. See also splitting may produce an “observing” part of the
egotism. —egoistic adj. individual that sees and can report on delusional
phenomena. 2. in the object relations the-
egoistic helping a form of helping behavior in ory of Melanie klein, fragmentation of the ego
which the goal of the helper is to increase his or in which parts that are perceived as bad are split
her positive feelings or to receive some other off from the main ego.
benefit. See also altruistic behavior.
ego state in psychoanalytic theory, an inte- E
egoistic suicide a type of suicide associated grated state of mind that determines the individ-
with an extreme sense of alienation. Lacking sig- ual’s relationships to the environment and to
nificant attachments to family members and other people.
others, the person withdraws from society and
comes to feel his or her life is meaningless. [asso- ego strength in psychoanalytic theory, the abil-
ciated with the work of French sociologist Émile ity of the ego to maintain an effective balance
Durkheim (1858–1917)] between the inner impulses of the id, the super-
ego, and outer reality. An individual with a
ego libido see ego cathexis. strong ego is thus one who is able to tolerate
egomania n. extreme, pathological preoccupa- frustration and stress, postpone gratification,
tion with oneself, often characterized by an ex- modify selfish desires when necessary, and re-
aggerated sense of one’s abilities and worth. This solve internal conflicts and emotional problems
includes the tendency to be totally self-centered, before they lead to neurosis. Compare ego
callous with regard to the needs of others, and weakness.
interested only in the gratification of one’s own ego stress any situation, external or internal,
impulses and desires. See also egopathy. —ego- that challenges the individual and produces
maniac n. stress (tension, anxiety, etc.) requiring adap-
egopathy n. hostile attitudes and actions stem- tation by the ego. Ego stress is sometimes ex-
ming from an exaggerated sense of self- pressed as such defensive reactions as dis-
importance, often manifested by a compulsion sociation, somatization, or panic.
to deprecate others. See also egomania. ego structure in psychoanalytic theory, the or-
ego psychology in psychoanalysis, an ap- ganization of the ego.
proach that emphasizes the functions of the ego ego suffering in psychoanalytic theory, the
in controlling impulses and dealing with the ex- guilt feelings produced in the ego by the aggres-
ternal environment. This is in contrast to id psy- sive forces in the superego when it disapproves
chology, which focuses on the primitive of the ego.
instincts of sex and hostility. Ego psychology
differs from classical psychoanalysis in pro- ego-syntonic adj. compatible with the ego or
posing that the ego contains a conflict-free conscious self-concept. Thoughts, wishes, im-
sphere of functioning and that it has its own pulses, and behavior are said to be ego-syntonic
store of energy with which to pursue goals that when they form no threat to the ego and can be
are independent of instinctual wishes. Ego psy- acted upon without interference from the super-
chology theories extend beyond classic psycho- ego. Compare ego-dystonic. [first described in
analytic drive theory by combining a biological 1914 by Sigmund freud]
and psychological view of the individual’s de- egotheism n. identification of oneself with a
velopment with a recognition of the complex deity. See also jehovah complex; messiah
influences of sociocultural dimensions on in- complex.
dividual functioning. The scope of psychoana- egotism n. excessive conceit or excessive preoc-
lysis is thereby broadened from the study of cupation with one’s own importance. See also
unconscious events and psychopathology to ex- egoism. —egotistic adj.
ploration of adaptive processes within the ma-
trix of interpersonal, familial, and sociocultural ego transcendence the feeling that one is be-
forces. yond concern with the self and is thus able to
perceive reality with less egocentric bias and
ego resiliency a personality characteristic con- greater objectivity.
sisting of the ability to vary, in an adaptive
manner, the degree to which one inhibits or ex- ego weakness in psychoanalytic theory, the in-
presses emotional impulses, depending on social ability of the ego to control impulses and toler-
demands. ate frustration, disappointment, or stress. The
individual with a weak ego is thus one who
ego resistance see repression-resistance. suffers from anxiety and conflicts, makes ex-
ego-splitting n. 1. in psychoanalytic theory, cessive use of defense mechanisms or uses
the ego’s development of opposed but coexist- immature defense mechanisms, and is likely
ing attitudes toward a phenomenon, whether in to develop neurotic symptoms. Compare ego
the normal, neurotic, or psychotic person. In the strength.
199
Einfühlung
Einfühlung n. German for empathy. sistance with daily living because of physical
either–or thinking a less common name for disabilities, cognitive impairments, or other con-
dichotomous thinking. ditions. Elder care may be home based (via spe-
cialized programs) or community based (via
ejaculation n. the automatic expulsion of assisted living, residential care, or a
semen and seminal fluid through the penis re- skilled nursing facility).
sulting from involuntary and voluntary contrac-
tions of various muscle groups. See orgasm. See elder neglect the failure of a responsible care-
also premature ejaculation; retrograde giver to provide needed care to an older adult.
ejaculation. —ejaculatory adj. Extreme neglect in the form of abandonment
can occur when the caregiver deserts the older
ejaculatio retardata excessively delayed ejac- adult in need. See elder abuse.
E ulation during sexual intercourse, usually due to
psychogenic factors, aging, or the use of drugs, elective mutism see selective mutism.
but also voluntary. Also called male conti- Electra complex the female counterpart of the
nence. oedipus complex, involving the daughter’s
love for her father, jealousy toward the mother,
Ekbom’s syndrome a sense of uneasiness,
and blame of the mother for depriving her of a
twitching, or restlessness that occurs in the legs
penis. Although Sigmund freud rejected the
when at rest (i.e., sitting or lying) or after retiring
phrase, using the term “Oedipus complex” to
for the night. The cause is unknown but it has
refer to both boys and girls, many modern text-
been associated with a deficiency of iron, vita-
books of psychology propagate the mistaken be-
min B12, or folic acid; nerve damage associated
lief that Electra complex is a Freudian term. The
with rheumatoid arthritis, kidney failure, or dia-
name derives from the Greek myth of Electra,
betes; and the use of such drugs as lithium,
daughter of Agamemnon and Clytemnestra,
anticonvulsants, antidepressants, and beta
who seeks to avenge her father’s murder by per-
blockers. Also called restless-legs syndrome;
suading her brother Orestes to help her kill
tachyathetosis; Wittmaack–Ekbom syn-
Clytemnestra and her lover Aegisthus. [defined
drome. [Karl-Axel Ekbom (1907–1977), Swedish
by Carl jung]
physician]
electrical stimulation the stimulation of
elaboration n. 1. the process of interpreting or
brain cells or sensory or motor neurons by elec-
embellishing information to be remembered or
trical or electronic devices. This is usually ac-
of relating it to other material already known
complished with the use of an electrode on a
and in memory. The levels-of-processing model
research animal but also occasionally on human
of memory holds that the level of elaboration
volunteers undergoing brain surgery.
applied to information as it is processed affects
both the length of time that it can be retained in electrical transcranial stimulation see
memory and the ease with which it can be re- electrosleep therapy.
trieved. See activation–elaboration. See also electric shock method the use of electricity in
chunking; deep processing; recoding. 2. the treating humans. See electroconvulsive
process of scrutinizing and thinking about the therapy; electrotherapy.
central merits of attitude-relevant information. electrocardiographic effect a change in the
This process includes generating inferences electrical activity of the heart as recorded by an
about the information, assessing its validity, and electrocardiogram, especially one associated
considering the implications of evaluative re- with administration of a drug. Prolongation of
sponses to the information. See also cognitive segments of the cardiac cycle, particularly the Q-
response. —elaborate vb. T interval (the period of ventricular contrac-
elation n. a state of extreme joy, exaggerated option), may be observed with excess doses of
timism, and restless excitement. In extreme or numerous antipsychotics and tricyclic antide-
prolonged forms, it is a symptom of a number of pressants. A malignant form of electrocardio-
disorders; in particular, it may be drug-induced graphic change is an arrhythmia known as
or a symptom of acute mania, but it is also found torsades de pointes (French, literally “twisting
in general paresis, schizophrenia, and psycho- of the points”), so called because of its character-
sis with brain tumor. —elated adj. istic outline on an electrocardiograph tracing.
Elavil n. a trade name for amitriptyline. Torsades de pointes syndrome may result from
drug interactions increasing the serum concen-
Eldepryl n. a trade name for selegiline. tration of certain drugs or from an abnormal re-
elder abuse harm to an older adult caused by action to single drugs (e.g., pimozide) in
another individual. The harm can be physical susceptible individuals.
(violence), sexual (nonconsensual sex), psycho- electroconvulsive therapy (ECT) a contro-
logical (causing emotional distress), material versial treatment in which a seizure is induced
(improper use of belongings or finances), or ne- by passing a controlled, low-dose electric current
glect (failure to provide needed care). (an electroconvulsive shock; ECS) through one
elder care the provision of health-related ser- or both temples. The patient is prepared by ad-
vices, supportive personal care, supervision, and ministration of an anesthetic and injection of a
social services to an older adult requiring as- muscle relaxant. An electric current is then ap-
200
Ellis–van Creveld syndrome
plied for a fraction of a second through elec- electroshock therapy (EST) see electro-
trodes placed on the temples and immediately convulsive therapy.
produces a two-stage seizure (tonic and clonic). electrosleep therapy a former treatment for
ECT may be bilateral or unilateral (usually of the depression, chronic anxiety, and insomnia by
right hemisphere). Now a somewhat rare proce- inducing a state of relaxation or sleep through
dure, it is sometimes used with patients with low-voltage electrical transcranial stimulation
severe endogenous depression who fail to re- (ETS; or cranial electrical stimulation, CES), a
spond to antidepressant drugs. Benefits are tem- technique developed in the Soviet Union in the
porary, and the mechanisms of therapeutic 1940s.
action are unknown. Also called electro-
electrostimulation n. an aversive, or negative-
convulsive shock therapy (EST); electro-
shock therapy (EST). See also brief stimulus
reinforcement, technique involving administra- E
tion of an electric shock. See also aversion
therapy; ect-induced amnesia. [introduced in
therapy.
1938 by Italian psychiatrists Ugo Cerletti (1877–
1963) and Lucio Bini (1908–1964)] electrotherapy n. any therapeutic measure
that involves the application of an electric cur-
electrocorticography (ECoG) n. a method of rent to the body.
studing the electrical activity of the brain using
Elephant Man’s disease see von reckling-
electrodes placed directly on the cerebral cortex,
hausen’s disease.
rather than on the scalp as in electroencepha-
lography. The resulting record of brain-wave elevated mood a heightened mood character-
patterns is called an electrocorticogram. ized by feelings of euphoria, elation, and well-
being.
electrodiagnosis n. the application of an elec-
elevator phobia a persistent and irrational fear
tric current to nerves and muscles for diagnostic
of elevators, which may represent fear of height
purposes. See electroencephalography; elec-
(acrophobia), fear of being enclosed (claus-
tromyography.
trophobia), or fear of having panic symptoms
electroencephalography (EEG) n. a method in people with agoraphobia.
of studying brain waves using an instrument elfin facies see williams syndrome.
(electroencephalograph) that amplifies and re-
elimination by aspects a theory of decision
cords the electrical activity of the brain through
making holding that a choice is reached through
electrodes placed at various points on the scalp.
a series of eliminations. At each stage, the de-
The resulting record (electroencephalogram
cision maker selects an attribute or aspect
[EEG]) of the brain-wave patterns is frequently
perceived to be important and eliminates alter-
used in studying sleep, monitoring the depth
natives lacking that attribute. The next most im-
of anesthesia, diagnosing epilepsy and other
portant attribute is then selected, and the
brain disorders or dysfunction, and studying
process continues until only one alternative is
normal brain function. Also called cognitive
left. [introduced in 1972 by Israeli psychologist
electrophysiology.
Amos Tversky (1937–1996)]
electromyography (EMG) n. the recording elimination disorder any disorder related to
(via an instrument called an electromyograph) defecation or urination, usually occurring in
of the electrical activity of muscles through elec- children (or individuals of equivalent mental
trodes placed in or on different muscle groups. age), that is not due to the use of substances or a
This procedure is used in the diagnosis of general medical condition. In DSM–IV–TR, this
neuromuscular diseases, such as myasthenia gra- class of disorders includes encopresis and
vis or amyotrophic lateral sclerosis. A print-out enuresis.
of the electric potentials is called an electro-
elimination drive the urge to expel feces or
myogram (EMG).
urine from the body. Psychological factors have
electronarcosis n. a form of electrotherapy considerable effects on these drives; for example,
in which the amount of electricity, the duration tension and fright may precipitate involuntary
of the shock, or both is sufficient to generate the voiding of both the bladder and bowel.
tonic phase of a seizure but either limits or pre- ellipsis n. in psychoanalysis, a form of
vents the clonic phase. Electronarcosis is a gener- parapraxis involving the omission of signifi-
ally less effective alternative to standard cant ideas in free association or dreams. Ef-
electroconvulsive therapy (ECT) and more forts are made to recover these ideas during
likely to cause side effects. The technique has analysis. —elliptical adj.
also been used to induce relaxation and sleep.
Ellis–van Creveld syndrome an autosomal
See electrosleep therapy.
recessive disorder (see recessive allele) marked
electronystagmography n. a neurological by polydactyly (extra fingers or toes); poorly
test that measures movements of the eye mus- formed hair, teeth, and nails; and skeletal anom-
cles, used to confirm the presence of nystag- alies. Associated abnormalities may include gen-
mus. A graphical recording of eye movements is ital anomalies and mental retardation. A high
generated and is used to evaluate dizziness, ver- incidence of the disorder is seen among the Old
tigo, and the function of the auditory nerve. Order Amish of Pennsylvania. Also called chon-
201
elopement
droectodermal dysplasia. [Richard White clot, cholesterol, fibrin, or other material break-
Bernard Ellis (1902–1966), British physician; ing away from the wall of an artery or the heart
Simon van Creveld (1894–1971), Dutch pediatri- and traveling up the arterial tree to lodge sud-
cian] denly in a smaller cerebral artery (see cerebral
elopement n. 1. the act of secretly leaving home embolism). Embolic strokes account for approx-
to marry without parental consent. 2. the depar- imately 30% of all strokes and are abrupt in
ture of a patient from a psychiatric hospital or onset.
unit without permission. 3. in law enforcement, embolism n. the interruption of blood flow due
slang for the escape of an inmate. to blockage of a vessel by an embolus, material
emancipation disorder a disorder of early formed elsewhere and carried by the blood-
E adulthood in which the individual experiences stream to become lodged at the site of obstruc-
conflict between a desire for freedom from tion. The embolus may be a blood clot, air
parental control and the responsibilities of inde- bubble, fat globule, or other substance, such as a
pendence. Symptoms may include indecisive- clump of bacteria or tissue cells. An embolus usu-
ness, homesickness, excessive dependence on ally occurs at a point where a blood vessel
peers, and paradoxical overdependence on pa- branches or narrows. The symptoms are those
rental advice. Also called emancipation disor- associated with a disruption of the normal flow
der of adolescence and early adulthood. of fresh blood to a part of an organ and include
pain, numbness, and loss of body warmth in the
emancipatory striving efforts to free oneself
affected area. An embolus in a coronary artery
from the influence or domination of parents and
may cause a fatal heart attack, whereas in the
to achieve a sense of independence and self-
brain the result is an embolic stroke.
dependence. Emancipatory striving is particu-
larly evident during adolescence. EMDR abbreviation for eye-movement desensi-
emasculation n. castration or, by extension, tization and reprocessing.
the reduction or removal of a man’s sense of emergence n. 1. in philosophy of mind, the no-
masculinity, as by depriving him of a culturally tion that conscious experience is the result of,
sanctioned male role. —emasculate vb. but cannot be reduced to, brain processes. 2. the
embarrassment n. a self-conscious emo- idea that higher order phenomena are derived
tion in which a person feels awkward or flus- from lower order phenomena but exhibit char-
tered in other people’s company or because of acteristics not predictable from those lower
the attention of others, as, for example, when order phenomena. See epigenetic theory.
being observed engaging in actions that are sub- emergency psychotherapy psychological
ject to mild disapproval from others. It often has treatment of individuals who have undergone a
an element of self-deprecating humor and is typ- traumatic experience (e.g., a road accident) and
ically characterized by nervous laughter, a shy are in a state of acute anxiety, panic, or shock or
smile, or blushing. —embarrassed adj. are suicidal. Therapists may call on a very broad
Embedded Figures Test (EFT) a test that con- range of techniques depending on the immedi-
sists of finding and tracing a simple form embed- ate needs of the client. See also crisis interven-
ded within a complex figure, in some cases tion.
further complicated by an irregularly colored emergency reaction see fight-or-flight re-
background. The test, for use with individuals sponse.
aged 10 years and over, was designed to evaluate emergency services in health care, services
cognitive style, particularly field dependence provided to an individual in response to per-
and field independence: Those demonstrat- ceived need for immediate medical or psycho-
ing ability in the test are defined as field- logical treatment.
independent people, who tend to follow active,
participant approaches to learning, whereas emergency theory of emotions the theory
those who have difficulties in performing the that the emotional and visceral changes con-
test are defined as field-dependent people, who trolled by the autonomic nervous system are
often use spectator approaches and are also more designed to prepare individuals for fight or flight
open and responsive to other people’s behavior. during an emergency (see fight-or-flight re-
The EFT is also employed in neuropsychological sponse).
contexts, as poor performance on the test may emergent evolution the theory that new phe-
indicate a lesion or injury in the cerebral cortex. nomena evolve from an interaction of ancestral
Also called Hidden Figures Test. [originally events but cannot be reduced to them.
developed in 1950 by U.S. psychologist Herman emergentism n. the view that complex phe-
Allen Witkin (1916–1979)] nomena and processes have emergent proper-
embodiment n. the claim that much human ties that arise from interactions of the more
thinking is a metaphorical extension of experi- basic processes that underlie them but cannot be
ences of the body and its immediate surround- deduced or explained from the nature and logic
ings. [attributable to U.S. cognitive linguist of these processes. Compare reductionism.
George Philip Lakoff (1941– )] emergent property a characteristic of a com-
embolic stroke a stroke caused by a blood plex system that is not implicit in or predictable
202
emotional divorce
from an analysis of the components or elements love and hate or the desire for success and fear of
that make it up and that, thus, often arises unex- failure, that causes distress to the individual.
pectedly. For example, it has been said that con- emotional contagion the rapid spread of an
scious experience is not predictable by analysis emotion from one or a few individuals to others.
of the neurophysiological and biochemical com- For example, fear of catching a disease can
plexity of the brain. spread rapidly through a community. See also
emetic therapy the use of drugs that produce behavioral contagion; contagion; mass
aversive states when combined with problem be- contagion.
haviors or stimuli. Side effects of the drugs used emotional content themes or characteristics
and other issues with regard to this form of treat- of feelings that tend to elicit strong emotions, es-
ment limit its application. See aversion ther- pecially as they are portrayed in various forms of E
apy. communication (reading material, motion pic-
EMG abbreviation for electromyography. tures, etc.) or as they are manifested in specific
emotion n. a complex reaction pattern, involv- situations.
ing experiential, behavioral, and physiological emotional control self-regulation of the in-
elements, by which the individual attempts to fluence that one’s emotions have on one’s
deal with a personally significant matter or thoughts and behavior.
event. The specific quality of the emotion (e.g.,
emotional dependence dependence on oth-
fear, shame) is determined by the specific sig-
ers for emotional support, comfort, and nurtur-
nificance of the event. For example, if the signifi-
ance.
cance involves threat, fear is likely to be
generated; if the significance involves disap- emotional deprivation lack of adequate in-
proval from another, shame is likely to be gener- terpersonal attachments that provide affirma-
ated. Emotion typically involves feeling but tion, love, affection, and interest, especially on
differs from feeling in having an overt or implicit the part of the primary caregiver during a child’s
engagement with the world. —emotional adj. developmental years.
emotional abuse nonphysical abuse: a pattern emotional deterioration an emotional state
of behavior in which one person deliberately characterized by carelessness toward oneself, in-
and repeatedly subjects another to acts that are difference to one’s surroundings, including
detrimental to behavioral and affective func- other people, and inappropriate emotional reac-
tioning and overall mental well-being. Re- tions.
searchers have yet to formulate a universally emotional development a gradual increase
agreed upon definition of the concept, but have in the capacity to experience, express, and inter-
identified a variety of forms emotional abuse pret the full range of emotions and in the ability
may take, including verbal abuse, intimidation to cope with them appropriately. For example,
and terrorization, humiliation and degradation, infants begin to smile and frown around 8 weeks
exploitation, harassment, rejection and with- of age and to laugh around 3 or 4 months, and
holding of affection, isolation, and excessive older children begin to learn that hitting others
control. Also called psychological abuse. is not an acceptable way of dealing with anger.
emotional adjustment the condition or pro- Expressions of delight, fear, anger, and disgust
cess of personal acceptance of and adaptation to are evident by 6 months of age, and fear of
one’s circumstances, which may require modifi- strangers from 8 months. Expressions of affec-
cation of attitudes and the expression of emotion and jealousy are seen between 1 and 2 years
tions that are appropriate to a given situation. of age, and expressions of rage in the form of
temper tantrums appear a year or so later. Corti-
emotional blocking the inhibition of
cal control, imitation of others, hormonal influ-
thought, speech, or other responses due to ex-
ences, home atmosphere, and conditioning play
treme emotion, often associated with extreme
major roles in emotional development. Also
fear. See also blocking.
called affective development.
emotional charge strong emotion, such as
anger, conceived as being bottled up under pres- emotional disorder 1. any psychological dis-
sure and ready to explode. The concept also in- order characterized primarily by maladjustive
volves the idea that emotions are negatively or emotional reactions that are inappropriate or
positively charged. disproportionate to reality. Also called emo-
tional illness. See also mood disorder. 2.
emotional cognition the ability to recognize loosely, any mental disorder.
and interpret the emotions of others, notably
from such cues as facial expression and voice emotional disposition a tendency to have a
tone, and to interpret one’s own feelings cor- particular type or class of affective experience
rectly. Impairment of emotional cognition is (e.g., positive affect or negative affect).
associated with a range of psychological condi- emotional dissemblance lack of correspon-
tions, notably asperger’s disorder. dence between an individual’s internal affec-
emotional conflict a state of disharmony be- tive state and its outward expression.
tween incompatible intense emotions, such as emotional divorce a marital relationship in
203
emotional expression
which the partners live separate lives, with an disappointing events. The extreme of emotional
absence of normal interaction between them. insulation is found in states of complete apathy
emotional expression 1. an outward manifes- and catatonic stupor; in lesser forms it appears as
tation of an intrapsychic state. For example, a emotional isolation.
high-pitched voice is a sign of arousal, blush- emotional intelligence a type of intelligence
ing is a sign of embarrassment, and so on. See that involves the ability to process emotional
also affect display. 2. an emotional response information and use it in reasoning and other
in which the individual attempts to influence cognitive activities, proposed by U.S. psychol-
his or her relation to the world through the oists Peter Salovey (1958– ) and John D. Mayer
intermediacy of others, rather than directly. For (1953– ). According to Mayer and Salovey’s
E example, a sad face and slumped posture elicit 1997 model, it comprises four abilities: to per-
nurturing from others. Expressions differ from ceive and appraise emotions accurately; to access
action tendencies, which influence the world and evoke emotions when they facilitate cogni-
directly, and from feelings, which are intra- tion; to comprehend emotional language and
psychic experiences of the significance of a make use of emotional information; and to regu-
transaction. late one’s own and others’ emotions to promote
emotional flatness see flat affect. growth and well-being. Their ideas were popu-
larized in a best-selling book by U.S. psycholo-
emotional flooding a lay term, not used in
gist and science journalist Daniel J. Goleman
current psychological or medical literature, for
(1946– ), who also altered the definition to in-
an influx of great and uncontrollable emotion
clude many personality variables. See also emo-
that may be overwhelming to the person who
tional intelligence quotient.
experiences it.
emotional handicap (EH) a fear-, anxiety-, or emotional intelligence quotient an index
other emotionally based condition that results of emotional intelligence. Popular writers
in maladaptive behavior—ranging from with- and the media sometimes abbreviate the term to
drawal and isolation to acting out and aggres- EQ (for emotional quotient, nominally similar to
sion—and adversely affects a student’s academic iq).
and social functioning. For example, the inabil- emotional isolation see emotional insula-
ity to form or sustain satisfactory relationships tion.
with peers or teachers would constitute an emo- emotionality n. the degree to which an indi-
tional handicap. vidual experiences and expresses emotions, irre-
emotional illness see emotional disorder. spective of the quality of the emotional experi-
emotional immaturity 1. a tendency to ex- ence.
press emotions without restraint or dispropor- emotional maturity a high and appropriate
tionately to the situation. Compare emotional level of emotional control and expression. Com-
maturity. 2. a lay term for maladjustment. pare emotional immaturity.
emotional incest a form of child sexual emotional processing theory a theory pro-
abuse consisting of nonphysical sexualized in- posing a hypothetical sequence of fear-reducing
teractions between parent figures and a child in changes that is evoked by emotional engage-
their care. Emotional incest may involve the par- ment with the memory of a significant event,
ent commenting on the child’s sexual attractive- particularly a trauma. The theory is based on the
ness, the parent’s own arousal to the child, or the concept of a fear structure, a type of mental
size or shape of the child’s secondary sexual framework for reacting to threat that includes in-
characteristics (e.g., breasts, pubic hair), or im- formation about a feared stimulus (e.g., a snake),
plying that the child is sexually active (e.g., call- about physiological and behavioral responses
ing a child a slut). (e.g., rapid heartbeat, sweating), and about the
emotional inoculation the imagining, prac- meaning of the stimulus and response elements
ticing, or cognitive rehearsal of an anxiety- (e.g., the snake is poisonous and will bite me and
producing experience. Rehearsal lowers anxiety I am afraid of it). Although most fear structures
by allowing the individual to anticipate reac- accurately represent legitimate threats, others
tions and plan responses. become distorted: Individuals do not reflect suf-
ficiently upon the event initially and thus do not
emotional insight the client’s awareness of
successfully evoke and cope with the associated
the emotional forces, such as internal conflicts
emotions, so that harmless stimuli become seen
or traumatic experiences, that underlie his or her
as dangerous and act to trigger excessive physio-
symptoms. This form of insight is considered a
logical reactions, deliberate avoidance of memo-
prerequisite to change in many therapeutic ap-
ries of the event, emotional withdrawal, and
proaches.
other maladaptive behaviors. The existence of
emotional instability a tendency to exhibit such erroneous fear structures originally was
unpredictable and rapid changes in emotions. proposed in response to the difficulties of tradi-
emotional insulation a defense mechanism tional learning theories in explaining intrusion
characterized by seeming indifference and de- symptoms and fear in posttraumatic stress
tachment in response to frustrating situations or disorder. According to this conceptualization,
204
emotive technique
which has since been expanded to other anxiety marked by depression or intense anxiety and ac-
disorders, treatment (i.e., prolonged exposure companied by mutism.
therapy) should be designed to provide infor- emotional support the verbal and nonverbal
mation that is incompatible with the pathologi- processes by which one communicates care and
cal elements of a specific fear structure. Thus the concern for another, offering reassurance, empa-
repetitive exposure to the event memory in a thy, comfort, and acceptance. It may be a major
safe environment in which the threat is not real- factor contributing to the effectiveness of self-
ized gradually decreases emotional responding help groups, within which members both pro-
until the fear structure changes to accommodate vide and receive emotional support.
this new, more accurate information (e.g., If I am
emotional tension see emotional stress.
not anxious, the situation cannot be so bad).
[proposed in 1986 by U.S. psychologists Edna B. emotion-focused coping a strategy for man- E
Foa (1937– ) and Michael J. Kozak (1952– )] aging stress in which a person focuses on regulat-
ing his or her negative emotional reactions to a
emotional quotient see emotional intelli- stressor. Rather than taking actions to change
gence quotient. the stressor itself, the individual tries to control
emotional reeducation psychotherapy fo- feelings using a variety of cognitive and behav-
cused on modifying the client’s attitudes, feel- ioral tools, including meditation and other
ings, and reactions by helping the client gain relaxation techniques, prayer, positive re-
greater insight into emotional conflicts and self- framing, wishful thinking and other avoid-
defeating behavior arising from affective dis- ance techniques, self-blame, seeking social
turbance or disorder. Typical objectives are an support (or conversely engaging in social
increase in self-confidence, sociability, and self- withdrawal), and talking with others (includ-
reliance. The methods used include group ing mental health care professionals). It has been
discussions, personal counseling, relationship proposed that emotion-focused coping is used
therapy, and self-exploration. primarily when a person appraises a stressor as
emotional regulation the ability of an indi- beyond his or her capacity to change. Compare
vidual to modulate an emotion or set of emo- problem-focused coping. [identified in 1984
tions. Techniques of conscious emotional by Richard S. Lazarus (1922–2002) and Susan
regulation can include learning to construe situ- Folkman (1938– ), U.S. psychologists]
ations differently in order to manage them emotion-focused couples therapy a form
better, changing the target of an emotion (e.g., of couples therapy that is based on the prem-
anger) in a way likely to produce a more positive ise that relationship problems are most often
outcome, and recognizing how different behav- due to thwarted fulfillment of emotional needs,
iors can be used in the service of a given emo- particularly the need for attachment. This inter-
tional state. Emotional regulation typically vention involves isolating the conflict regarding
increases across the life span. thwarted needs, interrupting the negative inter-
emotional release the catharsis or sudden action cycle, reframing the conflict, and accept-
outpouring of emotions that have been pent up ing the emotional experience of one’s partner as
or suppressed. valid.
emotional response an emotional reaction, emotion-focused therapy an integrative in-
such as happiness, fear, or sadness, to a given dividual therapy that focuses on emotion
stimulus. as the key determinant of personality devel-
opment and of psychotherapeutic change. In
emotional security the feeling of safety, confi- sessions, the therapist helps the client to become
dence, and freedom from apprehension. In the aware of, make sense of, accept, and regulate
approach of German-born U.S. psychoanalyst emotions as a way of resolving problems and
Karen D. Horney (1885–1952), the need for emo- promoting growth. Techniques are drawn from
tional security is the underlying determinant of client-centered therapy, gestalt therapy,
personality and behavior; in the approach of and cognitive behavior therapy. A principal
U.S. psychoanalyst Harry Stack Sullivan (1892– proponent of this approach is South African-
1949), it is itself determined primarily by inter- born Canadian psychologist Leslie S. Greenberg
personal relations. See also security opera- (1945– ).
tions.
emotive adj. related to or arousing emotion.
emotional stability predictability and consis- emotive imagery in behavior therapy and cog-
tency in emotional reactions, with absence of nitive behavior therapy, a procedure in which
rapid mood changes. the client imagines emotion-arousing scenes
emotional stress the feeling of psychological while relaxing in a comfortable, protective set-
strain and uneasiness produced by situations of ting. See reciprocal inhibition.
danger, threat, and loss of personal security or emotive technique any of various therapeutic
by internal conflicts, frustrations, loss of self- techniques designed to encourage clients to ex-
esteem, and grief. Also called emotional ten- press their thoughts and feelings in an intense
sion. and animated manner so as to make these more
emotional stupor a form of affective stupor obvious and available for discussion in therapy.
205
empathy
Emotive techniques are used, for example, in ra- rect clinical treatment by psychologists or other
tional emotive behavior therapy in attempts mental health professionals.
to dispute irrational beliefs in order to move employment counseling counseling de-
from intellectual to emotional insight. signed to help an individual with issues related
empathy n. understanding a person from his or to work, such as job seeking, work compatibility,
her frame of reference rather than one’s own, so outside pressures interfering with job perfor-
that one vicariously experiences the person’s mance, termination of employment, and work
feelings, perceptions, and thoughts. Empathy efficiency. Within an organization, employment
does not, of itself, entail motivation to be of as- counseling is often provided through an em-
sistance, although it may turn into sympathy or ployee assistance program.
E personal distress, which may result in action. In empowerment n. the promotion of the skills,
psychotherapy, therapist empathy for the client knowledge, and confidence necessary to take
can be a path to comprehension of the client’s greater control of one’s life, as in certain educa-
cognitions, affects, or behaviors. —empathic or tional or social schemes. In psychotherapy, the
—empathetic adj. —empathize vb. process involves helping clients become more
empathy–altruism helping a theory that ex- active in meeting their needs and fulfilling their
plains altruistic behaviors as resulting from desires. Empowerment provides a client with a
feelings of empathy and compassion toward sense of achievement and realization of his or
others. her own abilities and ambitions. See also en-
empathy training 1. a systematic procedure abling. —empower vb.
to increase empathetic feeling and communica- empty-chair technique a technique originat-
tions in an individual. 2. help given to convicted ing in gestalt therapy in which the client con-
abusers to enable them to envision their victims’ ducts an emotional dialogue with some aspect of
feelings and become sensitive to the pain they himself or herself or some significant person in
have caused, with the aim of decreasing the like- his or her life (e.g., a parent), who is imagined to
lihood that they will commit similar crimes in be sitting in an empty chair during the session.
the future. The client then exchanges chairs and takes the
empirical-criterion keying a method for de- role of that aspect or of that other person. This
veloping personality inventories, in which the technique is now sometimes also referred to as
items (presumed to measure one or more traits) the two-chair technique.
are created and then administered to a criterion empty speech fluent speech that lacks informa-
group of people known to possess a certain char- tion or meaningful content.
acteristic (e.g., antisocial behavior, significant
anxiety, exaggerated concern about physical EMR abbreviation for educable mentally re-
health) and to a control group of people without tarded.
the characteristic. Only those items that demon- enabler n. a person, often an intimate partner or
strate an ability to distinguish between the two good friend, who passively permits or unwit-
groups are chosen for inclusion in the final in- tingly encourages negative behavior in an indi-
ventory. vidual, such as abusing a child or maintaining an
empirically derived test a test developed addiction. Often, the enabler is aware of the de-
using content, criterion, or construct validation structiveness of the negative behavior but feels
procedures or a combination of these. powerless to prevent it.
empirically keyed test a test in which an- enabling n. 1. a process whereby someone un-
swers are coded in such a way as to maximize wittingly or knowingly contributes to continued
criterion validity, construct validity, or maladaptive or pathological behavior in another
both. See also empirical-criterion keying. person, such as one with substance dependence.
empiric-risk figure in genetic counseling, a 2. the process of encouraging or allowing indi-
percentage representing the risk for common viduals to meet their own needs and achieve de-
disorders, such as schizophrenia and depression, sired ends. A therapist attempts to enable clients
when there is evidence of genetic factors of un- to believe in themselves, have the confidence to
known mechanism. The figure is based upon react on their desires, and affirm their ability to
ports of frequency of occurrence in large series of achieve. See also empowerment.
families (in addition to the approximately 3% enaction n. the process of putting something
risk of mental retardation or birth defects that into action. The word is preferred to terms like
every couple takes when having a child). execution, which have computing or machine-
employee assistance program (EAP) a des- based connotations. Enaction thus involves
ignated formal function within an organization guidance and support; it does not imply com-
that is responsible for helping individual em- plete automation. Much of the literature on pro-
ployees with personal problems that affect their cess modeling states that models should be
job performance (e.g., substance abuse, family enactable.
difficulties, or emotional problems). EAP services enactment n. the acting out of an important life
range from screening, assessment, and referral of event, rather than expressing it in words. See
employees to community resources, through di- also psychodrama.
206
endogenous opioid
enantiodromia n. in the approach of Carl murmur, and minute hemorrhages (particularly

jung, the “necessary opposition” that governs in the extremities and conjunctiva of the eye).
psychic life, as in the interplay between con- endocathection n. the inward focusing of psy-
scious and unconscious, introverted and extra- chic energy and withdrawal from external pur-
verted tendencies, and the ego and shadow. suits. Compare exocathection. See cathexis.
encapsulated delusion a delusion that does [defined by U.S. psychologist Henry Alexander
not significantly affect the person’s functioning Murray (1893–1988)]
or everyday behavior. endocrine gland any ductless gland that se-
encapsulation n. the process of separating or cretes hormones directly into the bloodstream to
keeping separate, particularly the ability of some act on distant targets. Such glands include the pi-
people experiencing delusions to maintain high tuitary gland, adrenal gland, thyroid E
levels of functioning and prevent their delusions gland, gonads (testis and ovary), and islets of
from pervading everyday behavior and cognitive langerhans.
states.
endocrine system the set of endocrine
encephalization n. a larger than expected glands, which synthesize and secrete hor-
brain size for a species, given its body size. For ex- mones into the bloodstream.
ample, an average person weighing 140 lb has an
actual brain weight of 2.9 lb instead of the pre- endocrinology n. the study of the morphology,
dicted 0.6 lb. This enlargement is the result of physiology, biochemistry, and pathology of the
evolutionary advancement, with the brains of endocrine glands. See also neuroendocrin-
higher species increasing in anatomical com- ology. —endocrinological adj. —endocri-
plexity as cognitive functions are transferred nologist n.
from more primitive brain areas to the cerebral end of life the variable period during which in-
cortex. dividuals and their families, friends, and care-
encephalofacial angiomatosis see sturge– givers face issues and decisions related to the
weber syndrome. imminent prospect of death. The end-of-life
concept is a way of considering the total context
encoding n. the conversion of a sensory input of an approaching death, rather than medical
into a form capable of being processed and de- factors only. End-of-life issues include decisions
posited in memory. Encoding is the first stage of relating to the nature of terminal care (hospice
memory processing, followed by retention and or traditional), whether to resuscitate, the distri-
then retrieval. bution of property and assets, funeral and me-
encopresis n. repeated defecation in inappropri- morial arrangements, and leave taking and
ate places (clothing, floor, etc.) that occurs after possible reconciliations with family and friends.
the age of 4 and is not due to a substance (e.g., See also advance directive; informed con-
a laxative) or to a general medical condition. sent.
Encopresis may or may not be accompanied by
endogenous adj. originating within the body as
constipation and is often associated with poor
a result of normal biochemical or physiological
toilet training and stressful situations. Compare
processes (e.g., endogenous opioids) or of pre-
fecal incontinence.
disposing biological or genetic influences (e.g.,
encounter group a group of individuals in endogenous depression). Compare exoge-
which constructive insight, sensitivity to others, nous. —endogenously adv.
and personal growth are promoted through di-
endogenous depression depression that oc-
rect interactions on an emotional and social
curs in the absence of an obvious psychological
level. The leader functions as a catalyst and facil-
stressor and in which a biological or genetic
itator rather than as a therapist and focuses on
cause is implied. Compare reactive depres-
here-and-now feelings and interaction, rather
sion.
than on theory or individual motivation.
encounter movement a trend toward the for- endogenous opioid a substance produced in
mation of small groups in which various tech- the body that has the analgesic and euphoric ef-
niques, such as confrontation, games, and fects of morphine. Three families of endogenous
reenactment, are used to stimulate awareness, opioids are well known: the enkephalins,
personality growth, and productive interactions. endorphins, and dynorphins. All are
The movement gained popularity in the 1960s neuropeptides that bind to opioid receptors
but diminished at the end of the 20th century. in the central nervous system; they are mostly
inhibitory, acting like opiates to block pain.
endemic adj. occuring in a specific region or They bind relatively nonselectively to opioid re-
population, particularly with reference to a dis- ceptors, although enkephalins bind preferen-
ease or disorder. Compare epidemic; pandemic. tially to the delta opioid receptors and
endocarditis n. inflammation of the endo- dynorphins to kappa receptors. Recently, three
cardium, the inner lining of the heart, and often other endogenous opioid peptides have been
the heart valves. It is typically caused by bacte- identified: orphanin (nociceptin) and
rial or fungal infections. Primary diagnostic endomorphins 1 and 2. Also called opioid neu-
symptoms include fever, new or changing heart rotransmitter.
207
endogenous smile
endogenous smile a spontaneous or reflexive feces in the bowel. This condition is often associ-
smile that is observed when an infant, early in ated with eating disorders in which enemas
life, is in a state of rem sleep. Characterized by a are routinely used for purging. See also
simple turning up of the corners of the mouth, klismaphilia; laxative addiction.
such smiles are seen from birth and are not elic- enervate vb. 1. to weaken or deprive of energy.
ited by social stimulation. 2. to surgically remove a nerve or a part of a
endomorph n. in sheldon’s constitutional nerve. —enervation n.
theory of personality, a constitutional type engendering psychology the project of de-
characterized by a soft, round physique, which— veloping an approach to psychological issues
according to this theory—is highly corre- that is sensitive to questions of gender. See femi-
E lated with viscerotonia. Also called endo- nist psychology; woman-centered psy-
morphic body type. —endomorphic adj. chology. [introduced by U.S. psychologist
—endomorphy n. Florence L. Denmark (1932– )]
endophenotype n. a type of biological engulfment n. 1. extreme distress and anxiety
marker that is simpler to detect than genetic se- related to feelings of being taken over by an
quences and that may be useful in researching external force. 2. fear of close interpersonal re-
vulnerability to a wide range of psychological lationships because of a perceived loss of inde-
and neurological disorders. Endophenotypes pendence and selfhood. This fear is common in
may be a useful link between genetic sequences those with feelings of personal insecurity, who
and their external emotional, cognitive, or be- experience relationships as overwhelming threats
havioral manifestations. to personal identity. It may also be associated
endopsychic adj. pertaining to unconscious with borderline personality disorder. [first
material or intrapsychic processes (i.e., processes described by British psychiatrist R. D. Laing
occurring within the mind). Compare exopsy- (1927–1989)]
chic. Enlon n. a trade name for edrophonium.
endopsychic structure in psychoanalysis, the enmeshment n. a condition in which two or
internal structure of the mind or psyche. In more people, typically family members, are in-
Sigmund freud’s formulation the mind is di- volved in each other’s activities and personal re-
vided into three components: the id, ego, and lationships to an excessive degree, thus limiting
superego. See structural model. or precluding healthy interaction and compro-
endorphin n. any of a class of neuropeptides, mising individual autonomy and identity.
found mainly in the pituitary gland, that func- enriched environment an environment that
tion as endogenous opioids. The best known is offers many opportunities to engage in activity
beta-endorphin; the others are alpha-endor- and provides plenty of sensory and intellectual
phin and gamma-endorphin. The production of stimulation. See enrichment.
endorphins during intense physical activity is
one explanation for the runner’s high or exercise enrichment n. 1. enhancement or improve-
high, as well as for an athlete’s ability to feel little ment by the addition or augmentation of some
or no pain during a competition. desirable property, quality, or component. For
example, the Instrumental Enrichment program
end-stage renal disease the terminal stage of was originally designed to help pupils with men-
chronic kidney failure, indicating the necessity tal retardation improve their metacognitive and
for the individual with the disease to undergo re- cognitive skills; job enrichment policies are de-
placement therapy (hemodialysis, peritoneal di- signed to enhance quality of worklife and thus
alysis, or kidney transplant) in order to survive. employees’ interest in and attitude toward work
The psychological effects of living with the con- tasks; and marriage-enrichment groups are
dition and its treatment can include depression intended to enhance the interpersonal relation-
arising from a sense of lost or limited personal ships of married couples. 2. the provision of
control due to dependence on a dialysis ma- opportunities to increase levels of behavioral
chine, to dialysis-related diet restrictions, and or intellectual activity in an otherwise unstim-
the like. Body-image problems caused by trans- ulating (i.e., impoverished) environment. For
plantation can develop as well. example, the provision of play materials and
enelicomorphism n. see adultomorphism. opportunities for social contacts has been shown
enema n. the injection of a liquid into the rectum to enhance the development of young children.
via the anus to empty the bowel. It is also used enthusiasm n. a feeling of excitement or pas-
for introducing radiopaque contrast media into sion for an activity, cause, or object. —enthusi-
the bowel for radiography and also for adminis- astic adj.
tration of certain drugs in solution for absorp- entitlement n. 1. rights or benefits legally be-
tion through the rectal mucosa. stowed on a person or group, for example, by
enema addiction a dependence upon enemas legislation or contract. 2. unreasonable claims to
to empty the bowel. Enema addiction may de- special consideration, especially as a disturbance
velop through the repeated use of enemas, of self-concept in narcissistic personality
which reduce rectal sensitivity to the presence of disorder. The exploitiveness–entitlement di-
208
environmental stress theory
mension of narcissism may be particularly useful vironmental assessment of employee job

for explaining why people with narcissistic per- satisfaction.
sonality disorder report higher rates of interper- environmental constraint any circum-
sonal transgressions in their daily lives. stance of a person’s situation or environment
entitlement program a program of the U.S. that discourages the development of skills and
government that provides financial assistance abilities, independence, social competence, or
and welfare benefits to individuals who meet re- adaptive behavior or inhibits the display of skills
quirements set by law, for example, people with previously acquired. For example, living in a
mental or physical disabilities. Entitlement pro- community residence where staff prepare all
grams are administered through medicare, the meals would act as an environmental con-
medicaid, social security disability insur- straint for someone who has learned how to E
ance, and similar funding sources. make sandwiches, since it would provide no op-
portunity to display this ability.
entity theory the belief that psychological at-
tributes, such as level of intelligence, are fixed, environmental deprivation an absence of
essential qualities rather than attributes that de- conditions that stimulate intellectual and be-
velop gradually. [formulated by U.S. personality havioral growth and development, such as edu-
psychologist Carol S. Dweck (1946– ) in her cational, recreational, and social opportunities.
analysis of cognition, personality, and motiva- Environmental deprivation is often associated
tion] with social isolation and may be so severe that it
causes pseudoretardation.
entrapment n. a pathological condition in environmental determinism the view that
which swelling of surrounding tissue places ex-
psychological and behavioral characteristics are
cessive pressure on a nerve. Fibers located on the
largely or completely the result of environmen-
surface of the nerve usually bear the brunt of the
tal conditions. Biological factors are considered
compression, while interior fibers tend to be less
to be of minor importance, exerting little if
affected. Repeated or long-term entrapment can
any influence. Compare biological determin-
cause nerve damage and muscle weakness.
ism; genetic determinism. See determinism;
enucleation n. the removal of an entire organic nature–nurture.
structure, such as a tumor or a bodily organ, environmentalism n. 1. the concept that the
without damaging the surrounding structure. environment and learning are the chief determi-
Enucleation often refers to the removal of an nants of behavior. They are, therefore, the major
eyeball in which the optic nerve and connective cause of interpersonal variations in ability and
eye muscles have been severed so that the eye adjustment; accordingly, behavior is largely
can be removed wholly and cleanly. See also modifiable. Compare hereditarianism. See
autoenucleation. also nature–nurture. 2. a social movement
enuresis n. repeated involuntary urination in and position that emphasizes the ecological rela-
inappropriate places (clothing, floor, etc.) that tionship between humans and the natural envi-
occurs after the chronological age when conti- ronment and strives to protect the environment
nence is expected (generally 5 years old) and is as an essential resource. —environmentalist
not due to a substance (e.g., a diuretic) or to a n.
general medical condition. Enuresis may occur environmental load theory the theory that
during the day (diurnal enuresis), night (noctur- humans have a limited ability to handle envi-
nal enuresis), or both and is frequently associ- ronmental stimuli. The limit is determined by
ated with delayed bladder development, poor the amount of information inputs that can be
toilet training, and stressful situations. See also processed by the central nervous system. When
bed-wetting. Compare urinary incontinence. the environmental load exceeds the individual’s
environmental approach a therapeutic ap- capacity for processing, the central nervous sys-
proach in which efforts are directed either totem reacts by ignoring some of the inputs. See
ward reducing external pressures (e.g., employ- also cognitive overload; information over-
ment or financial problems) that contribute to load; sensory overload; stimulus over-
emotional difficulties or toward modifying as- load.
pects of the individual’s living or working space environmental manipulation a method of
to improve functioning. improving the well-being of people by changing
their living conditions, for example, by placing
environmental assessment the evaluation
an abused or delinquent child in a foster home
of situational and environmental variables that
or by transferring an adult patient from a mental
have an influence on behavior, based on the the-
institution to an adult home or a halfway
ory that disordered functioning may be rooted
house.
partly in the social system, or particular social
context, rather than wholly in the individual environmental stress any kind of stress
and his or her personal characteristics. In an or- caused by factors in the environment.
ganizational context, for example, measures of environmental stress theory the concept
manager support and availability of resources to that autonomic and cognitive factors combine
accomplish a job would likely be used in the en- to form an individual’s appraisal of stressors in
209
environmental therapy
the environment as threatening or nonthreaten- which the enzyme acts), or irreversible, when a
ing. Stressors perceived as threatening may lead drug binds so completely to an enzyme that it
to stress reactions involving physiological, emo- fundamentally alters the enzyme and even par-
tional, and behavioral elements, which in turn tial metabolism of other substances cannot take
may elicit strategies designed to cope with and place.
potentially adapt to the threat. eonism n. the adoption by a male of a female
environmental therapy therapy that in- role, or vice versa, as in transvestism. Eonism is
cludes and addresses the client’s interaction with named for Charles Eon de Beaumont, a French
his or her physical or social surroundings (or political adventurer, who died in 1810 after pos-
both) in an effort to promote greater cognitive, ing as a woman for many years.
E affective, and behavioral health. See milieu epena n. a hallucinogenic snuff prepared from
therapy; therapeutic community. the bark of South American trees of the genus
envy 1. n. a negative emotion of discontent Virola and used in Colombia, Brazil, and Vene-
and resentment generated by desire for the pos- zuela. The bark is scraped from the trees and
sessions, attributes, qualities, or achievements of boiled to extract a red resin that is dried, ground,
another (the target of the envy). Unlike jeal- and mixed with wood ash. The active agents,
ousy, with which it shares certain similarities which include dimethyltryptamine (see dmt),
and with which it is often confused, envy need produce effects that are comparable to those of
involve only two individuals: the envious per- lsd. Also called nyakwana; parica; yakee.
son and the person envied. 2. vb. to feel such dis- ephebophilia n. sexual attraction to and
content or resentment. —envious adj. arousal by adolescent children, usually early ad-
olescents who are just going through puberty.
enzyme n. a protein that acts as a biological cata-
lyst, accelerating the rate of a biochemical reac- ephedra n. a bushy shrub (Ephedra sinica),
tion without itself becoming permanently known to Chinese herbalists as ma huang, that is
altered. Many enzymes require other organic indigenous to arid regions of the world, particu-
molecules (coenzymes) or inorganic ions (co- larly Mongolia and northern China. The leaves
factors) to function normally. Most enzymes are contain significant amounts of the alkaloid stim-
named according to the type of reaction they ulants ephedrine and pseudoephedrine and are
catalyze; for example, glucosidases convert traditionally made into a tisane and drunk as
glucosides to glucose; acetylcholinesterase (see a stimulating beverage. Both ephedrine and
cholinesterase) splits and inactivates mol- pseudoephedrine are strong sympathomimetic
ecules of the neurotransmitter acetylcholine. agents and therefore increase blood pressure,
alertness, and anxiety, as well as causing periph-
enzyme induction the ability of drugs or other eral symptoms of sympathetic activity (e.g.,
substances to increase the activity of enzymes, tremor, sweating). These agents also relax
especially hepatic (liver) enzymes, that are re- smooth muscle, hence the plant and its active
sponsible for the metabolism of those drugs or components have often been used as a remedy
other substances. The cytochrome p450 for asthma or other respiratory complaints. In
hepatic enzymes, which are responsible for the addition, ephedra has been combined into many
metabolism of numerous psychotropic com- dietary supplements that are reputed to aid
pounds, are susceptible to induction. Barbitu- weight loss, increase energy, and enhance ath-
rates, some anticonvulsants, and steroids may letic performance. There is, however, little evi-
induce hepatic enzymes, usually resulting in a dence of ephedra’s effectiveness for these uses
decrease in activity of the drug or other sub- except for modest, short-term weight loss with-
stances metabolized via the same enzyme sys- out any clear health benefit. It is toxic and po-
tem. Substances contained in cigarette smoke, tentially fatal, particularly in high doses or when
charbroiled meat, and environmental pollutants combined with other stimulants, such as caf-
are also capable of enzyme induction. feine. In 2004 the U.S. Food and Drug Adminis-
enzyme inhibition the ability of drugs or tration banned the sale of products containing
other substances to impair or arrest the ability of ephedra, the first U.S. government ban of a di-
enzymes, especially liver (hepatic) enzymes, to etary supplement.
metabolize those drugs or other substances. The ephedrine n. see ephedra.
cytochrome p450 enzymes that are respon-
EPI 1. abbreviation for extrapyramidal involve-
sible for the metabolism of numerous psy-
ment. See extrapyramidal symptoms. 2. ab-
chotropic drugs are susceptible to inhibition by
breviation for eysenck personality inventory.
psychotropics or other substances. Many of the
SSRIs (selective serotonin reuptake inhibitors) epidemic adj. generally prevalent: affecting a
inhibit the activity of enzymes for which they significant number of people, particularly with
are substrates, leading to increased concentra- reference to a disease or disorder not ordinarily
tions of the SSRIs or other drugs that are metabo- present in a specific population or present at a
lized by the same enzyme. Enyzme inhibition much higher rate than is typical. Compare en-
can be competitive, when a drug partially inhib- demic; pandemic.
its an enzyme by competing for the same bind- epidemic catalepsy a situation in which cat-
ing site as the substrate (the compound on alepsy occurs in a number of individuals at the
210
episodic disorder
same time as a result of identification or imita- bles an epileptic seizure but is unrelated to
tion. epilepsy. See also nonepileptic seizure.
Epidemiologic Catchment Area Survey epileptoidism n. see epileptoid personality.
(ECA Survey) a telephone survey of mental dis- epileptoid personality a personality pattern
orders carried out in two waves from 1980 to that includes such traits as irritability, selfish-
1985 using DSM–III and the diagnostic inter- ness, uncooperativeness, and aggressiveness.
view schedule (DIS). More than 20,000 people This personality pattern is believed by some to
were surveyed in households, group homes, and be associated with epilepsy. Also called epilep-
long-term care institutions across the United toidism.
States to obtain information on the prevalence
and incidence of mental disorders, the use of ser- epinephrine n. a catecholamine neurotrans-
mitter and adrenal hormone that is the end E
vices for mental health problems, and the extent
to which those with mental disorders are product of the metabolism of the dietary amino
underserved. acid tyrosine. It is synthesized primarily in the
adrenal medulla by methylation of norepineph-
epidemiology n. the study of the incidence and rine, which itself is formed from dopamine by
distribution of specific diseases and disorders. the action of the enzyme dopamine β-hydroxy-
The epidemiologist also seeks to establish rela- lase. As a hormone, it is secreted in large
tionships to such factors as heredity, environ- amounts when an individual is stimulated by
ment, nutrition, or age at onset. Results of fear, anxiety, or a similar stressful situation. As a
epidemiological studies are intended to find neurotransmitter, it is the primary stimulant of
clues and associations rather than necessarily to both alpha-adrenergic receptors and beta-
show causal relationships. See also incidence; adrenergic receptors. Thus it increases the
prevalence; relative risk. —epidemiologic heart rate and force of heart contractions, relaxes
or epidemiological adj. bronchial and intestinal smooth muscle, and
epigenesis n. 1. the theory that characteristics of produces varying effects on blood pressure as it
an organism, both physical and behavioral, arise acts both as a vasodilator and vasoconstrictor.
from an interaction between genetic and envi- Also called adrenaline.
ronmental influences rather than from one or
epiphany n. a sudden perception of the essential
the other. See also nature–nurture. 2. in ge-
nature of oneself, others, or reality.
netics, the occurrence of a heritable change in
gene function that is not the result of a change in epiphenomenalism n. the position that
the base sequence of the organism’s DNA. 3. in bodily (physical) events produce mental events,
the theory of Erik erikson, the emergence of dif- such as thoughts and feelings, but that mental
ferent goals at each stage of ego and social devel- events do not have causal power to produce
opment. See erikson’s eight stages of bodily (physical) events. Thus, causality between
development. —epigenetic adj. the mental and the physical proceeds in one di-
rection only. A more radical form of the same
epigenetic theory the concept that mind and
position would add that mental events lack
consciousness developed when living organisms
causal efficacy to produce anything, including
reached a high level of complexity. See emer-
other mental events. An example of this radical
gence.
position is the claim that consciousness is
epilepsy n. a group of chronic brain disorders as- merely a side effect of the functioning of the
sociated with disturbances in the electrical dis- brain, with no causal connection to it. See also
charges of brain cells and characterized by mind–body problem; reductionism. [coined
recurrent seizures, with or without clouding or by British philosopher and psychologist James
loss of consciousness. Symptomatic epilepsy is Ward (1843–1925)]
due to known conditions, such as brain inflam-
mation, brain tumor, vascular disturbances,
epiphora n. excessive secretion of tears, which is
most commonly due to an organic condition
structural abnormality, brain injury, or degener-
causing an insufficient drainage of tears but may
ative disease; idiopathic epilepsy is of unknown
be associated with emotional stress, such as
origin or is due to nonspecific brain defects.
chronic anxiety or fear.
Types of seizure vary depending on the nature of
the abnormal electrical discharge and the area of episode n. a noteworthy isolated event or series
the brain affected (see absence seizure; gener- of events. An episode of an illness is an isolated
alized seizure; partial seizure; tonic– occurrence, which may be repeated.
clonic seizure). Epilepsy was formerly known episodic amnesia a loss of memory only for
as falling sickness. Also called seizure disor- certain significant events. Episodic amnesia may
der. —epileptic adj. also involve a transient ability to recall an event
epileptic cry a momentary cry produced by followed by periods of inability to access the
sudden contraction of the chest and laryngeal memory.
muscles during the tonic phase of a tonic– episodic buffer see working memory.
clonic seizure. Also called initial cry.
episodic disorder any disorder characterized
epileptic furor see furor. by the appearance of symptoms in discrete,
epileptiform seizure an episode that resem- often brief, periods or episodes.
211
episodic memory
episodic memory the ability to remember per- learning and certain other complex processes,
sonally experienced events that happened at a such that intact cortical areas can assume to
particular time and place. As defined in 1972 by some extent the functions of damaged or de-
Estonian-born Canadian psychologist Endel stroyed areas. Proposed in 1929 following exper-
Tulving (1927– ), episodic memory supple- imental observations of the effects of different
ments semantic memory as a form of declara- brain lesions on rats’ ability to learn a complex
tive memory. Although Tulving’s original maze, the concept has been challenged by subse-
description of episodic memory required recol- quent research showing that areas of cortex have
lecting the three ‘Ws’ of an event—what, where, relatively specific functions. See also mass ac-
and when—it has since been revised to include a tion.
sense of self-awareness and a subjective con- equity theory see social exchange theory.
E scious experience as well (termed autonoetic
equivalence n. a relationship between two or
consciousness). In other words, in addition to re-
more items (e.g., stimuli or variables) that per-
calling the facts of a past event, an individual
mits one to replace another.
also has to engage in “mental time travel” and
remember that he or she was the one who lived equivocal sign see soft sign.
the event. The hippocampus plays a key role in erectile dysfunction the lack or loss of ability
episodic memory formation and retrieval. In- to achieve an erection. Causes of erectile dys-
deed, atrophy of this area and structures in the function may be psychological or physical, in-
associated hippocampal formation is a hall- cluding the effects of medications or drug abuse.
mark feature of Alzheimer’s disease, although If a man normally experiences a nocturnal erec-
episodic memory also declines considerably tion or is able to induce an erection by masturba-
with normal aging. See also autobiographical tion, but cannot achieve or maintain an erection
memory. during sexual intercourse, the dysfunction is as-
epistemological loneliness a profound sense sumed to be due largely or solely to psychologi-
of alienation or separation from others. cal factors and in DSM–IV–TR is called male
erectile disorder. See also primary erectile
epistemophilia n. the love of knowledge: the dysfunction; secondary erectile dysfunc-
impulse to investigate and inquire. See also cu-
tion.
riosity.
eremophilia n. a pathological desire to be
EPPS abbreviation for edwards personal pref- alone.
erence schedule.
erethism n. 1. an abnormally high degree of sen-
EPQ abbreviation for Eysenck Personality Ques- sitivity to sensory stimulation in some or all
tionnaire. See eysenck personality inven- parts of the body. It is associated with a number
tory. of conditions and is a major symptom of mer-
EPS abbreviation for extrapyramidal symp- cury poisoning. See also mad hatter’s disease.
toms. 2. any abnormally high degree of sensitivity, ex-
EPSDT abbreviation for early and periodic citability, or irritability in response to stimula-
screening, diagnosis, and treatment. tion, such as emotional erethism.
epsilon alcoholism the least common of the erg n. 1. a term used by British-born U.S. psychol-
five types of alcoholism defined by U.S. physi- ogist Raymond B. Cattell (1905–1998) in prefer-
cian Elvin M. Jellinek (1890–1963), the others ence to drive or instinct, to denote a type of
being alpha alcoholism, beta alcoholism, innate dynamic trait that directs an individual
gamma alcoholism, and delta alcoholism. toward a goal and provides the motivational en-
It is characterized by periodic drinking bouts or ergy to obtain it. Examples include curiosity,
binges interspersed with dry periods lasting self-assertion, gregariousness, protectiveness,
weeks or months. and hunger. 2. in physics, a unit of work or en-
ergy.
Epstein–Barr virus (EBV) a herpes virus that
is the cause of infectious mononucleosis. It is ergasiology n. see psychobiology.
commonly found in the extracellular oral fluids ergic trait a dynamic trait that motivates an in-
of those who have been exposed to the disease. dividual to achieve an objective.
The virus has also been isolated from the cells of ergomania n. a compulsion to work and keep
patients with certain cancers (e.g., Burkitt’s lym- busy. Also called workaholism. See worka-
phoma). [Michael Anthony Epstein (1921– ) holic.
and Yvonne M. Barr (1932– ), British patholo-
gists] ergonovine n. see ergot derivatives; oxyto-
cics.
EQ abbreviation for
.
ergot alkaloids pharmacologically active sub-
stances derived from the parasitic fungus Clavi-
equal-interval scale see interval scale. ceps purpurea, which grows naturally on rye and
equipotentiality n. U.S. psychologist Karl S. other grains. Although highly toxic, ergot alka-
lashley’s generalization that large areas of cere- loids have been used for centuries by midwives
bral cortex have equal potential to perform par- to induce abortion or labor. A number have been
ticular functions, being equally involved in isolated, including lysergic acid, and the com-
212
erotic delusion
pounds are sometimes utilized as adrenoreceptor of adolescence. Erikson argued for the impor-
blocking agents (see ergot derivatives). Epi- tance of researching individual life histories in
demics of ergot poisoning (ergotism) were wide- personality theory, opposing the trend toward
spread until relatively modern times in Europe; the use of aggregate statistics in his field. Erik-
symptoms included peripheral vasoconstriction son’s most influential works include Childhood
(rarely gangrene) and changes in mental func- and Society (1950) and Identity: Youth and Crisis
tioning, including visual hallucinations. Because (1968), as well as two psychobiographies, Young
of the pharmacological relationship between ergot Man Luther (1958) and Ghandi’s Truth (1969).
and lsd (lysergic acid diethylamide), the halluci- See also epigenesis; psychobiography; psycho-
nogenic effects are similar to those of LSD. history.
ergotamine n. an alkaloid drug (an ergot de- Erikson’s eight stages of development E
rivative) used in the treatment of vascular the theory of psychosocial development pro-
headaches, including migraines. The exact na- posed by Erik erikson, in which ego identity is
ture of its therapeutic action is unknown, but gradually achieved by facing positive goals and
ergotamine is believed to constrict the dilated negative risks during eight stages of develop-
cranial blood vessels responsible for the head- ment across the lifespan. The stages are: (a) in-
ache symptoms. U.S. trade name (among oth- fancy: basic trust versus mistrust; (b)
ers): Cafergot. toddler: autonomy versus shame and doubt;
(c) preschool age: initiative versus guilt; (d)
ergot derivatives a group of adrenergic
school age: industry versus inferiority; (e)
blocking agents with selective inhibitory ac-
adolescence: identity versus identity confu-
tivity, derived from ergot alkaloids. Ergot de-
sion; (f) young adulthood: intimacy versus
rivatives act on the central nervous system in a
isolation; (g) middle age: generativity ver-
complex manner and, in various forms and
sus stagnation; and (h) older adulthood: in-
doses, can both stimulate and depress higher
tegrity versus despair.
brain centers. A circulatory effect is vasocon-
striction. Some of these agents, including erogenous zone an area or part of the body sen-
ergotamine, are used in the control of migraine sitive to stimulation that is a source of erotic or
headaches, sometimes combined with other sexual feeling or pleasure. Among the primary
drugs (e.g., caffeine). The derivative ergonovine zones are the genitals, buttocks and anus, the
is used as an oxytocic. breasts (especially the nipples), and the mouth.
Erhard Seminar Training (est; EST) a con- Eros n. the god of love in Greek mythology
troversial group therapy technique and personal (equivalent to the Roman Cupid), whose name
development training system introduced in 1971. was chosen by Sigmund freud to designate a
It purports to be consciousness-expanding, bor- theoretical set of strivings oriented toward sexu-
rowing from business-world motivation tech- ality, development, and increased life activity
niques and various theories of psychology. It was (see life instinct). In Freud’s dual instinct
renamed Landmark Forum in 1985. [Werner Er- theory, Eros is seen as involved in a dialectic
hard (born John Paul Rosenberg; 1935– ), U.S. process with thanatos, the striving toward re-
consultant and lecturer] duced psychical tension and life activity (see
death instinct). See also libido.
Ericksonian psychotherapy a form of psy-
chotherapy in which the therapist works with
erotica pl. n. literature, illustrations, motion pic-
tures or other artistic material likely to arouse
the client to create, through hypnosis (specifi-
sexual response. The term is sometimes used in-
cally through indirect suggestion) and sugges-
terchangeably with pornography. However,
tive metaphors, real-life experiences intended to
the distinction is often made that erotica, unlike
activate previously dormant, intrapsychic re-
pornography, does not involve violence, coer-
sources. Also called Ericksonian hypnother-
cion, or exploitative sexuality, instead depicting
apy. [Milton H. Erickson (1902–1980), U.S. psy-
sexuality in a positive manner.
chiatrist and psychologist]
erotic-arousal pattern the sequence of ac-
Erikson, Erik H. (1902–1994) German-born tions or stimuli that produces sexual response.
U.S. psychologist. Originally called Erik Hom- The actions or stimuli vary with different spe-
burger, he lived from 1927 to 1933 in Vienna, cies: In humans they may involve dress, per-
where he underwent training in psychoanaly- fume, music, and foreplay.
sis with Anna freud for 3 years. When the Nazis
rose to power, Erikson emigrated with his wife erotic asphyxiation sexual pleasure associ-
Joan to the United States, where he spent the ated with restriction of breathing during sexual
bulk of his career at Harvard University. Erikson activity. See asphyxophilia; autoerotic as-
is best known as a personality theorist and pre- phyxiation.
eminent figure in the field of ego psychology. erotic delusion the false perception or belief
His theory of the eight stages of the life cycle (see that one is loved by or has had a sexual af-
erikson’s eight stages of development) con- fair with a public figure or other individual.
tained the development of self-identity as its Also called erotomanic delusion. See clér-
central theme; he coined the term identity cri- ambault’s syndrome; delusional disorder;
sis to describe the crucial developmental process erotic paranoia; simenon’s syndrome.
213
erotic instinct
erotic instinct 1. in psychoanalytic theory, the erotomania n. 1. a preoccupation with sexual

sex drive or libido. 2. eros, or the life in- activities, thoughts, and fantasies. 2. the false be-
stinct. lief that one is loved by another person. See
eroticism n. 1. the quality of being sexually erotic delusion. 3. compulsive, insatiable sex-
arousing or pleasurable or the condition of being ual activity with the opposite sex. Also called
sexually aroused. 2. a preoccupation with or sus- aidoiomania. See don juan; nymphomania;
ceptibility to sexual excitement. 3. the use of satyriasis. —erotomanic adj.
sexually arousing themes, images, or suggestions erotomanic delusion see erotic delusion.
in entertainment or the arts. 4. in psychoana- erotophonophilia n. see lust murder.
lytic theory, the pleasurable sensations associ- ERP abbreviation for event-related potential.
E ated not only with stimulation of the genitals
error n. 1. in experimentation, any change in a
but also with nongenital parts of the body, such
as the mouth or anus (see anal eroticism; oral dependent variable not attributable to the ma-
eroticism). Also called erotism. See also nipulation of an independent variable. 2. in
autoeroticism; erotization. —erotic adj. statistics, a deviation of an observed score from a
true score, where true score is often defined by
eroticization n. see erotization. the mean of the particular group or condition in
erotic paranoia a disorder in which the indi- which the score being assessed for error occurs,
vidual experiences erotic delusions. Also or from the score predicted by a model.
called erotomanic-type delusional disorder. error of measurement any deviation or de-
See delusional disorder. See also cléram- parture of a measurement from its true value.
bault’s syndrome; simenon’s syndrome.
error rate the rate at which errors are made, for
erotic plasticity the degree to which sexual de- example, the proportion of an experimenter’s
sire and sexual behavior are shaped by social, data recordings that are wrong.
cultural, and situational factors. See behavioral error score in classical test theory, the dif-
plasticity. ference between a person’s observed measure-
erotic pyromania see pyrolagnia. ment or score and his or her expected
erotic type see libidinal types. measurement or score.
erotism n. see eroticism. error term the element of a statistical equation
that indicates what is unexplained by the inde-
erotization n. the investment of bodily organs pendent variables. Also called disturbance
and biological functions or other not specifically term; residual term.
sensual or sexual activities with sexual pleasure
and gratification. Common examples are the error variance unexplained variability in a
erotization of certain areas of the body, such as score that is produced by extraneous factors,
the oral or anal erogenous zones; organs, such such as measurement imprecision, and is not at-
as the nipple or skin; functions, such as sucking, tributable to the independent variable or
defecation, urination, or scopophilic activities other controlled experimental manipulations.
(looking at nudity or sexual activity); and olfac- erythema multiforme major see stevens–
tory sensations associated with sex. Theo- johnson syndrome.
retically, almost any interest or activity can be Esalen Institute an alternative educational
erotized by the individual; for example, activi- center in California, founded in 1962, where en-
ties such as dancing and eating are not infre- hancement of well-being is approached through
quently seen as erotic or as having erotic a number of meditative and new-age therapies.
components. Also called eroticization; libi- Therapists and members of the general public
dinization; sexualization. —erotize vb. participate in seminars, workshops, experiential
erotogenesis n. in psychoanalytic theory, the programs, and other events that are designed to
origination of erotic impulses from sources that promote self-exploration and enhance relation-
may include the anal, oral, and genital zones. See ships with others.
erotization. escalation of commitment continued com-
erotogenic adj. denoting or relating to any stim- mitment and increased allocation of resources to
ulus that evokes or excites sexual feelings or re- a failing course of action, often in the hope of re-
sponses. Also called erotogenetic. couping past losses associated with that course
of action. It is often associated with expenditures
erotogenic masochism see primary mas- and decision making in the development of new
ochism. products, when a company increases the alloca-
erotographomania n. an obsession with tion of resources to a failing product, regardless
erotic writing that is accompanied by a patho- of the low probability of its success, in an at-
logical compulsion to write about sexual matters tempt to recover some of its initial investment.
or draw sexual images, typically expressed Also called creeping commitment.
through anonymous love letters or graffiti. escape behavior any response designed to
erotolalia n. speech that contains sexual ob- move away from or eliminate an already present
scenities, particularly as used to enhance gratifi- aversive stimulus. Escape behavior may be men-
cation during sexual intercourse. tal (through fantasy or daydreams) or behavioral
214
ethanol
(physical withdrawal from a noxious stimulus or or separation from oneself or others. See
a conditioned response, as when an animal taps alienation. 2. a significant decrease or discon-
a lever in order to terminate a shock). See also tinuation of contact with individuals with
active avoidance. Compare avoidance be- whom one formerly had close relationships,
havior. such as a spouse or family member, due to apa-
escape from freedom a false solution to the thy or antagonism. —estranged adj.
individual’s problems of loneliness and isola- estrogen n. any of a class of steroid hormones
tion, in which he or she seeks refuge in social that are produced mainly by the ovaries and act
conformity. See also identity need. [defined by as the principal female sex hormones, inducing
Erich fromm] estrus in female mammals and secondary female
escape from reality a defensive reaction in- sexual characteristics in humans. The estrogens E
volving the use of fantasy as a means of avoiding occurring naturally in humans are estradiol,
conflicts and problems of daily living. See also estrone, and estriol, secreted by the ovarian folli-
flight from reality. cle, corpus luteum, placenta, testes, and adrenal
escape into illness see flight into illness. cortex. Estrogens are also produced by certain
plants; these phytoestrogens may be used in the
escape mechanism see defense mechanism. manufacture of synthetic steroid hormones.
escapism n. the tendency to escape from the real Estrogens are used therapeutically in estrogen
world to the delight or security of a fantasy replacement therapy and oral contraceptives
world. Escapism may reflect a periodic, normal, and to treat certain menstrual disorders and
and common impulse, as might be seen in harm- some types of breast and prostate cancers.
less daydreams, or it may be evidence of or ac- estrogen antagonist see antiestrogen.
company other symptoms of neurosis or more
serious mental pathology. —escapist adj. estrogen replacement therapy the admin-
istration of natural or synthetic estrogens, such
Eskalith n. a trade name for lithium.
as estradiol or ethinyl estradiol, for the relief of
espanto n. see susto. symptoms associated with menopause, surgical
essential dysmenorrhea see dysmenorrhea. removal of the ovaries, or failure of the ovaries to
essential hypertension high blood pressure develop. Although estrogen replacement ther-
(see hypertension) that is not secondary to an- apy is an extremely common therapy in meno-
other disease and for which no obvious cause pausal women, recent studies have questioned
can be found. It accounts for at least 85% of all its material long-term benefits. See hormone
cases of hypertension; predisposing factors in- replacement therapy.
clude obesity, cigarette smoking, genetic factors, estrone n. an estrogen produced by ovarian
and psychological influences (e.g., an aggressive follicles and other tissues. It is used therapeuti-
personality or stressful environment). See also cally in the treatment of menopausal and other
type a personality. estrogen-deficiency disorders (see estrogen re-
est (EST) abbreviation for erhard seminar placement therapy) and in certain cases of
training. vaginitis.
EST 1. abbreviation for electroshock therapy or eszopiclone n. a nonbenzodiazepine hypnotic
electroconvulsive shock therapy. See electro- used for the short-term treatment of insomnia.
convulsive therapy. 2. see est. Like the related drug zaleplon, it is relatively se-
estazolam n. a high-potency benzodiazepine lective for a specific subunit on the gabaa recep-
used for the short-term treatment of insomnia tor complex. Side effects include excessive
(see hypnotic). U.S. trade name: ProSom. sedation or confusion, dry mouth, and a bitter
taste. U.S. trade name: Lunesta.
esteem need any desire for achievement, repu-
tation, or prestige that is necessary for a sense of ethanol n. a substance formed naturally or syn-
personal value and the development of self- thetically by the fermentation of glucose and
esteem. Comprising the fourth level of found in beverages such as beers, wines, and dis-
maslow’s motivational hierarchy, esteem tilled liquors. It is the most frequently used and
needs thus are dependent upon the admiration abused cns depressant in many cultures. When
and approval of others. consumed its primary effects are on the central
nervous system, mood, and cognitive functions.
estimate 1. n. a best guess of the value of a pa-
In small doses, it can produce feelings of
rameter of a distribution on the basis of a set of
warmth, well-being, and confidence. As more is
empirical observations. 2. vb. to assign a value to
consumed, there is a gradual loss of self-control,
a parameter in this way.
and speech and control of limbs become diffi-
estimator n. a quantity calculated from the val- cult; at high consumption levels, nausea and
ues in a sample according to some rule and used vomiting, loss of consciousness, and even fatal
to give an estimate of the value in a population. respiratory arrest may occur. Ethanol has been
For example, the sample mean is an estimator for mistakenly identified as a stimulant, since its
the population mean; the value of the sample stimulating effect derives from an associated loss
mean is the estimate. of cortical inhibition. Also called alcohol;
estrangement n. 1. a state of increased distance ethyl alcohol. See also alcohol abuse; alco-
215
ethchlorvynol
hol dependence; alcohol intoxication; alent relates to others, expresses himself or herself,
cohol withdrawal. and deals with problems. See also multicul-
ethchlorvynol n. an alcohol derivative intro- tural therapy.
duced in the 1950s as a nonbarbiturate sedative. ethosuximide n. see succinimide.
Ethchlorvynol is an effective, rapidly acting hyp- ethotoin n. see hydantoin.
notic, but because of its toxicity in overdose, as
well as its ability to induce enzymes involved in ethyl alcohol see ethanol.
drug metabolism (see enzyme induction) and etiology n. 1. the causes and progress of a disease
its association with blood disorders, it has be- or disorder. 2. the branch of medical and psy-
come clinically obsolete. It is at times a sub- chological science concerned with the system-
E stance of abuse. U.S. trade name: Placidyl. atic study of the causes of physical and mental
ether n. a drug introduced into medicine as a disorders. —etiological adj.
general anesthetic in the mid-1800s. The effects Etrafon n. a trade name for a combination of the
of ether include a progressive series of physical tricyclic antidepressant amitriptyline and the
and psychological reactions, beginning with a antipsychotic perphenazine, used for the treat-
feeling of suffocation, bodily warmth, visual and ment of concurrent anxiety and depression.
auditory aberrations, and a feeling of stiffness
E trisomy see trisomy 17–18.
and inability to move the limbs. A second stage
may be marked by some resistance to the sense euergasia n. normal mental or psychobiological
of suffocation of the anesthetic, but the muscles functioning. Also called orthergasia. [defined
relax, blood pressure and pulse increase, and pu- by U.S. psychiatrist Adolf Meyer (1866–1950)]
pils dilate. In the third stage, pulse and blood eugenics n. a social and political philosophy,
pressure return to normal, pupils contract, and based loosely on the evolutionary theory of
reflexes are absent. If additional ether is adminis- Charles Darwin (1809–1882) and the research on
tered beyond the third stage, there is danger of hereditary genius of Francis Galton (1822–1911),
paralysis of the medullary centers, followed by that seeks to eradicate genetic defects and im-
shock and death. In clinical practice, ether has prove the genetic makeup of populations
been replaced by safer anesthetics. through selective human breeding. Positive eu-
e-therapy n. an Internet-based form of dis- genics is directed toward promoting reproduc-
tance therapy used to expand access to clinical tion by individuals with superior traits, whereas
services typically offered face-to-face. This ther- negative eugenics is directed toward preventing
apy can be conducted in real-time messaging, in reproduction by individuals with undesirable
chat rooms, and in e-mail messages. Also called traits. The eugenic position is groundless and sci-
online therapy. entifically naive, in that many conditions associ-
ethical code see code of ethics. ated with disability or disorder, such as
syndromes that increase risk of mental retar-
ethical conflict see boundary issues; con- dation, are inherited recessively and occur un-
flict of interest; double-agentry. predictably. Nevertheless, the philosophy
ethics n. 1. the branch of philosophy that inves- gained popularity in the United Kingdom and
tigates both the content of moral judgments United States, where eugenic policies, such as
(i.e., what is right and what is wrong) and their sterilization of women with mental retardation,
nature (i.e., whether such judgments should be persisted into the latter half of the 20th century.
considered objective or subjective). The study of Attitudes toward genetics in the 21st century are
the first type of question is sometimes termed often influenced by individual and community
normative ethics and that of the second concerns about prior eugenic abuses.
metaethics. Also called moral philosophy. 2. eunuch n. a male who has been castrated before
the principles of morally right conduct accepted puberty and who therefore develops the second-
by a person or a group or considered appropriate ary sex characteristics of a female, such as a
to a specific field (e.g., medical ethics, ethics of higher voice and absence of facial hair. See also
animal research). See code of ethics; profes- castration.
sional ethics. —ethical adj.
euphenics n. interventions that aim to improve
ethnopsychology n. see cross-cultural psy- the outcome of a genetic disease by altering the
chology. environment to minimize expression of the dis-
ethnopsychopharmacology n. the branch of ease. For example, people with phenylketo-
pharmacology that deals with issues related to nuria can reduce or prevent its expression by
ethnic and cultural variations in the use of and eliminating major sources of phenylalanine
response to psychoactive agents across divergent (e.g., soft drinks sweetened with aspartame)
groups, as well as the mechanisms responsible from their diet.
for such differences. —ethnopsychopharma- euphoria n. an elevated mood of well-being and
cological adj. happiness. An exaggerated degree of euphoria
ethnotherapy n. therapy sensitive to the dis- that does not reflect the reality of one’s situation
tinct cultural features of a client from an ethnic is a frequent symptom of manic episodes and
minority and the various ways in which the cli- hypomanic episodes. —euphoric adj.
216
evidence-based practice
euphoriant n. a substance capable of inducing a rity, and program monitoring, whereas the pur-
subjective sense of well-being and happiness. pose of summative evaluations is to focus on
euphorogenic adj. describing an event or medi- program impact, program effectiveness, and cost
cation that generates a state of euphoria. analysis.
eureka task a problem-solving task designed to evaluation research the use of scientific prin-
investigate the phenomenon of sudden insight ciples and methods to assess the effectiveness of
into a problem’s solution. The route to solving social interventions and programs, including
the problem is usually not obvious, and usually those related to mental health, education, and
requires a mental leap of some kind beyond the safety (e.g., crime prevention, automobile acci-
sorts of solutions used for everyday problems. dent prevention). Evaluation research is thus a
See also aha experience; discontinuity hy- type of applied research. E
pothesis. evaluative reasoning a form of critical
European Federation of Professional thinking that involves appraisal of the effec-
Psychologists’ Associations (EFPPA) a tiveness, validity, meaning, or relevance of any
federation of national psychology associations act, idea, feeling, technique, or object.
founded in 1981 to provide a forum for Euro- evaluator n. an individual whose role is to eval-
pean cooperation in a wide range of fields of aca- uate and provide advice about the progress of a
demic training, psychology practice, and therapy or sensitivity group, a project team, an
research. institution, or an individual.
eustress n. the positive stress response, involving evasion n. 1. a form of paralogia in which an
optimal levels of stimulation: a type of stress that idea that is logically next in a chain of thought is
results from challenging but attainable and en- replaced by another idea closely but not accu-
joyable or worthwhile tasks (e.g., participating rately or appropriately related to it. 2. elusion or
in an athletic event, giving a speech). It has a avoidance.
beneficial effect by generating a sense of fulfill-
ment or achievement and facilitating growth, evenly hovering attention see free-
development, mastery, and high levels of perfor- floating attention.
mance. Compare distress. [first described by event-related potential (ERP) a specific pat-
Canadian physician Hans Selye (1907–1982)] tern of electrical activity produced in the brain
euthanasia n. the act or process of terminating a when a person is engaged in a cognitive act, such
life to prevent further suffering. Voluntary eu- as discriminating one stimulus from another.
thanasia requires the consent of a competent There are a number of different ERP compo-
person who has established a valid advance di- nents, including the highly researched P3 com-
rective or made his or her wishes otherwise ponent, and different cognitive operations have
clearly known. Euthanasia is distinguished from been associated with the amplitude and latency
the much more widely accepted practice of for- of each. Because ERPs provide specific infor-
going invasive treatments, as permitted under mation about the precise timing and (given ap-
natural-death laws throughout the United propriate caveats) location of mental events,
States. Traditionally, a distinction between pas- they can yield data about cognitive operations
sive euthanasia (withholding treatment) and not readily derived from behavioral measures
active euthanasia (taking directly lethal ac- and also serve as an important bridge between
tion) has been made. In current practice, how- psychological function and neural structures.
ever, the term euthanasia typically is used to Although the terms are sometimes used synony-
mean active euthanasia only. See also assisted mously, ERPs are distinct from evoked poten-
death. tials, which are associated with more
elementary sensory stimulation.
euthymia n. a mood of well-being and tranquil-
lity. The term often is used to refer to a state in everyday creativity the ability to think diver-
patients with a bipolar disorder that is neither gently and demonstrate flexibility and original-
manic nor depressive but in between, associated ity in one’s daily work and leisure activities.
with adaptive behavior and enhanced function- Examples include redecorating a room at home
ing. —euthymic adj. or devising a novel solution to a business prob-
evaluability-assessment data information lem. Also called ordinary creativity. Com-
sought to identify problematic areas of program pare exceptional creativity.
evaluation. Evaluability assessment comprises a everyday intelligence the intellectual skills
review of expectations for program performance used in everyday living (e.g., activities such as
and questions to be answered by evaluation price comparison shopping and using a map to
data, followed by a study of program implemen- travel unfamiliar streets). Everyday intelligence
tation to identify designs, measurements, and refers not to a psychometrically validated con-
analyses that are possible. struct but to a loosely conceptualized kind of in-
evaluation objective any of the purposes of telligence relevant to the problems people face
an evaluation of a program. For example, the on a daily basis.
purpose of formative evaluations is to con- evidence-based practice (EBP) the integra-
sider implementation problems, program integ- tion of the best available scientific research from
217
eviration
laboratory and field settings with clinical exper- tebrates, birds, fish, and reptiles. From those
tise so as to provide effective psychological ser- concentrations of brain tissue evolved the
vices that are responsive to a patient’s culture, forebrain, with its highly convoluted cere-
preferences, and characteristics (e.g., functional bral cortex, of mammals, especially promi-
status, level of social support, strengths). In unit- nent in whales, great apes, and Homo sapiens. See
ing researchers and practitioners, EBP ensures also cephalization; encephalization.
that the research on psychological assessment, evolved mechanism a subsystem of the brain
case formulation, intervention strategies, thera- (or mind) that is a product of natural selection
peutic relationships and outcomes, and specific and is generally seen as having evolved as a re-
problems and patient populations is both clini- sult of its success in solving a problem related to
cally relevant and internally valid. Clinical deci- survival or reproduction during the evolution of
E sions should be made in collaboration with the a species. For example, the elements of the
patient, based on relevant data, and with consid- brain’s visual system that enable organisms to
eration for the probable costs, benefits, and perceive objects in three-dimensional space (de-
available resources and options. The ultimate spite the fact that vision involves the projection
goal of EBP is to promote empirically supported of light onto a two-dimensional surface, the ret-
principles that can be used to enhance public ina) would be seen as an evolved mechanism
health. that solved the problem of determining the dis-
eviration n. 1. castration or emasculation. 2. the tance between oneself and objects in the envi-
delusion of a man that he has been turned into a ronment.
woman. exact replication repetition of an experiment
evocative therapy therapy based on the idea in which the goal is to duplicate as closely as pos-
that behavior is aroused by underlying factors. sible the conditions of the original experiment.
Once the factors underlying a maladaptive or See replication.
unwanted behavior have been identified, dis- exaggeration n. the act of embellishing or over-
positional and environmental changes can be stating a quality or characteristic of a person,
made to affect those factors and therefore alter thing, or situation. It is often a defensive reac-
the behavior. [originated by U.S. psychologist tion in which the individual justifies question-
Jerome D. Frank (1910–2005)] able attitudes or behavior through overstate-
evoked potential (EP) a specific pattern of ment, such as dramatizing the oppressive acts of
electrical activity produced in a particular part of a parent as a means of justifying rebellious be-
the nervous system, especially the brain, in re- havior.
sponse to external stimulation, such as a flash of exaltation n. an extreme state of euphoria and
light or a brief tone. Different modalities and psychomotor agitation, accompanied by a
types of stimuli produce different types of sen- lack of restraint. It occurs in some manic epi-
sory potentials, and these are labeled according sodes.
to their electrical polarity (positive- or negative-
examination n. a test, observation, or other
going) and timing (by serial order or in millisec-
means of investigation carried out on a patient
onds). Although the terms are sometimes used
to evaluate physical or mental health or detect
synonymously, EPs are distinct from event-
the presence or absence of signs or symptoms of
related potentials, which are associated with
diseases, disorders, or conditions. See also men-
higher level cognitive processes. Also called
tal examination; neurological evalua-
evoked response (ER).
tion; psychological examination.
evolutionary psychology an approach to examination anxiety see test anxiety.
psychological inquiry that views human cogni-
tion and behavior in a broadly Darwinian con- exceptional child a child who is substantially
text of adaptation to evolving physical and above or below the average in some significant
social environments and new intellectual chal- respect. Often applied to a child who shows
lenges. It differs from sociobiology mainly in marked deviations in intelligence, the term may
its emphasis on the effects of natural selection also be used to indicate the presence of a special
on information processing and the structure talent or an unusual emotional or social diffi-
of the human mind. culty. See also giftedness; slow learner.
evolution of the brain the concept that the exceptional creativity the capability of indi-
brains of complex animals have evolved over viduals to make unique and important contribu-
many millions of years from a network of simple tions to society through their work and the
nerve fibers connecting various body areas, as in products of their work. Exceptional creativity, as
primitive multicellular animals. At a more ad- measured by creative output, seems to peak at
vanced stage, a neural axis developed to connect different points in the adult life span depending
and integrate neurons serving the periphery and on the field of activity. Also called creative ge-
to house cell bodies; this axis became a spinal nius. Compare everyday creativity.
cord. Still later, collections of neurons with con- excitability n. 1. the tendency of some individ-
trol functions developed at the head end of the uals to be readily aroused to emotional re-
spinal cord, as in the brains of higher inver- sponses. 2. in neurophysiology, the capacity of
218
exhaustion delirium
neurons and some muscle cells to respond elec- the multiple cognitive deficits characteristic
trically to external stimulation with a sudden, of alcohol-induced persisting dementia
transient increase in their ionic permeability and and substance-induced persisting demen-
a change in the electric potential across their cell tia. Also called disturbance in executive
membrane. —excitable adj. functioning.
excitation-transfer theory the theory that executive functions higher level cognitive
emotional responses can be intensified by processes that organize and order behavior, such
arousal from other stimuli not directly related as judgment, abstraction and concept forma-
to the stimulus that originally provoked the re- tion, logic and reasoning, problem solving, plan-
sponse. According to this theory, when a person ning, and sequencing of actions. Deficits in
becomes aroused physiologically, there is a sub- executive functioning are seen in various disor- E
sequent period of time when the person will ex- ders, including Alzheimer’s disease and schizo-
perience a state of residual arousal yet be phrenia. In the latter, for example, major deficits
unaware of it. If additional arousing stimuli are in such cognitive abilities as selecting goals or
presented during this time, the individual will task-relevant information and eliminating extra-
experience more arousal, and thus greater re- neous information are apparent and are a focus
sponse, to those succeeding stimuli than if there of neurorehabilitative treatment. Also called
had been no residual arousal. See also arousal central processes; higher order processes.
transfer. [originally proposed in 1971 by psy- executive self the agent to which regulation
chologist Dolf Zillman] and implementation of voluntary actions is ordi-
excitatory–inhibitory processes 1. pro- narily attributed. The concept of an executive
cesses in which the transmission of neuronal sig- self has acquired considerable scientific plausi-
nals is activated or inhibited by the effects of bility, being associated with well-studied func-
neurotransmitters on the postsynaptic mem- tions of the prefrontal cortex of the brain.
brane. 2. antagonistic functions of the nervous However, there is a class of false attributions of
system defined by Ivan Petrovich pavlov. 3. the executive control (see illusion of agency).
stimulation of the cortex and the subsequent fa-
Exelon n. a trade name for rivastigmine.
cilitation of the processes of learning, memory,
and action (excitatory processes) and central exercise addiction the condition of being de-
nervous system processes that inhibit or inter- pendent on or devoted to physical exercise.
fere with perceptual, cognitive, and motor activ- Stopping exercise will cause the addicted person
ities (inhibitory processes). Individuals with to experience withdrawal symptoms. Also called
predominant inhibitory processes are theorized exercise dependence. See negative exercise
to be predisposed to a higher degree of intro- addiction; positive exercise addiction.
version, whereas individuals with predominant exercise–behavior model an adaptation of
excitatory processes are theorized to be predis- the health–belief model that identifies the re-
posed to a higher degree of extraversion. [pro- lationships of the following to likelihood of ex-
posed by Hans eysenck] ercising: (a) personal predispositions, (b) socio-
excitement n. an emotional state marked by demographic variables, (c) perceived cost and
enthusiam, eagerness or anticipation, and gen- benefits of exercising, and (d) perceived self-
eral arousal. efficacy and locus of control.
excitement phase see sexual-response exercise obsession see negative exercise ad-
cycle. diction.
excrement n. see feces. exercise therapy the prevention or treatment
executive n. a theoretical superordinate mecha- of disorders and chronic disease using regular,
nism in some models of cognition—particularly repetitive physical activity that enhances fitness
those in cognitive science, cognitive neuro- and mobility. This type of therapy is designed to
psychology, and artificial intelligence—that or- improve the functional capacity of body struc-
ganizes, initiates, monitors, and otherwise tures and has been demonstrated to have benefi-
controls information-processing activities and cial effects for a wide variety of conditions, for
other mental operations. A similar concept is example the alleviation of symptoms of depres-
that of the central executive (see working mem- sion and multiple sclerosis and the reduction in
ory). risk of developing cardiovascular disease and os-
executive area a region of the brain hypothe- teoporosis. More generally, there is widespread
sized to account for higher order brain func- research evidence for a positive relationship be-
tions, such as thinking and reasoning (see tween regular exercise and several indices of
executive functions). The frontal lobe is mental health and physical well-being.
commonly referred to as an executive area. exhaustion death see lethal catatonia.
executive dysfunction impairment in the exhaustion delirium a state of delirium oc-
ability to think abstractly and to plan, initiate, curring under conditions of extreme fatigue,
sequence, monitor, and stop complex behavior. which result from prolonged and intense over-
Related especially to disorders of the frontal lobe exertion, particularly when coupled with other
or associated subcortical pathways, it is one of forms of stress, such as prolonged insomnia, star-
219
exhibitionism
vation, excessive heat or cold, or toxic states. It is philosopher and author Jean-Paul Sartre (1905–
typically associated with the extreme physical 1980), who is usually seen as the existentialist
effort required of those who engage in prolonged thinker par excellence. In the immediate postwar
duration sports or of others facing extreme envi- years Sartre popularized both the term “existen-
ronmental conditions, as well as with debilitat- tialism” and most of the ideas now associated
ing diseases. with it. Existentialism represents a turning away
exhibitionism n. 1. the disposition or ten- from systematic philosophy, with its emphasis
dency to draw attention to oneself, particularly on metaphysical absolutes and principles of ra-
through conspicuous behavior. See also attentional certainty, and toward an emphasis on the
tion-getting. 2. a paraphilia in which the concrete existence of a human being “thrown”
into a world that is merely “given” and contin-
E genitals are repeatedly exposed to unsuspecting
gent. Such a being encounters the world as a sub-
strangers as a means of achieving sexual excite-
ment, but without any attempt at further sexual jective consciousness, “condemned” to create its
activity with the stranger. —exhibitionist n. own meanings and values in an “absurd” and
purposeless universe. The human being must
existential analysis a type of psychoanalysis, perform this task without benefit of a fixed es-
or a phase in existential psychotherapy, that sence or inherent nature, and in the absence of
places an emphasis on conscious perception and any possibility of rational certainty. However, by
experience over unconscious motivation and accepting the burden of this responsibility, and
drive in the search for meaning. The therapist refusing the “bad faith” of religion and other
typically takes an active, often confrontational, spurious rationalizations, he or she can achieve
role by posing difficult questions and noting authenticity. Various forms of existential
maladaptive decision making. The approach to psychology have taken up the task of provid-
“being” is future- or growth-oriented, and the ing explanations, understandings of human be-
goal is the development and encouragement of havior, and therapies based on existentialist
highly conscious decision making on the part of assumptions about human existence. They have
the client. Also called existential psycho- emphasized such constructs as alienation, au-
analysis. thenticity, and freedom, as well as the difficul-
existential anxiety a general sense of anguish ties associated with finding meaning and
or despair associated with an individual’s recog- overcoming anxiety. —existential adj. —exis-
nition of the inevitability of death and associ- tentialist n., adj.
ated search for purpose and meaning in life, in existential living the capacity to live fully in
light of the finitude of past choices and the un- the present and respond freely and flexibly to
knowns inherent to future choices. new experience without fear. Existential living is
existential–humanistic therapy a form of considered to be a central feature of the fully
psychotherapy that focuses on the entire person, functioning person. [defined in psychology
rather than just behavior, cognition, or underly- by Carl rogers]
ing motivations. Emphasis is placed on the cli- existential neurosis a pathological condition
ent’s subjective experiences, free will, and ability characterized by feelings of despair and anxiety
to decide the course of his or her own life. Also that arise from living inauthentically, that is,
called humanistic–existential therapy. from failing to take responsibility for one’s own
existentialism n. a philosophical and literary life and to make choices and find meaning in liv-
movement that emerged in Europe in the period ing. See authenticity.
between the two World Wars and became the existential psychoanalysis see existential
dominant trend in Continental thought during analysis.
the 1940s and 1950s. Existentialism is notori-
ously difficult to sum up in a single definition— existential psychology a general approach to
partly because many who might be identified psychological theory and practice that derives
with the movement reject the label, and partly from existentialism. It emphasizes the sub-
because the movement is itself, in many ways, a jective meaning of human experience, the
rejection of systematization and classification. uniqueness of the individual, and personal re-
The origins of existentialism have been traced to sponsibility reflected in choice. Such an ap-
a range of thinkers, including French philoso- proach was pioneered by Swiss psychologist
pher and mathematician Blaise Pascal (1623– Ludwig Binswanger (1881–1966). See being-in-
1662), Danish philosopher Søren Kierkegaard the-world. See also humanistic psychology.
(1813–1855), German philosopher Friedrich existential psychotherapy a form of psycho-
Nietzsche (1844–1900), and Russian novelist therapy that deals with the here and now of the
Fyodor Dostoevsky (1821–1881). However, the client’s total situation rather than with the cli-
first fully developed philosophy of existen- ent’s past or underlying dynamics. It emphasizes
tialism is usually taken to be the “existential the exploration and development of meaning in
phenomenology” elaborated by German philos- life, focuses on emotional experiences and deci-
opher Martin Heidegger (1889–1976) in the sion making, and stresses a person’s responsibil-
1910s and 1920s. Heidegger’s concept of dasein ity for his or her own existence. See also logo-
was a key influence on the work of the French therapy.
220
experimental group
exocathection n. a concentration of psychic tions can produce a particular outcome (e.g.,

energy on practical, worldly affairs rather than attainment of a goal). —expectant adj.
personal matters. Compare endocathection. expectant analysis the orthodox technique of
See cathexis. [defined by U.S. psychologist psychoanalysis, in which the analyst awaits the
Henry Alexander Murray (1893–1988)] gradual, free-floating unfolding of the patient’s
exogenous adj. originating outside the body: re- psyche. Compare focused analysis.
ferring, for example, to drugs (exogenous chemi- expected frequency 1. a frequency predicted
cals) or to phenomena, conditions, or disorders from a theoretical model and contrasted with an
resulting from the influence of external factors observed frequency. 2. a frequency that would
(e.g., exogenous stress). Compare endoge- occur on the basis of chance alone.
nous. —exogenously adv.
expected value the mean value of a random E
exogenous depression see reactive depres- variable or one of its functions as derived by
sion. mathematical calculation.
exogenous stress stress arising from external experience n. 1. a conscious event: an event
situations, such as natural catastrophes, exces- that is lived through, or undergone, as opposed
sive competition at work, or climbing a precipi- to one that is imagined or thought about. 2. the
tous mountain. present contents of consciousness. —experi-
exopsychic adj. characterizing mental activity ential adj.
that purportedly produces effects outside the in- experiential family therapy a therapist
dividual. Compare endopsychic. who emphasizes intuition, feelings, and under-
exorcism n. the act or practice in which sup- lying processes in treating families and who
posed evil spirits are expelled from a person be- deemphasizes theoretical frameworks. The work
lieved to be possessed, or a place thought to be is often characterized by the use of the thera-
haunted, by means of certain rites, ceremonies, pist’s own feelings and self-disclosures in inter-
prayers, and incantations. It was formerly widely actions with clients. Notable experiential family
believed that such spirits were the major cause of therapists have included U.S. psychiatrists Carl
mental disease and other disorders and that ex- A. Whitaker (died 1995) and Virginia M. Satir
orcism was therefore a suitable form of treat- (1916–1988).
ment. The Roman Catholic Church still makes experiential history the social, environmen-
use of ritual exorcism in certain very restricted tal, and behavioral components of an individ-
circumstances. —exorcise vb. —exorcist n. ual’s background from birth to death.
exotic psychosis see hysterical psychosis. experiential knowledge understanding and
expertise that emerge from life experience,
expanded consciousness a purported sense
rather than from professional training. Members
that one’s mind has been opened to a new kind
of self-help groups draw upon experiential
of awareness or to new concepts, associated par-
knowledge in supporting and helping each
ticularly with meditation or drug use. See also
other.
altered state of consciousness.
experiential psychotherapy a broad family
expansive delusion a less common name for a
of psychotherapies originating in the 1950s and
delusion of grandeur.
1960s and falling under the umbrella of existen-
expansive mood a mood that reflects feelings tial–humanistic psychology. A core belief of the
of grandiosity. approach is that true change occurs through the
expansiveness n. a personality trait manifested client’s direct, active “experiencing” of what the
by loquaciousness, overfriendliness, hyperactiv- client is undergoing and feeling at any given
ity, and lack of restraint. point in therapy, both on the surface and at a
deeper level. Experiential therapists typically en-
ex-patient club in psychiatry, an ongoing
gage clients very directly with regard to accessing
group organized by a former mental patient or
and expressing their inner feelings and experi-
by a hospital as part of its aftercare program. The
encing both present and past life scenes, and
objective is to provide social and recreational ex-
they offer clients perspectives for integrating
perience, to promote readjustment and rehabili-
such experiences into realistic and healthy self-
tation, and to maintain improvement through
concepts. Experiential psychotherapy has its an-
group support and, in some cases, group ther-
tecedents in the work of U.S. psychiatrists Carl A.
apy. See also mental patient organization.
Whitaker (1912–1995) and Thomas P. Malone
expectancy n. the internal state resulting from (died 2000), U.S. psychologist Carl rogers, U.S.
experience with predictable relationships be- philosopher and psychologist Eugene T. Gendlin
tween stimuli or between responses and stimuli. (1926– ), and others.
This basic meaning becomes slightly more spe-
experimental attrition see attrition.
cific in some fields. For example, in cognitive
psychology it refers to an attitude or mental set experimental control see control.
that determines the way in which a person ap- experimental group a group of participants
proaches a situation, and in motivation theory it in an experiment who are exposed to a particular
refers to an individual’s belief that his or her ac- manipulation of the independent variable (i.e.,
221
experimental hypothesis
a particular treatment level or, more briefly, a explicit attitude a relatively enduring and
particular treatment). Compare control group. general evaluative response of which a person is
The responses of the experimental group are consciously aware. Compare implicit atti-
compared to the responses of a control group, tude.
other experimental groups, or both. explicit behavior see overt behavior.
experimental hypothesis a premise that de- explicit memory long-term memory that can
scribes what a researcher in a scientific study be consciously recalled: general knowledge or in-
hopes to demonstrate if certain experimental formation about personal experiences that an in-
conditions are met. dividual retrieves in response to a specific need
experimental psychology the scientific or request to do so. This term, proposed in 1985
E study of behavior, motives, or cognition in a lab- by Canadian psychologist Peter Graf and U.S.
oratory or other experimental setting in order to psychologist Daniel Schacter, is used inter-
predict, explain, or control behavior or other changeably with declarative memory but typ-
psychological phenomena. Experimental psy- ically with a performance-based orientation—
chology aims at establishing quantified relation- that is, a person is aware that he or she possesses
ships and explanatory theory through the certain knowledge and specifically retrieves it to
analysis of responses under various controlled complete successfully a task overtly eliciting that
conditions and the synthesis of adequate theo- knowledge (e.g., a multiple-choice exam). Com-
retical accounts from the results of these obser- pare implicit memory.
vations. explicit process 1. a cognitive event that can
experimental treatment 1. in research, the be described accurately and that is available to
conditions applied to one or more groups that introspection, especially one that involves a de-
are expected to cause change in some outcomes. fined meaning. 2. an occasional synonym for
2. an intervention or regimen that has shown conscious process. Compare implicit pro-
some promise as a cure or ameliorative for a dis- cess.
ease or condition but is still being evaluated for exploitative orientation in the existential
efficacy, safety, and acceptability. psychoanalysis of Erich fromm, a character pat-
experimental variable an independent tern marked by the use of stealth, deceit, power,
variable: a variable under investigation that is or violence to obtain what the individual wants.
manipulated by the experimenter to determine The character type is plagiaristic rather than
its relationship to or influence upon some de- spontaneously or resourcefully creative. Also
pendent variable. called exploitative character. Compare
hoarding orientation; marketing orienta-
experimenter bias any unintended errors in tion.
the experimental process or the interpretation of
its results that are attributable to an experi- exploratory data analysis data analysis de-
menter’s preconceived beliefs about results. signed to generate new research questions or in-
sights rather than to address specific preplanned
expert testimony evidence given in court by research questions. Compare confirmatory
an expert witness. Unlike other testimony, this data analysis.
evidence may include the witness’s opinions
explosive personality a personality with a
about certain facts in order to help the trier of
pattern of frequent outbursts of uncontrolled
fact to make a decision. See ultimate opinion
anger and hostility out of proportion to any
testimony.
provocation. See intermittent explosive dis-
expert witness an individual who is qualified order.
to testify regarding scientific, technical, or pro- ex post facto research research that uses
fessional matters and provide an opinion con- existing data collected previously for another
cerning the evidence or facts presented in a court purpose or that is conducted following the oc-
of law. Eligibility to testify as an expert witnesses currence of an event of interest. Ex post facto
is based on the person’s special skills or knowl- research does not permit the systematic manipu-
edge as judged by the court. In U.S. federal courts, lation of variables (i.e, is nonexperimental) but
eligibility criteria are established by the Federal nonetheless is used to identify potential causal
Rules of Evidence 702–706. Mental health pro- relationships. [from Latin ex post facto, “after the
fessionals often serve as expert witnesses in such event”]
complex issues as insanity pleas and child cus-
tody cases. See daubert test; daubert v. mer- exposure therapy a form of behavior ther-
rell dow pharmaceuticals inc. apy that is effective in treating anxiety disorders.
Exposure therapy involves systematic confronta-
expiation n. atonement for wrongdoing that tion with a feared stimulus, either in vivo (live)
represents acknowledgment, relieves or reduces or in the imagination, and may encompass any
feelings of guilt, and moves toward righting the of a number of behavioral interventions, includ-
situation. ing desensitization, flooding, implosive
explanatory style an individual’s unique style therapy, and extinction-based techniques. It
of describing and explaining some phenome- works by (a) habituation, in which repeated
non, event, or personal history. exposure reduces anxiety over time by a process
222
external validity
of extinction; (b) disconfirming fearful predic- ous hospital stay that has equaled or exceeded
tions; (c) deeper processing of the feared stimu- the period defined by a hospital or third-party
lus; and (d) increasing feelings of self-efficacy utilization review. See also continued-stay
and mastery. review.
expressed emotion (EE) negative attitudes, in extended suicide murder–suicide in which
the form of criticism, hostility, and emotional both the murder and the suicide reflect the sui-
overinvolvement, demonstrated by family cidal process. The individual first kills those per-
members toward a person with a mental disor- ceived as being a part of his or her identity or
der. High levels of expressed emotion have been extended self and then commits suicide.
shown to be associated with poorer outcomes in exteriorization n. 1. the act of relating one’s
mood, anxiety, and schizophrenic disorders and inner feelings and attitudes to external, objec- E
increased likelihood of relapse. [first described in tive reality. 2. the outward expression of one’s
a study (1972) by British psychiatrists George W. private and personal ideas.
Brown, Jim L. T. Birley, and John K. Wing]
external attribution see situational attri-
expression n. an external manifestation of an bution.
internal condition or characteristic. For exam-
external boundary in psychoanalytic theory,
ple, gene expression is the process by which the
the boundary between the ego and external re-
instructions encoded in DNA are used to create
ality, as opposed to the internal boundary be-
observable products, such as proteins (and by ex-
tween ego and id. Also called outer boundary.
tension demonstrable physical attributes, such
as hair or eye color). The term, however, is most external control the belief that one’s experi-
often used in reference to the communication of ences and behavior are determined by circum-
a thought, behavior, or emotion, as in emo- stances, luck, other people, or other external
tional expression or facial expression. factors. See externalizers; locus of control.
Compare internal control.
expressive language disorder a develop-
mental disorder characterized by impairment in externalization n. 1. a defense mechanism in
acquiring the ability to use language effectively which one’s thoughts, feelings, or perceptions
for communicating with others despite normal are attributed to the external world and per-
language comprehension. Manifestations in- ceived as independent of oneself or one’s own
clude below-average vocabulary skills, difficulty experiences. A common expression of this is
producing complete sentences, and problems re- projection. 2. the process of learning to distin-
calling words. guish between the self and the environment dur-
ing childhood. 3. the process by which a drive,
expressive therapy 1. a form of psychother- such as hunger, is aroused by external stimuli,
apy in which the client is encouraged to talk such as food, rather than by internal stimuli.
through his or her problems and to express feel-
ings openly and without restraint. Compare sup- externalizers pl. n. people who believe that
pressive therapy. 2. any of a variety of their behavior and reactions to conditions or sit-
therapies that rely on nonverbal methods (e.g., uations around them are determined largely or
art, dance, movement) to facilitate change. entirely by events beyond their control, that is,
they have an external locus of control. Com-
extended care a health care service provided at pare internalizers.
a residential facility where 24-hour nursing care
externalizing behavior see externalizing–
and rehabilitation therapy are available, usually
internalizing.
following an acute hospitalization. A facility
that provides such a service is known as an ex- externalizing–internalizing 1. a broad clas-
tended care facility (ECF). See also continuing sification of children’s behaviors and disorders
care unit; convalescent center; skilled based on their reactions to stressors. External-
nursing facility. izing behaviors and disorders are characterized
primarily by actions in the external world, such
extended family 1. a family unit consisting of as acting out, antisocial behavior, hostility, and
parents and children living in one household
aggression. Internalizing behaviors and disor-
with certain other individuals united by kinship
ders are characterized primarily by processes
(e.g., grandparents, cousins). 2. in modern West-
within the self, such as anxiety, somatization,
ern societies, the nuclear family together with
and depression. [proposed by U.S. psychologist
various other relatives who live nearby and keep
Thomas M. Achenbach (1940– )] 2. see exter-
in regular touch.
nalization; internalization.
extended-family therapy group therapy external locus of control see locus of con-
involving not only the nuclear family but also trol.
other family members, such as aunts, uncles,
grandparents, and cousins. See also family external validity the extent to which the re-
therapy. sults of research or testing can be generalized be-
yond the sample that generated the results to
extended-release preparation see slow- other individuals or situations. For example, if
release preparation. research has been conducted only with male par-
extended-stay review a review of a continu- ticipants, it cannot be assumed that similar re-
223
extinction
sults will apply to female participants. The more cle tone and body posture and coordinates op-
specialized the sample, the less likely will it be posing sets of skeletal muscles and movement of
that the results are highly generalizable. their associated skeletal parts. Also called
extinction n. 1. in pavlovian conditioning: extrapyramidal motor system; extra-
(a) a procedure in which pairing of stimulus pyramidal system.
events is discontinued, either by presenting the extra-small acrocentric chromosome
conditioned stimulus alone or by presenting syndrome see cat’s-eye syndrome.
the conditioned stimulus and the uncondi- extra sum of squares principle a basic ap-
tioned stimulus independently of one an- proach for model comparison in the general
other; or (b) the result of this procedure, which is linear model in which the value of an addi-
E a gradual decline in the probability and magni- tional parameter in the model is assessed in
tude of the conditioned response. 2. in oper- terms of the reduction in the sum of squares
ant conditioning: (a) a procedure in which error that its addition accomplishes.
reinforcement is discontinued, that is, the re-
inforcing stimulus is no longer presented; or extraterrestrial kidnapping see alien ab-
(b) the result of this procedure, which is a decline duction.
in the rate of the formerly reinforced response. extrauterine pregnancy see ectopic preg-
—extinguish vb. nancy.
extirpation n. see ablation. extraversion (extroversion) n. one of the ele-
ments of the Big Five and five-factor person-
extraception n. an attitude of skepticism, ob-
ality models, characterized by an orientation
jectivity, and adherence to the facts. [defined by
of one’s interests and energies toward the outer
U.S. psychologist Henry Alexander Murray
world of people and things rather than the inner
(1893–1988)]
world of subjective experience. Extraversion is a
extrapsychic adj. pertaining to that which orig- broad personality trait and, like introversion,
inates outside the mind or that which occurs be- exists on a continuum of attitudes and behav-
tween the mind and the environment. Compare iors. Extroverts are relatively more outgoing,
intrapsychic. gregarious, sociable, and openly expressive. Ex-
extrapsychic conflict conflict arising be- troversion is also one of the three personality
tween the individual and the environment, as dimensions, along with psychoticism and neu-
contrasted with intrapsychic conflict. roticism, of eysenck’s typology. —extra-
versive adj. —extraverted adj. —extravert n.
extrapunitive adj. referring to the punishment
of others: tending to direct anger, blame, or hos- extrinsic motivation an external incentive to
tility away from the self toward the external fac- engage in a specific activity, especially motiva-
tors, such as situations and other people, tion arising from the expectation of punishment
perceived to be the source of one’s frustrations. or reward (e.g., studying to avoid failing an ex-
Compare intropunitive. amination). Compare intrinsic motivation.
extrapyramidal dyskinesia any of various extrinsic reward a reward for behavior that is
distortions of voluntary movement (dyskin- not a natural consequence of that behavior. For
esias), such as tremors, spasms, tics, rigidity, or example, winning a trophy for finishing first in a
gait disturbances, associated with some lesion of race and receiving praise or money in the work
the extrapyramidal tract. These dyskinesias setting are extrinsic rewards. Compare intrinsic
can occur in neurological disorders or as a side reward.
effect of antipsychotic drugs, which produce extroversion n. see extraversion.
such conditions as akathisia and tardive dys- eye contact a direct look exchanged between
kinesia. two people who are interacting. Maintaining eye
extrapyramidal symptoms (EPS) a group of contact is considered essential to communica-
adverse drug reactions attributable to dysfunction between therapist and client during face-to-
tion of the extrapyramidal tract of the cen- face interviews. This communication behavior is
tral nervous system, such as rigidity of the limbs, used as a variable in some social-psychological
tremor, and other Parkinson-like signs; dystonia studies to represent the degree of interpersonal
(abnormal facial and body movements); and intimacy. Social-psychological studies of eye
akathisia (restlessness). Extrapyramidal symp- contact generally find that people typically look
toms are among the most common side effects of more at the other person when listening to that
the high-potency antipsychotics and have person than when they themselves are talking,
also been reported with use of other drugs (e.g., that they tend to avoid eye contact when they
ssris). Also called extrapyramidal syn- are embarrassed, that women are apt to maintain
drome (EPS). more eye contact than are men, and that the
extrapyramidal tract a motor portion of the more intimate the relationship, the greater is the
central nervous system that includes the basal eye contact. Also called mutual gaze.
ganglia and some closely related structures eyelash sign a reaction of eyelid movement to
(e.g., the subthalamic nucleus) and descend- the stimulus of stroking the eyelashes. It can be
ing pathways to the midbrain. It regulates mus- used as part of a diagnostic test for loss of con-
224
Eysenck’s typology
sciousness due to a functional or psychogenic ventory. Eysenck was often controversial, most
disorder. If the loss of consciousness is due to a notably for his claim that patients undergoing
neurological disease or injury, the reflex will not Freudian psychoanalysis and other psycho-
occur. dynamic therapies were no more likely to im-
eye-movement desensitization and re- prove than patients who had no therapy. He
processing (EMDR) a treatment methodology favored behavioral treatments for emotional and
used to reduce the emotional impact of trauma- behavioral disorders. Eysenck also advocated the
based symptomatology associated with anxiety, controversial view that racial differences in intel-
nightmares, flashbacks, or intrusive thought ligence are genetically based, publishing Race, In-
processes. The therapy incorporates simulta- telligence, and Education in 1971; in later years,
however, he acknowledged the mitigating influ-
neous visualization of the traumatic event while
ences of environment. E
concentrating on the rapid lateral movements of
a therapist’s finger. [developed in the late 1980s Eysenck Personality Inventory (EPI) a self-
by U.S. psychologist Francine Shapiro] report personality test for use with adolescents
and adults. It comprises 57 yes–no questions
eye-roll sign a physiological index believed to that are designed to measure two major person-
show susceptibility to hypnosis. The participant ality dimensions of eysenck’s typology—in-
is directed to roll his or her eyes upward as far as troversion–extraversion and neuroticism—and
possible and at the same time lower the eyelids includes a Lie scale intended to detect response
slowly. Hypnotizability or depth of hypnosis is distortion. It was a modification and replace-
believed to be a function of the amount of white ment of the Maudsley Personality Inventory
sclera that becomes visible below the cornea. (MPI), a personality test containing 24 items
eyewitness memory an individual’s recollec- measuring neuroticism and 24 measuring
tion of an event, often a crime or accident of extraversion that was developed in 1959 by Hans
some kind, that he or she personally saw or expe- eysenck while working at the Maudsley Hospi-
rienced. The reliability of eyewitness testimony tal, London, England. The EPI has been revised
is a major issue in forensic psychology. and expanded since its initial publication in
1963 to become the Eysenck Personality Ques-
Eysenck, Hans Jurgen (1916–1997) German-
tionnaire (EPQ), the most recent version of
born British psychologist. An emigré from Ger-
which (the EPQ–R) includes 90 questions and
many because of his unwillingness to join the
measures the additional personality dimension
Nazi party, Eysenck earned his doctorate in psy-
of psychoticism. [Hans Eysenck and British
chology at University College, London, in 1940.
psychologist Sybil B. G. Eysenck]
He founded the Department of Psychology at
the Institute of Psychiatry, Maudsley Hospital, Eysenck’s typology a system for classifying
University of London, where he remained personality types in which individual dif-
throughout his career. He is best known for con- ferences are described according to three di-
tributions to personality theory, popularizing the mensions: psychoticism, extraversion, and
terms “introvert” and “extravert” (see eysenck’s neuroticism (referred to as PEN). Also called
typology), and developing a number of person- PEN typology. See also factor theory of
ality tests, such as the eysenck personality in- personality. [Hans eysenck]
225
Ff
fabrication n. 1. the act of concocting or in- parkinsonism, and the face can be a mirror of
venting a whole or part of a story, often with the emotional disorder, as evidenced by the an-
intention to deceive. 2. a story concocted in this guished look of those who are depressed.
way. facial feedback hypothesis the hypothesis
fabulation n. random speech that includes the that sensory information provided to the brain
recounting of imaginary incidents by a person from facial muscle movements is a major deter-
who believes these incidents are real. See also de- minant of intrapsychic feeling states, such as
lusion. [first described by Swiss-born U.S. psy- fear, anger, joy, contempt, and so on. This idea
chiatrist Adolf Meyer (1866–1950)] was introduced by British naturalist Charles Dar-
win (1809–1882) and developed by U.S. psychol-
face-to-face group any group whose members ogists Sylvan S. Tomkins (1911–1991) and
are in personal contact and, as a result, are able Carroll E. Izard (1923– ).
to perceive each other’s needs and responses
and carry on direct interaction. Examples in- facies n. facial expression, which is often con-
clude t-groups and psychotherapy groups. Also sidered to be a guide to an individual’s emotions
called direct-contact group. or state of health.
facilitated communication 1. communica-
face validity apparent validity: the extent to
tion that is made more effective or efficient (e.g.,
which the items or content of a test or other as-
easier to understand or faster), often with the aid
sessment instrument appear to be appropriate
of a technological device or process. Examples
for measuring something, regardless of whether
include the captioning of TV broadcasts for the
they really are.
benefit of viewers with hearing loss (close-
facial disfigurement any distortion, malfor- captioned television) and the use of speech syn-
mation, or abnormality of the facial features due thesizers by people who are unable to talk. 2. a
to injury, disease, or congenital anomaly. Be- controversial method of communication in
cause of a common tendency to assign traits to which a person with a severe developmental dis-
individuals on the basis of facial features, people ability (e.g., autism) is assisted by a facilitator in
with facial disfigurements are particularly vul- typing letters, words, phrases, or sentences using
nerable to social, psychological, and economic a typewriter, computer keyboard, or alphabet
discrimination and unfavorable stress effects. facsimile. Facilitated communication involves a
See disfigurement. graduated manual prompting procedure, with
facial electromyography a technique for the intent of supporting a person’s hand suffi-
measuring the endogenous electrical activity of ciently to make it more feasible to strike the keys
any muscle or muscle group in the face by the he or she wishes to strike, without influencing
appropriate placement of electrodes (see electro- the key selection. The procedure is often claimed
myography). This procedure is usually carried to produce unexpected literacy, revealed
out to detect implicit, invisible facial movements through age-normative or superior communica-
related to emotion or speech. tion content, syntax, and fluency. Scientific re-
search findings, however, indicate that the
facial expression a form of nonverbal signal-
content of the communication is being deter-
ing using the movement of facial muscles. As
mined by the facilitator via nonconscious move-
well as being an integral part of communication,
ments. [developed in the 1970s by Australian
facial expression also reflects an individual’s
educator Rosemary Crossley (1945– )]
emotional state. British naturalist Charles Dar-
win (1809–1882) suggested that facial expres- facilitation n. 1. the strengthening or increased
sions are innate reactions that possess specific occurrence of a response resulting from environ-
survival value; for example, a baby’s smile mental support for the response. See also social
evokes nurturing responses in parents. Although facilitation. 2. in neuroscience, the phenome-
controversial, this theory has been supported by non in which the threshold for propagation of
cross-cultural research and studies of blind chil- the action potential of a neuron is lowered due
dren, which indicate that certain facial expres- to repeated signals at a synapse or the summa-
sions are spontaneous and universally correlated tion of subthreshold impulses. —facilitate vb.
with such primary emotions as surprise, fear, facilitator n. 1. a professionally trained or lay
anger, sadness, and happiness. Physical condi- member of a group who fulfills some or all of the
tions can produce characteristic facial expres- functions of a group leader. The facilitator en-
sions, such as the masklike countenance in courages discussion among all group members,
226
Fairbairnian theory
without necessarily entering into the discussion. linear composites for use in subsequent analysis
2. see facilitated communication. (data reduction).
FACM abbreviation for functional analytic factorial design an experimental design in
causal model. which two or more independent variables are si-
multaneously manipulated or observed in order
fact giver a person who assumes the role of pro- to study their joint and separate influences on a
viding information during a group therapy
dependent variable. See also simple factorial
discussion of a particular topic.
design; two-by-two factorial design; two-
factitious disorder in DSM–IV–TR, any of a factor design.
group of disorders in which the patient inten- factor loading the correlation between a mani-
tionally produces or feigns physical or psycho- fest variable and a latent variable (factor) in fac-
logical symptoms solely so that he or she may tor analysis. The factor loading reflects the
assume the sick role (compare malingering). degree to which a manifest variable is said to be
Four subtypes are recognized: factitious disorder “made up of” the factor whose loading is being
F
with predominantly psychological signs and examined.
symptoms (e.g., depression, suicidal thoughts
following the [unconfirmed] death of a spouse, factor rotation in factor analysis, the repo-
hallucinations, delusions), in which the symp- sitioning of factors (latent variables) to a new,
toms often become aggravated if the individual more interpretable configuration by a set of
is aware of being observed and very often do not mathematically specifiable transformations.
respond to treatment or follow traditional Factor rotation is possible because for any one
courses; factitious disorder with predominantly factor solution that fits the data to a specific de-
physical signs and symptoms (e.g., pain, vomit- gree there will exist an infinite number of
ing, blackouts, seizures, infections), the most se- equally good solutions, each represented by a
vere form of which is munchausen syndrome; different factor loading matrix. Rotations can be
factitious disorder with combined psychological orthogonal (e.g., varimax, quarimax), in which
and physical signs and symptoms; and facti- the rotated factors are uncorrelated, or oblique,
tious disorder not otherwise specified. in which the rotated factors are correlated.
factor theory of personality an approach to
factitious disorder by proxy see
the discovery and measurement of personality
munchausen syndrome by proxy.
components through factor analysis. The com-
factitious disorder not otherwise speci- ponents are identified primarily by a statistical
fied in DSM–IV–TR, a factitious disorder study of the differences between people as re-
that does not meet the criteria for one of the four vealed by tests covering various aspects of behav-
specific subtypes. An example is factitious disor- ior. The factor-analytic method is central to such
der by proxy (commonly known as munchausen personality models as the big five personality
syndrome by proxy), in which a caretaker, very model, cattell’s personality trait theory,
often a mother, will intentionally produce and eysenck’s typology.
symptoms (usually physical) in the person being fact seeker a person who takes the role of seek-
cared for, solely to play a role in the illness, its ing further information in relation to specific
treatment, or both (i.e., to assume the sick role topics, for example, during a group therapy
by proxy). discussion.
factor n. 1. anything that contributes to a result faculty n. 1. in cognitive psychology, see cogni-
or has a causal relationship to a phenomenon, tive faculty. 2. more generally, any intrinsic
event, or action. 2. an underlying influence that mental or physical power, such as reason, sight,
accounts in part for variations in individual be- or will. 3. the body of the teaching, research, and
havior. 3. in analysis of variance, an inde- administrative staff of an educational institu-
pendent variable. 4. in factor analysis, an tion.
underlying, unobservable latent variable
FAE abbreviation for fetal alcohol effects (see
thought (together with other factors) to be re-
fetal alcohol syndrome).
sponsible for the interrelations among a set of
variables. failure to grow see failure to thrive.
factor analysis a broad family of mathematical failure to thrive (FTT) significantly inade-
procedures for reducing a set of intercorrelations quate gain in weight and height by an infant. It
among manifest variables to a smaller set of reflects a degree of growth failure due to inade-
unobserved latent variables (factors). For ex- quate release of growth hormone and, despite an
ample, a number of tests of mechanical ability initial focus on parental neglect and emotional
might be intercorrelated to enable factor analysis deprivation, is currently believed to have multi-
to reduce them to a few factors, such as fine factorial etiology, including biological, nutri-
motor coordination, speed, and attention. This tional, and environmental contributors. The
technique is often used to examine the common condition is associated with poor long-term
influences believed to give rise to a set of ob- developmental, growth, health, and socio-
served measures (measurement structure) or to emotional outcomes.
reduce a larger set of measures to a smaller set of Fairbairnian theory the psychoanalytic ap-
227
faith healing
proach of British psychoanalyst W. Ronald D. ing the reports with vivid sensory detail (e.g., the
Fairbairn (1889–1964), which forms a part of ob- clothes that the rescuer was wearing). The phe-
ject relations theory. Fairbairn saw personal- nomenon is of particular interest in legal cases,
ity structure developing in terms of object specifically those involving eyewitness memo-
relationships, rather than in terms of Sigmund ries and false memory syndrome (FMS), in
freud’s id, ego, and superego. Fairbairn pro- which adults seem to recover memories of hav-
posed the existence of an ego at birth, which ing been physically or sexually abused as chil-
then splits apart during the paranoid-schizoid dren, with such recoveries often occurring
position to form the structures of personality. during therapy. The label is controversial, as is
In response to frustrations and excitement expe- the evidence for and against recovery of abuse
rienced in the relationship with the mother, the memories; false memory syndrome is not an
ego is split into (a) the central ego, which corre- accepted diagnostic term, and some have sug-
sponds to Freud’s concept of the ego; (b) the gested using the more neutral phrase recov-
F libidinal ego, which corresponds to the id; and ered memory. Also called illusory memory;
(c) the antilibidinal ego, which corresponds paramnesia; pseudomemory.
to the superego.
false negative a case that is incorrectly ex-
faith healing 1. the treatment of physical or cluded from a group by the test used to deter-
psychological illness by means of religious prac- mine inclusion. In diagnostics, for example, a
tices, such as prayer or “laying on of hands.” Be- false negative is an individual who, in reality,
lievers hold that this may be effective even when has a particular condition but whom the diag-
those being prayed for have no knowledge of the nostic instrument indicates does not have the
fact and no faith themselves. Also called faith condition.
cure; religious healing; spiritual healing.
false positive a case that is incorrectly included
2. any form of unorthodox medical treatment
in a group by the test used to determine inclu-
whose efficacy is said to depend upon the pa-
sion. In diagnostics, for example, a false positive
tient’s faith in the healer or the healing process
is an individual who, in reality, does not have a
(see placebo effect). In such cases any benefi-
particular condition but whom the diagnostic
cial effects may be attributed to a psychosomatic
instrument indicates does have the condition.
process rather than a paranormal or supernatu-
ral one. See also mental healing; psychic false pregnancy see pseudocyesis.
healing. false self in the object relations theory of
falling out a culture-bound syndrome British psychoanalyst Donald Winnicott (1896–
found in the United States and the Caribbean. 1971), the self that develops as a defense against
Symptoms include sudden collapse, sometimes impingements and in adaptation to the envi-
preceded by feelings of dizziness or “swimming” ronment. This contrasts with the true self,
in the head. Although their eyes are usually which develops in an environment that adapts
open, patients claim to be unable to see; they to the infant and allows him or her to discover
usually hear and understand what is occurring and express his or her true impulses.
around them but feel powerless to move. The familial factor an element or condition in a
condition may correspond to conversion dis- family, inherited or not, that accounts for a cer-
order or dissociative disorder. Also called tain disease, disorder, or trait.
blacking out.
familial hormonal disorder a syndrome as-
false belief an internal cognitive representation
sociated with mental deficiency, deafness, and
that has no basis in reality.
ataxia. Urinary gonadotropins, estrogen, preg-
false dementia a condition that mimics the nandiol, and 17-ketosteroids are markedly re-
symptoms of dementia but is a normal response duced in the patients, who seldom exceed a
to certain environmental conditions, such as mental age of 5 years. Development of genitalia
sensory deprivation, restricted movement, or is impaired, and female patients may never expe-
institutionalization with prolonged medication. rience menstruation. The disease is believed
false memory a distorted recollection of an to be hereditary. [first observed in 1919 by W.
event or, most severely, recollection of an event Koennicke]
that never happened at all. False memories are familial microcephaly see microcephaly.
errors of commission, because details, facts, or
events come to mind, often vividly, but the re-
familial retardation see cultural-familial
mental retardation.
membrances fail to correspond to prior events.
Even when people are highly confident that they familial study a study in which some measure
are remembering “the truth” of the original situ- or measures of an attribute or condition (e.g., a
ation, experimental evidence shows that they disorder, intelligence, suicidal behavior) among
can be wrong. For example, one quarter of adults people of a known genetic relationship are corre-
in a particular experiment who were told an un- lated. The extent to which performance on a
true story about being lost in a mall as a child— given measure varies as a function of genetic
ostensibly obtained from their family mem- similarity is used as an indication of the
bers—adopted the belief, sometimes embellish- heritability of that measure.
228
family therapy
familial Turner syndrome see noonan’s other. Some families are warm, others cool; some
syndrome. are extremely close and symbiotic, in others the
familism n. a cultural value common in collec- members keep each other at a distance; some are
tivist or traditional societies that emphasizes open to friends and relatives, others are not; in
strong interpersonal relationships within the ex- some, one or more children are accepted and
tended family together with interdependence, loved, in others one or more children are dis-
collaboration, and the placing of group interests tanced or otherwise rejected. Such patterns or el-
ahead of individual interests. —familistic adj. ements of such patterns may range from
unconscious to fully realized. See also patho-
family n. a kinship unit consisting of a group of genic family pattern.
individuals united by blood or by marital, adop-
tive, or other intimate ties. Although the family family psychology a basic and applied spe-
is the fundamental social unit of most human cialty in psychology that focuses on interactions
societies, its form and structure vary widely. See within the family and developmentally influen-
biological family; extended family; nu- tial contexts (neighborhood, schools, etc.). Re- F
clear family; permeable family; stepfamily. search and clinical intervention in this specialty
—familial adj. are taught in doctoral psychology programs, ei-
ther within a specified family curriculum or
family constellation the total set of relation- more often within broader programs, such as
ships within a particular family, as characterized clinical research and applied clinical and coun-
by such factors as the number and birth order of seling programs.
members and their ages, roles, and patterns of
interaction. The term is associated with Alfred family romance a common childhood fantasy
adler. in which a child imagines that he or she is not
the child of his or her biological parents but the
family counseling counseling of parents or offspring of a noble or royal personage. Sigmund
other family members by psychologists, social
freud saw this as rooted in the oedipus com-
workers, licensed counselors, or other profes-
plex. See foster-child fantasy.
sionals, who provide information, emotional
support, and practical guidance on problems family sculpting a technique in family ther-
faced in the family context, such as raising a apy in which the therapist asks one or more
child with visual or hearing impairment, adop- members of the family to physically arrange the
tion, public assistance, family planning, and other family members (and lastly themselves) in
substance abuse. See also genetic counseling. relation to one another in terms of posture,
space, and attitude so as to portray the arranger’s
family group psychotherapy therapeutic
perception of the family, either in general or
methods that treat a family as a system rather
with regard to a particular situation or conflict.
than concentrating on individual family mem-
This technique often reveals family dynamics vi-
bers. The various approaches include psychody-
sually in a way that may not be adequately cap-
namic, behavioral, systemic, and structural, but
tured in verbal descriptions by family members.
all regard the interpersonal dynamics within the
family as more important than individual intrafamily support services partial, periodic, or
psychic factors. See also family therapy. intermittent services provided to one or more
family members of a person with a developmen-
family interaction method a study tech-
tal disability for the purpose of enhancing their
nique for investigating family behavior by ob-
ability to care for the person or alleviating stress
serving the interaction of its members in a
associated with family living. Examples include
controlled situation, such as a clinic or labora-
day and overnight respite (see respite care),
tory.
parent training, behavioral consultation, parent
family mediation a structured process in education, transportation to appointments, and
which a neutral third party, typically an attorney sibling services (e.g., counseling).
or a mental health practitioner with training in
negotiation, helps individuals or families to re-
family systems theory a broad conceptual
model underlying various family therapies. Fam-
solve conflicts and reach agreements in such
ily systems theory focuses on the relationships
areas as divorce and child custody.
between and among interacting individuals in
family method in behavior genetics, the study the family and combines core concepts from
of the frequency of a trait or disorder by deter- general systems theory, cybernetics, family
mining its occurrence in relatives who share the development theory, object relations the-
same genetic background. ory, and social learning theory. Family sys-
family of origin the family in which an indi- tems theory stresses that therapists cannot work
vidual was raised, which may or may not be his only with individual family members to create
or her biological family. constructive family changes but must see the
family pattern a characteristic quality of the whole family to effect systemic and lasting
relationship between the members of a particu- changes. Also called Bowen family systems
lar family (e.g., between parents and children). theory; family systems model. [developed
Family patterns vary widely in emotional tone by U.S. psychiatrist Murray Bowen (1913–1990)]
and in the attitudes of the members toward each family therapy a form of psychotherapy that
229
Fanapt
focuses on the improvement of interfamilial re- and defeat are inevitable. Also called destiny
lationships and behavioral patterns of the family neurosis.
unit as a whole, as well as among individual father–daughter incest sexual relations be-
members and groupings, or subsystems, within tween father and daughter, which is the most
the family. Family therapy includes a large num- common form of incest.
ber of treatment forms with diverse conceptual
principles, processes and structures, and clinical
father figure see father surrogate.
foci. Some family therapy approaches (e.g., ob- father fixation in psychoanalytic theory, an
ject relations theory) reflect extensions of abnormally strong emotional attachment to the
models of psychotherapy with individuals in the father. See fixation.
interpersonal realm, whereas others (e.g., struc- father-ideal n. in psychoanalytic theory, the fa-
tural family therapy) evolved in less tradi- ther component of the ego-ideal, which is
tional contexts. Most approaches emphasize formed through identification with the parents.
F contexts in which clinical problems arise. This father surrogate a substitute for a person’s bi-
accompanying systemic view potentially allows ological father, who performs typical paternal
clinical attention to all levels of the organization functions and serves as an object of identifica-
of behavior, for example from individual uncon- tion and attachment. Father surrogates may in-
scious and conscious dynamics, to the family, clude such individuals as adoptive fathers,
and to the community. Family therapy models stepfathers, older brothers, teachers, and others.
vary enormously in terms of length, past versus Also called father figure; surrogate father.
present orientation, techniques used, and treat-
ment goals. See also conjoint therapy; cou- fatigue n. 1. a state of tiredness and diminished
ples therapy; family group psychotherapy; functioning. Fatigue is typically a normal, tran-
family systems theory. sient response to exertion, stress, boredom, or
inadequate sleep but also may be unusually pro-
Fanapt n. a trade name for iloperidone. longed and indicative of disorder (e.g., chronic
fanaticism n. excessive and often irrational zeal fatigue syndrome, anemia, hypothyroidism). 2.
or devotion, for example, to a cause or a set of ex- reduced response of a receptor cell or sense organ
treme beliefs. —fanatic adj., n. resulting from excessive stimulation.
fantasy n. 1. any of a range of mental experi- fatigue checklist a list of the symptoms of fa-
ences and processes marked by vivid imagery, in- tigue, including (a) an increased need to sleep,
tensity of emotion, and relaxation or absence of (b) trouble finding the energy to start new tasks,
logic. Fantasizing is normal and common and (c) poor endurance for completing a task that
often serves a healthy purpose of releasing ten- has been started, (d) difficulty in concentrating
sion, giving pleasure and amusement, or stimu- on any task, and (e) weakness or fatigability of
lating creativity. It can also be indicative of muscles during physical effort.
pathology, as in delusional thinking or signifi-
fatigue effect a decline in performance on a
cant disconnection from reality. 2. in psychoan-
prolonged or physically demanding research
alytic theories, a figment of the imagination: a
task that is generally attributed to the partici-
mental image, night dream, or daydream in
pant becoming tired or bored with the task.
which a person’s conscious or unconscious
wishes and impulses are fulfilled (see wish- fatigue studies research on factors that cause
fulfillment). Followers of Melanie klein use both mental and physical fatigue. Physiological
the spelling phantasy to denote specifically un- and psychological studies are conducted in nu-
conscious wishes. —fantasize vb. merous and varied contexts, such as job stress,
caregiving, chronic illness, and ergonomic de-
fantasy play pretend or make-believe play that
sign.
includes an as-if orientation to actions, objects,
and peers. It often involves playing a distinct F distribution a theoretical probability dis-
role, such as mother, teacher, or doctor. Fantasy tribution widely used in the analysis of vari-
play involves taking a stance that is different ance and other statistical tests of hypotheses
from reality and using a mental representation about population variances. It is the ratio of the
of a situation as part of an enactment. See also variances of two independent random variables
symbolic play. each divided by its degrees of freedom.
FAR abbreviation for fetus at risk. fear n. an intense emotion aroused by the detec-
tion of imminent threat, involving an immedi-
FAS abbreviation for fetal alcohol syndrome.
ate alarm reaction that mobilizes the organism
fascination n. 1. profound interest in, attrac- by triggering a set of physiological changes.
tion to, or enchantment with a person, object, These include rapid heartbeat, redirection of
activity, or phenomenon. 2. in psychoanalytic blood flow away from the periphery toward the
theory, an infant’s primitive attempt to master gut, tensing of the muscles, and a general mobili-
what is perceived (e.g., a light) by identifying zation of the organism to take action (see fear
with it. —fascinate vb. response; fight-or-flight response). Accord-
fate neurosis in psychoanalytic theory, a coming to some theorists, fear differs from anxiety
pulsive, unconscious, and self-punitive need to in that it has an object (e.g., a predator, financial
arrange life experiences in such a way that failure ruin) and is a proportionate response to the ob-
230
feature abstraction
jective threat, whereas anxiety typically lacks an avoid doing so. Fear of success was originally
object or is a more intense response than is war- thought to be experienced primarily by women,
ranted by the perceived threat. See also fright. because striving for success was held to place a
feared self in analyses of self-concept, a mental woman in conflict between a general need for
representation of psychological attributes that achievement and social values that tell her not
one might possess in the future, in which to achieve “too much.” It is now thought that
thoughts about the acquisition of these attrib- men and women are equally likely to experience
utes elicits a sense of anxiety or dread. fear of success. Also called fear of success
syndrome; Horner effect. See also jonah
fearful attachment an adult attachment style complex. [first proposed in 1969 by U.S. psy-
characterized by a negative internal working chologist Matina Horner (1939– )]
model of attachment of oneself and of others.
Individuals with fearful attachment doubt both fear response a response to a threat in which
their own and others’ competence and efficacy the threatened organism attempts to guard vul-
and are presumed not to seek help from others nerable vital organs and to protect the integrity F
when distressed. Compare dismissive attach- of the self. In addition to these protective func-
ment; preoccupied attachment; secure at- tions, the fear response is aimed at removing the
tachment. person or animal from the threatening situation,
either by overt withdrawal or by coping behav-
fear of commitment feelings of anxiety and iors, such as shutting the eyes to avoid seeing the
uncertainty related to the decision to become fear stimulus. Physiological responses vary de-
bound to a course of action. Such feelings are pending on the situation and the proximity of
commonly aroused by the decision to become the threat. See also fight-or-flight response.
emotionally or legally committed to a long-
standing relationship with another person and fear structure see emotional processing
often stem from problems with intimacy and at- theory.
tachment; in an extreme form, fear of commit- Fear Survey Schedule (FSS) a questionnaire
ment may lead to social maladjustment. designed to measure fear, phobic behavior, and
fear of darkness normal or pathological fear of generalized anxiety. It is currently available in
darkness or night. Fear of darkness is associated numerous versions, with the 72-item FSS–III
with feelings of helplessness and a sense of unfa- being the most commonly used, particularly in
miliarity because things look different in the systematic desensitization. These items con-
dark. The fear first occurs at about 3 years of age sist of fear- or anxiety-producing objects or situa-
but may develop into a specific phobia in tions, grouped into six classes (animal fears,
which darkness is associated with danger and social fears, etc.), to which participants respond
threat (this phobia is also known variously as on a scale from 0 (“Not at all”) to 4 (“Very
achluophobia, nictiphobia, noctiphobia, nycto- much”) regarding their degree of discomfort.
phobia, and scotophobia, although these names [originally published in 1964 by South African-
are now seldom used). born U.S. psychologist Joseph Wolpe (1915–
1997) and U.S. clinical psychologist Peter J. Lang
fear of failure persistent and irrational anxiety
(1930– )]
about failing to measure up to the standards and
goals set by oneself or others. This may include feasibility standards criteria used to judge
anxiety over academic standing, losing a job, the practical, feasible, and cost-effective nature
sexual inadequacy, or loss of face and self- of any enterprise or project. For example, the fea-
esteem. Fear of failure may be associated with sibility of an evaluation research study is de-
perfectionism and is implicated in a number of termined on the basis of its pragmatic imple-
psychological disorders, including some anxi- mentation, its political viability among various
ety disorders and eating disorders. A patho- stakeholders, and the cost of the resources neces-
logical fear of failure has been called kakor- sary to carry out the research. See also accuracy
rhaphiophobia, but this name is now seldom standards; propriety standards; utility
used. standards.
fear of flying a persistent and irrational fear of feasibility test an investigation conducted
flying in an airplane or other airborne vehicle, prior to a study in order to establish properties of
also called aviophobia (although this name is response measures and to determine the success-
now seldom used). In DSM–IV–TR, fear of flying fulness of the study’s design. It is used to estab-
is classified as a specific phobia, situational lish the validity of response measures, to provide
type. early information on the probable level of ef-
fects, or to try out new methodologies. See also
fear of public speaking see social phobia.
evaluability-assessment data; feasibility
fear of rejection a persistent and irrational fear standards.
of being socially excluded or ostracized, which is
often a feature of social phobia. feature abstraction a hypothetical process by
which people learn from their experience with
fear of strangers see stranger anxiety. exemplars of different categories which features
fear of success a fear of accomplishing one’s might be used to define membership in these
goals or succeeding in society, or a tendency to categories.
231
febrile delirium
febrile delirium delirium associated with or significant failure to gain weight or significant
caused by fever. loss of weight over a period of 1 month or more.
fecal incontinence the involuntary passage of There is no apparent cause.
flatus and feces in inappropriate places (cloth- feeding problem a form of behavior disorder
ing, floor, etc.) resulting from loss of bowel con- in children that is characterized by refusal to eat,
trol and due to an injury or organic condition. persistent failure to eat adequate amounts or
Also called bowel incontinence. Compare types of food, or failure to hold down the food
encopresis. ingested. It is not due to a gastrointestinal or
other medical condition or lack of available
feces n. waste matter expelled from the bowels. In
food, and it is not an eating disorder. Also
psychoanalytic theory, a child’s interest in feces
called feeding disturbance. See also rumina-
is one of the earliest expressions of curiosity and
tion disorder.
withholding feces is one of the earliest expres-
sions of the drive for aggression and independ- fee-for-service adj. denoting the traditional
F method of payment for health care services, in
ence. Also called excrement; fecal matter.
See also anal-expulsive phase; anal-retentive which physicians or other providers set their
phase; anal personality; anal-sadistic phase; own fees for services, and patients or insurance
sphincter control. —fecal adj. companies pay all or a percentage of these
charges. This is the system of reimbursement
fecundity n. 1. in biology, a measure of the
used by indemnity insurance plans.
number of offspring produced by an individual
organism over a given time. 2. in demography, feeling n. 1. a self-contained phenomenal expe-
the general capacity of a human population to rience. Feelings are subjective, evaluative, and
have offspring. A below-average capacity is independent of the sensory modality of the sen-
termed subfecundity. —fecund adj. sations, thoughts, or images evoking them. They
are inevitably evaluated as pleasant or unpleas-
Federation of Behavioral, Psychological, ant but they can have more specific intrapsychic
and Cognitive Sciences an association of qualities, so that, for example, the affective
scientific societies with interests in basic re- tone of fear is experienced as different from that
search on problems of behavior, psychology, of anger. The core characteristic that differenti-
language, education, and knowledge systems ates feelings from cognitive, sensory, or percep-
and their psychological, behavioral, and physio- tual intrapsychic experiences is the link of
logical bases. The federation was incorporated in affect to appraisal. Feelings differ from emo-
1980; its efforts focus on legislative and regulations in being purely mental, whereas emotions
tory advocacy, education, and the communica- are designed to engage with the world. 2. any ex-
tion of information to scientists. perienced sensation, particularly a tactile or tem-
feeblemindedness n. an obsolete name for perature sensation (e.g., pain or coldness).
mental retardation or learning disability. feeling of unreality see depersonalization.
feedback n. information about a process or in- feeling tone see affective tone.
teraction provided to the governing system or
feeling type in Carl jung’s analytic psychol-
agent and used to make adjustments that elimi-
ogy, a functional type characterized by a
nate problems or otherwise optimize function-
dominance of feeling or affects. Feeling types
ing. It may be stabilizing negative feedback or
evaluate their experiences and the world in
amplifying positive feedback. The term’s ori-
terms of how these make them feel. The feeling
gins in engineering and cybernetics lend it a dis-
type is one of Jung’s two rational types, the
tinct connotation of input–output models that is
other being the thinking type. See also intu-
not as strictly applicable to the wide variety of
itive type; sensation type.
usages found in psychology, such as biofeed-
back, information feedback, and social feed- felbamate n. an anticonvulsant drug, struc-
back. turally related to meprobamate, that is thought
to work by both enhancing the effects of the
feedback evaluation see formative evalua- inhibitory neurotransmitter gamma-aminobu-
tion. tyric acid (see gaba agonists) and inhibiting
feeding and eating disorders of infancy the effects of the excitatory amino acid glu-
or early childhood in DSM–IV–TR, a cat- tamate (see nmda receptor). Due to the in-
egory of disorders characterized by pathological creased incidence of aplastic anemia and hepati-
feeding or eating behaviors that are usually first tis associated with this drug, it is less commonly
diagnosed in infancy, childhood, or adoles- used than other anticonvulsants; it is generally
cence. They include pica, rumination disor- reserved for patients with severe epilepsy who re-
der, and feeding disorder of infancy or spond inadequately to other treatments. U.S.
early childhood. trade name: Felbatol.
feeding disorder of infancy or early Feldenkrais method a process of body move-
childhood in DSM–IV–TR, a disorder with an ments that are designed to enhance psychologi-
onset before the age of 6 (but typically within cal functioning. The method is used by certified
the 1st year following birth) characterized by practitioners and may be interpreted in numer-
persistent failure to eat adequately that results in ous ways, but always involves a dynamic interac-
232
feminist therapy
tion between bodily movements and psycho- turbation, sensate focus, and systematic
logical awareness. [Moshe Feldenkrais (1904– desensitization.
1984), physicist and engineer] female sexual arousal disorder in DSM–IV–
fellatio n. the use of the mouth in sexual stimu- TR, a condition in which a woman recurrently or
lation of the penis. Also called fellation; oral persistently is unable to attain or maintain ad-
coitus; penilingus. See also orogenital ac- equate vaginal lubrication and swelling during
tivity. —fellate vb. sexual excitement, causing marked distress or in-
felt need a consciously experienced need that terpersonal difficulty. It is a prevalent sexual
may relate to a sense of deprivation or a discrep- problem for women and has a complex etiology
ancy with an affective ideal. involving a variety of physiological and psycho-
logical factors.
felt sense in focusing therapy, the subjective
qualities of the contents of consciousness. femininity n. possession of social-role behav-
iors that are presumed to be characteristic of a
See fringe consciousness. [defined by Aus-
girl or woman, as contrasted with femaleness,
F
trian-born U.S. psychologist Eugene T. Gendlin
(1926– )] which is genetically determined. —feminine
adj.
female circumcision see female genital mu-
tilation. femininity complex in psychoanalytic the-
ory, a man’s envy of women’s procreative pow-
female genital mutilation (FGM) any ers that has its roots in the young boy’s envy of
nontherapeutic procedure performed to modify the mother’s body. Some psychoanalysts see the
or remove any part of the external genitalia of femininity complex as the male counterpart to
prepubertal or adolescent girls. It is a traditional the female castration complex and penis
practice in certain countries, with the highest envy. [first used in 1930 by German psychoana-
prevalence in Africa, and variously associated lyst Felix Boehm (1881–1958)]
with cultural norms of femininity, chastity, and
religious observance. Female genital mutilation femininity phase in the object relations
takes one of four forms: excision of the clitoral theory of Melanie klein, a period during the
hood only; excision of the entire clitoris early phases of the oedipus complex in which
(clitoridectomy) and often the labia minora; both boys and girls are posited to adopt a femi-
excision of the clitoris, labia minora, and most of nine attitude toward the father and desire a child
the labia majora, and the sewing together of the by him. Klein saw this as turning to the father as
remaining tissue, leaving only a small vaginal an object of desire and away from the mother as
opening (infibulation); and any other injuri- the child’s first object.
ous procedure, such as incising or burning of the feminist family therapy an intervention
clitoris, cutting of the vagina, and insertion of model, informed by feminist therapy, used by
substances to cause vaginal bleeding. Female therapists to reorganize the family so that no one
genital mutilation is sometimes called female (or is entrapped in dysfunctional roles or patterns of
clitoral) circumcision and—more recently—fe- interaction that are based on the politics of
male genital cutting (FGC), terms that downplay power, particularly with regard to patriarchal
its potential adverse medical, psychological, and roles.
sexual consequences. These may include (but are feminist psychology an approach to psycho-
not limited to) severe pain, excessive bleeding, logical issues that emphasizes the role of the fe-
infection, gynecological and obstetrical compli- male perspective in thought, action, and
cations, disordered sleeping and eating habits, emotion in the life of the individual and in soci-
mood changes, impaired cognition (e.g., poor ety. It is seen by its proponents as an attempt to
concentration and difficulty learning), reduced counterbalance traditional male-oriented and
sexual sensitivity, less frequent orgasm, and de- male-dominated psychology, as well as a model
creased enjoyment of sexual intercourse. for similar approaches for other less represented
femaleness n. the quality of being female in the groups. See also engendering psychology;
anatomical and physiological sense by virtue of woman-centered psychology.
possessing the female complement of a pair of x feminist therapy an eclectic approach to psy-
chromosomes. Compare femininity. chotherapy based conceptually in feminist polit-
female orgasmic disorder in DSM–IV–TR, a ical analyses and feminist scholarship on the
condition in which a woman recurrently or per- psychology of women and gender. In this orien-
sistently has difficulty obtaining orgasm or is un- tation, the ways in which gender and gendered
able to reach orgasm at all following sexual experiences inform people’s understanding of
stimulation and excitement, causing marked dis- their lives and the development of the distress
tress or interpersonal difficulty. Female orgasmic that serves as a catalyst for seeking therapy are
disorder is the second most frequently reported central. Race, class, sexual orientation, age co-
women’s sexual problem. Cognitive behavior hort, and ability, as they interact with gender,
therapy has been shown to be an effective treat- are explored. Feminist therapy attempts to create
ment and involves promoting attitude and sexu- an egalitarian therapy relationship in which in-
ally relevant thought changes and anxiety tentional efforts are made by the therapist to em-
reduction using such exercises as directed mas- power the client and define the client as an
233
feminization
authority equal in value to the therapist. Femi- Academy of Arts and Sciences and received the
nist therapy can be indicated for both female Distinguished Scientific Contribution Award of
and male clients. the American Psychological Association in 1959.
feminization n. the process of acquiring femi- fetal alcohol syndrome (FAS) a group of ad-
ninity, regardless of the sex of the individual. verse fetal and infant health effects associated
—feminize vb. with heavy maternal alcohol intake during preg-
fenfluramine n. a sympathomimetic agent, nancy. It is characterized by low birth weight
structurally related to the amphetamines, that and retarded growth, craniofacial anomalies
functions as a serotonin-receptor agonist (e.g., microcephaly), neurobehavioral problems
and was formerly used for management of obe- (e.g., hyperactivity), and cognitive abnormalities
sity (see appetite suppressant). It was with- (e.g., language acquisition deficits); mental retar-
drawn from the U.S. market in 1997 due to the dation may be present. Children showing some
incidence of heart-valve abnormalities associ- (but not all) features of this syndrome are de-
F scribed as having fetal alcohol effects (FAE).
ated with its use.
fetal distress the condition of a fetus during
fentanyl n. a highly potent opioid analgesic
late pregnancy or labor whose life or health is
that is used for anesthesia during surgery, for the
threatened, most commonly by an inadequate
management of severe cancer pain in patients re-
supply of oxygen via the placenta. Signs of fetal
sistant to other opioids, and (as a lozenge or
distress include abnormal heart rate, elevated
sucker) for the relief of severe anxiety in children
blood acidity, and absence of movement. This
prior to surgical procedures. Its toxicity is similar
term has been criticized as imprecise and non-
to that of other opioids, with respiratory and cir-
specific, and the alternative nonreassuring fetal
culatory depression predominating. It is known
status (NRFS) is recommended by many instead.
as China white in illicit use. Analogs of fentanyl
in current use include sufentanil, alfentanil fetal hypoxia a significant reduction in oxygen
(U.S. trade name: Alfenta), and remifentanil to the human fetus, which is believed to be a risk
(U.S. trade name: Ultiva). U.S. trade names: factor for severe mental illness, such as schizo-
Sublimaze (injectable form); Actiq and Oralet phrenia. See also hypoxia.
(oral forms); Duragesic (transdermal form, i.e., fetal–maternal exchange the exchange of
applied to the skin). substances between mother and fetus, via the
fertility n. 1. in biology, the potential of an indi- placenta, during gestation. The fetus is thereby
vidual to have offspring. Although most fre- supplied with nutrients and oxygen, and its
quently applied to females, it may also refer to waste products (e.g., carbon dioxide, urea) are
reproductive capacity in males. 2. in demogra- eliminated. Substances of low molecular weight
phy, the number of live children born to an indi- cross the placental barrier easily, but large mol-
vidual or a population. Compare fecundity. ecules (e.g., proteins) do not, therefore the fetus
manufactures its own proteins from amino acids
fertilization n. the fusion of a sperm and an egg supplied by the mother. Some drugs (e.g., alco-
cell to produce a zygote.
hol, opioids) as well as disease agents (e.g., the
Festinger, Leon (1919–1989) U.S. psychologist. rubella virus) may cross the placental barrier and
Festinger earned his doctorate at the University produce congenital defects.
of Iowa under Kurt lewin in 1942. He was hired fetal response a response of a fetus to environ-
as a statistician for the remainder of World War mental conditions. For example, there is an in-
II and was involved in the training and selection crease in the fetal heart rate when the mother
of Air Force pilots. After the war he held brief ap- smokes, and some investigators claim that there
pointments at the Massachusetts Institute of is an increase in activity when the mother is un-
Technology, the University of Michigan, and the dergoing severe emotional stress. See prenatal
University of Minnesota before settling at Stan- influence.
ford University in 1955 for 13 years; he com-
pleted his career at the New School for Social fetish n. 1. a material object (e.g., a shoe, an un-
Research in New York City. Festinger’s research dergarment) or nonsexual part of the body (e.g.,
interests in social psychology included such phe- a foot, lock of hair) that arouses sexual interest or
nomena as group cohesion, conformity, and excitement. 2. any object, idea, or behavior that
social comparison theory. He is best known, is the focus of irrational devotion or abnormally
however, for his series of experiments that tested excessive attention, for example, punctuality or
his cognitive dissonance theory. Festinger the pursuit of wealth. 3. in anthropology, an ob-
argued that dissonance reduction was capa- ject, such as a talisman or amulet, that is be-
ble of explaining phenomena that traditional lieved to embody a supernatural spirit or exert
behaviorist theories of reinforcement could not, magical force.
such as why low or infrequent rewards could re- fetishism n. a type of paraphilia in which inan-
sult in persistent behavior. His most influential imate objects—commonly undergarments, stock-
writings include his books, A Theory of Cognitive ings, rubber items, shoes, or boots—are re-
Dissonance (1957) and Conflict, Decision, and Dis- peatedly or exclusively used in achieving sexual
sonance (1964). Festinger was elected to the Na- excitement. Objects designed for use in stimulat-
tional Academy of Sciences and the American ing the genitals (e.g., vibrators) are not consid-
234
fight-or-flight response
ered to be involved in fetishism. Fetishism the individual consistently relies more on

occurs primarily among males and may compete external referents (environmental cues) than on
or interfere with sexual contact with a partner. internal referents (bodily sensation cues). The
See also partialism. —fetishistic adj. opposite tendency, relying more on internal
fetus n. an animal embryo in the later stages of than external referents, is called field inde-
development. In humans, the fetal period is pendence. Discovered during experiments con-
from the end of the eighth week after fertiliza- ducted in the 1950s to understand the factors
tion until birth. —fetal adj. that determine perception of the upright in
space, field dependence–independence typically
fetus at risk (FAR) a fetus that has a significant is measured using the rod-and-frame test.
risk of being born with a mental or physical dis-
order because of known influences from the par- field independence a cognitive style in
ents or other family members (e.g., a mother which the individual consistently relies more on
with diabetes or hypertension). The risk of a internal referents (body sensation cues) than on
mental disorder in a child born into a family external referents (environmental cues). Field- F
with no history of mental disorder is relatively independent people tend to be able to disregard
small, but the risk may be as much as 50% in cer- deceptive environmental cues, particularly in
tain cases, for example, if the disorder is a sex- tasks requiring the performance of simple ac-
linked recessive trait inherited from the tions or the identification of familiar elements in
mother’s side of the family and the parents are unfamiliar contexts. Compare field depend-
related. See also fetal distress. ence.
FFM abbreviation for five-factor personality field of consciousness the total awareness of
model. an individual at a given time. See conscious-
ness.
FGM abbreviation for female genital mutila-
tion.
field properties the environmental factors
that surround and influence a living organism.
fibromyalgia syndrome a syndrome of un-
field research studies conducted outside the
certain origin that is characterized by wide-
laboratory, in a “real-world” setting, which typi-
spread musculoskeletal pain and chronic fatigue.
cally involve observing or interacting with par-
Pain may be triggered by pressure on numerous
ticipants in their typical environments over an
tender points on the body. Other commonly as-
extended period of time. Field research has the
sociated symptoms are muscle stiffness, head-
advantages of ecological validity, the opportu-
aches, sleep disturbance, and depression.
nity to understand how and why behavior oc-
Symptoms overlap with those of chronic fa-
curs in a natural social environment; it has the
tigue syndrome, and fibromyalgia syndrome
disadvantages of loss of environmental control
often occurs simultaneously with other disor-
and ability to do precise experimental manipula-
ders, such as irritable bowel syndrome and
tions. Thus, field research is often said to have
migraine. The condition was formerly called
more external validity and less internal va-
fibromyositis–fibromyalgia syndrome. See also
lidity than laboratory-based research.
chronic myofascial pain.
field theory in psychology, a systematic ap-
fiction n. 1. in psychology, an unproven or proach describing behavior in terms of patterns
imaginary concept that may be accepted by an
of dynamic interrelationships between individu-
individual as if it were true for pragmatic rea-
als and the psychological, social, and physical
sons. See as-if hypothesis. 2. see guiding fic-
situation in which they exist. This situation is
tion. —fictional adj.
known as the field space or life space, and the
fictional finalism in the psychoanalytic the- dynamic interactions are conceived as forces
ory of Alfred adler, the belief that human be- with positive or negative valences. [proposed
ings are more strongly motivated by the goals by Kurt lewin]
and ideals—realizable or unattainable—that field theory of personality a theory in which
they create for themselves and more influenced personality is understood in terms of dynamic
by future possibilities than by past events such as interrelations among a field of intrapsychic
childhood experiences. This is in strong contrast forces. See field theory. [devised by Kurt lewin]
to the emphasis of classical Freudian psychoana-
lytic theory. See also guiding fiction; individ- field work 1. a less common name for field re-
ual psychology. search. 2. in clinical practice education, a
practicum in which the student supplements
fidelity n. 1. faithfulness to a person, group, be- and applies classroom theory by taking responsi-
lief, or the like. 2. the degree of accuracy of a bility for actual cases under the tutelage of expe-
measuring instrument. 3. the degree of accuracy rienced, qualified supervisors.
of sound or visual reproduction in an electronic
device (e.g., a sound system or television). fight-or-flight response a pattern of physio-
logical changes elicited by activity of the sym-
fidgetiness n. a state of increased motor activity, pathetic nervous system in response to
which is associated with anxiety, tics, chorea, or threatening or otherwise stressful situations that
boredom. leads to mobilization of energy for physical ac-
field dependence a cognitive style in which tivity (e.g., attacking or avoiding the offending
235
figure-drawing test
stimulus), either directly or by inhibiting physi- fire-setting behavior a tendency to set fires.
ological activity that does not contribute to en- Compare pyromania.
ergy mobilization. Specific sympathetic responses FIRO theory acronym for fundamental inter-
involved in the reaction include increased heart personal relations orientation theory.
rate, respiratory rate, and sweat gland activity;
elevated blood pressure; decreased digestive ac-
first admission a patient admitted for the first
time to a mental institution.
tivity; pupil dilation; and a routing of blood flow
to skeletal muscles. In the emergency theory first-episode schizophrenia the first time
of emotions, such changes are the basis of all that the criteria for a diagnosis of schizophre-
human emotions. Also called emergency reac- nia are met in an individual, a situation that
tion; emergency syndrome. [first described poses a number of specific treatment challenges
by U.S. physiologist Walter B. Cannon (1871– that the practitioner must address, such as denial
1945)] and grief in the patient and his or her family. It is
F figure-drawing test any test in which the par-
helpful to study specific impairments, underly-
ing neurological deficits, and course of treat-
ticipant draws a human figure, used as a measure
ment response in such patients, since there is
of intellectual development or as a projective
hypothetically no confounding of results due to
technique. See machover draw-a-person
previous administration of antipsychotic drugs.
test.
first-generation antipsychotic see anti-
filial anxiety fear and apprehension in chil- psychotic.
dren caused by their relationships with their par-
ents, often in anticipation of caregiving first-impression bias see primacy effect.
responsibility by adult children of older parents. first-line medication a drug that is the first
choice for treating a particular condition be-
filicide n. the intentional killing of one’s chil-
cause it is considered a very effective treatment
dren, a very rare event that is sometimes thought
for that condition with the least likelihood of
to be caused by severe major depressive disor-
causing side effects. A first-line medication may
der.
be a class of drugs (e.g., ssris for depression) as
final free recall an unexpected test of memory well as a single drug.
given at the end of a memory assessment ses- first-order factor in factor analysis, any of
sion, asking the individual to recall all of the ma- the factors that are derived from the correlation
terials that were studied and tested in the (or covariance) among the manifest variables,
session. as opposed to second-order factors, which
finasteride n. see antiandrogen. are determined from the correlation (or
fine motor describing activities or skills that re- covariance) among the factors.
quire coordination of small muscles to control first-person perspective the point of view of
small, precise movements, particularly in the the subjective observer. Compare second-
hands and face. Examples of fine motor skills in- person perspective; third-person perspec-
clude handwriting, drawing, cutting, and mative.
nipulating small objects. Compare gross motor. first-rank symptoms symptoms originally
Finger Localization Test a 60-item proposed by German psychiatrist Kurt Schneider
neuropsychological test consisting of three (1887–1967) for the differential diagnosis of
parts: (1) The participant is asked to identify schizophrenia. They are audible thoughts; hear-
which finger is touched by the examiner; (2) the ing voices arguing or commenting on one’s ac-
participant is blindfolded or otherwise pre- tions; thought withdrawal, diffusion, and other
vented from using vision and then asked to iden- disturbances; delusional perceptions; somatic
tify which finger is touched; and (3) the passivity (experiencing external forces as influ-
participant again is blindfolded or otherwise pre- encing or controlling one’s body); and other ex-
vented from using vision and then asked to iden- ternal impositions on feelings, inputs, and
tify which two fingers are simultaneously actions. It is now known that these symptoms
touched. Each hand is tested in each part of the can also occur in other psychotic disorders, in
test, which is scored for the number of correct mood disorders, and in neurological disorders.
identifications and currently appears in a variety fishbowl technique a procedure used in a
of forms and as part of several neuropsycho- growth group in which participants form two
logical test batteries. Also called Tactile Finger concentric circles. The individuals in the inner
Recognition. [originally developed in 1983 by group engage in a discussion or other form of in-
U.S. neuropsychologist Arthur Lester Benton teraction while the members of the outer group
(1909–2006) and colleagues] observe. When the interaction has concluded,
Finger Tapping Test a measure of fine motor the outer group provides information and feed-
speed in which the individual taps an index fin- back to the inner group. Later, the groups may
ger as quickly as possible against a response key. exchange places and repeat the exercise.
The test is part of the halstead–reitan neuro- Fisher’s r to Z transformation a mathemat-
psychological battery. It was originally called ical transformation of the product–moment
the Finger Oscillation Test. correlation coefficient (r) to a new statistic (Z)
236
flexibilitas cerea
whose sampling distribution is the normal distri- fixed-effects model a statistical procedure for
bution. It is used for testing hypotheses about analyzing data from experimental designs that
correlations and constructing confidence in- use fixed factors, independent variables whose
tervals on correlations. [Sir Ronald Aylmer levels are specifically selected by the researcher
Fisher (1890–1962), British statistician and ge- for study rather than randomly chosen from a
neticist] wide range of possible values. For example, a re-
fissure n. a cleft, groove, or indentation in a sur- searcher may wish to investigate the effects of
face, especially any of the deep grooves in the ce- the available dosages of a certain drug on symp-
rebral cortex. tom alleviation. Fixed-effects models generally
are intended to make inferences solely about the
fit 1. n. the degree to which values predicted by a
specific levels of the independent variables actu-
model correspond with empirically observed
ally used in the experiment. See also mixed-
values. 2. n. a lay term for an epileptic seizure.
effects model.
3. n. a colloquial name for an emotional out-
burst. 4. adj. see fitness. fixed factor a factor (independent variable) F
fitness n. 1. a set of attributes that people have or in an experimental design whose levels are speci-
are able to achieve relating to their ability to per- fied by the researcher rather than randomly gen-
form physical work and to carry out daily tasks erated within some range of permissible values.
with vigor and alertness, without undue fatigue, As a rule, one should not generalize results of
and with ample energy to enjoy leisure pursuits. studies of this type beyond the specific levels of
2. in biology, the extent to which an organism the factors used in the experiment.
or population is able to produce viable offspring fixed idea see idée fixe.
in a given environment, which is a measure of fixed model see fixed-effects model; fixed
that organism’s or population’s adaptation to factor.
that environment. —fit adj.
flagellation n. whipping another person or
fitness for duty evaluation (FFDE) a psy- oneself or submitting to whipping. Flagellation
chological assessment of an employee’s present may be a form of penitence (as a religious ritual)
mental state and functioning to estimate the em- or a means of achieving sexual excitement. Flag-
ployee’s future functioning and determine ellation is a common practice among those who
whether that individual is able to safely and ef- engage in bondage and discipline. Also called
fectively perform his or her job duties. An FFDE flagellantism.
is also used to determine if mental illness or
emotional stress experienced by a person has in- flashback n. 1. the reliving of a traumatic event
terfered with his or her job performance. It is after the initial adjustment to the trauma ap-
routinely conducted on police officers after they pears to have been made. Flashbacks are part of
have had a traumatic experience in the line of posttraumatic stress disorder: Forgotten
duty. Also called fit for duty evaluation. memories are reawakened by words, sounds,
smells, or scenes that are reminiscent of the orig-
fitness for trial see competency to stand inal trauma (e.g., when a backfiring car elicits
trial.
the kind of anxiety that a combat veteran experi-
five-factor personality model (FFM) a enced when he or she was the target of enemy
model of personality in which five dimensions fire). 2. the spontaneous recurrence of the per-
of individual difference—extraversion, neu- ceptual distortions and disorientation to time
roticism, conscientiousness, agreeable- and place experienced during a previous period
ness, and openness to experience—are viewed of hallucinogen intoxication. Flashbacks may
as core personality structures. Unlike the big occur months or even years after the last use of
five personality model, which views the five the drug and are associated particularly with
personality dimensions as descriptions of behav- LSD.
ior and treats the five-dimensional structure as a
flashbulb memory a vivid, enduring memory
taxonomy of individual differences, the FFM
associated with a personally significant and
also views the factors as psychological entities
emotional event. Such memories have the qual-
with causal force. The two models are frequently
ity of a photograph taken the moment the indi-
and incorrectly conflated in the scientific litera-
vidual experienced the emotion, including such
ture, without regard for their distinctly different
details as where the individual was or what he or
emphases. [proposed by U.S. psychologists Rob-
she was doing. [first described in 1977 by U.S.
ert R. McCrae (1949– ) and Paul T. Costa, Jr.
psychologists Roger brown and James Kulick
(1942– )]
(1940– ) in their study of people’s recollection
fixation n. 1. an obsessive preoccupation with a of public events, such as U.S. President John F.
single idea, impulse, or aim, as in an idée fixe. 2. Kennedy’s assassination]
in psychoanalytic theory, the persistence of an
early psychosexual stage (see psychosexual de- flat affect total or near absence of appropriate
velopment) or inappropriate attachment to an emotional responses to situations and events.
early psychosexual object or mode of gratifica- See also shallow affect.
tion, such as anal or oral activity. —fixate vb. Flexeril n. a trade name for cyclobenzaprine.
fixed belief see idée fixe. flexibilitas cerea see catalepsy.
237
flight from reality
flight from reality a defensive reaction in- at clothing or bedding, typically associated with
volving withdrawal into inactivity, detachment, dementia, delirium, and high fever. It is some-
or fantasy as an unconscious defense against times a sign of extreme exhaustion and is consid-
anxiety-provoking situations. This may be ex- ered a serious symptom, often associated with a
pressed as a number of defensive behaviors, such poor prognosis. Also called carphology.
as rationalization, daydreaming, or substance flooding n. a technique in behavior therapy in
abuse. It may include a retreat into psychotic be- which the individual is exposed directly to a
havior as a means of avoiding real or imagined maximum-intensity anxiety-producing situa-
problems. Also called retreat from reality. tion or stimulus, either in the imagination but
See also escape from reality. Compare flight most often in reality, without any attempt made
into fantasy; flight into reality. to lessen or avoid anxiety or fear during the ex-
flight into disease see flight into illness. posure. For an individual with claustrophobia,
flight into fantasy a defensive reaction in for example, this would entail spending ex-
F tended periods of time in a small room. Flooding
which individuals experiencing disturbing
thoughts and impulses retreat into fantasy (e.g., techniques aim to diminish or extinguish the
through daydreams) as a means of avoiding undesired behavior and are used primarily in the
harming themselves or others by acting on these treatment of individuals with phobias and simi-
impulses. In this way they can maintain control lar disorders. It is distinct from systematic de-
over their impulses. Compare flight from re- sensitization, which involves a gradual, step-
ality; flight into reality. by-step approach to encountering the feared sit-
uation or stimulus while attempting throughout
flight into health in psychotherapy, an to maintain a nonanxious state. See also implo-
abrupt “recuperation” by a prospective client sive therapy.
after or during intake interviews and before entry
floor effect a situation in which a large propor-
into therapy proper or, more commonly, by a
tion of participants perform as poorly as, or nearly
client in ongoing therapy in order to avoid fur-
as poorly as, possible on a task or other evalu-
ther confrontation with cognitive, emotional, or
ative measure, thus skewing the distribution of
behavioral problems. Psychoanalytic theory in-
scores and making it impossible to discriminate
terprets the flight into health as an unconscious
differences among the many individuals at that
defense mechanism. Also called transference
low level. For example, a test whose items are too
cure; transference remission.
difficult for those taking it would show a floor ef-
flight into illness 1. a tendency to focus on or fect because most people would obtain or be
exaggerate minor physical complaints as an un- close to the lowest possible score of 0. Compare
conscious means of avoiding stressful situations ceiling effect.
and feelings. 2. in psychotherapy, the sudden
flourishing n. a condition denoting good men-
development of neurotic or physical symptoms
tal and physical health: the state of being free
by a client or prospective client. Psychoanalytic
from illness and distress but, more important, of
theory interprets this as an unconscious defense
being filled with vitality and functioning well in
mechanism that is used to avoid examination of
one’s personal and social life. Compare lan-
a deeper underlying conflict. Also called escape
guishing. —flourish vb.
into illness; flight into disease.
flow n. a state of optimal experience arising from
flight into reality a defensive reaction in intense involvement in an activity that is enjoy-
which an individual becomes overinvolved in
able, such as playing a sport, performing a musi-
activity and work as an unconscious means of
cal passage, or writing a creative piece. Flow
avoiding threatening situations or painful
arises when one’s skills are fully utilized yet
thoughts and feelings. Compare flight from
equal to the demands of the task, intrinsic moti-
reality; flight into fantasy.
vation is at a peak, one loses self-consciousness
flight of ideas a rapid, continuous succession and temporal awareness, and one has a sense of
of superficially related thoughts and ideas, mani- total control, effortlessness, and complete con-
fest as hurried speech with frequent abrupt shifts centration on the immediate situation (the here
in topic. A common symptom of a manic epi- and now).
sode, such disturbed thinking occasionally is flowing consciousness the pleasurable sense
seen in other disorders as well, including schizo- of flow and effortlessness that accompanies
phrenia. skilled, nonconflictual activities.
flippancy n. inappropriate levity when address- fluency n. in cognitive psychology, the ability to
ing a serious problem or an anxiety-provoking generate ideas, words, mental associations, or
subject, often as a defensive strategy for limiting potential solutions to a problem with ease and
discussion. —flippant adj. rapidity. It is usually considered to be an impor-
floating-limb response in standard hypnotic tant dimension of creativity. See associative
inductions, a positive response to the suggestion fluency. —fluent adj.
to allow the hand and arm to float upward. See fluent speech speech that is essentially normal
also kohnstamm test. in quantity, stress, pitch, rhythm, and intona-
floccillation n. aimless grasping and plucking tion.
238
focus group
fluid–crystallized intelligence theory an as an agent for treating obsessive-compulsive

occasional synonym of cattell–horn theory disorder (see also clomipramine). U.S. trade
of intelligence. name: Luvox.
fluid intelligence (fluid ability) see fly agaric the highly poisonous mushroom
cattell–horn theory of intelligence. Amanita muscaria, so called because it was once
flumazenil n. a drug used for the emergency re- used as an insecticide to kill flies. muscarine
versal of symptoms of benzodiazepine overdose was the first active ingredient to be identified,
and in anesthesia to reverse benzodiazepine- but it is now known that ibotenic acid and its
induced sedation. It acts by displacing benzo- metabolite muscimol, which is similar in struc-
diazepine (which acts as a gaba agonist) from ture to the inhibitory neurotransmitter gamma-
binding sites on the GABA receptor complex (see aminobutyric acid (GABA) and acts as a gaba
benzodiazepine antagonists; gabaa recep- agonist, are the principal active components.
tor). Because it is a short-acting agent, multiple Effects on humans are initially stimulating,
doses may be required. It is not effective in man- ranging from euphoria through hallucinations F
aging benzodiazepine dependence, because its to hyperactivity or excitement, and then sedat-
rapid action may precipitate a sudden with- ing, inducing deep sleep. Symptoms of poison-
drawal syndrome, nor does it antagonize the ing include dizziness, abdominal pains,
central nervous system effects of other GABA vomiting, muscle cramps, and movement diffi-
agonists (e.g., barbiturates) or reverse their ef- culties; at higher doses these symptoms may be
fects. U.S. trade name: Romazicon. followed by unconsciousness, asphyxiation,
coma, and potentially death. Fly agaric has been
flunitrazepam n. a benzodiazepine that is le-
variously identified as the substance taken by
gally prescribed in some countries (but not the
Norse berserkers before battle, as the plant soma
United States) for the short-term treatment of in-
worshipped in ancient times, and, in fiction, as
somnia and as a preanesthetic medication. It is
the mushroom eaten by Alice before she per-
also used as a drug of abuse for its sedating and
ceived objects larger than life in Lewis Carroll’s
disinhibiting effects. When combined with alco-
Alice in Wonderland.
hol, like many other cns depressants, it can
cause serious problems (see date-rape drug). fMRI abbreviation for functional magnetic
Trade name: Rohypnol. resonance imaging.
fluoxetine n. an antidepressant that is the pro- FMS abbreviation for false memory syndrome; see
totype of the ssris (selective serotonin reuptake false memory.
inhibitors). It acts by inhibiting the serotonin focal degeneration the development of a le-
transporter, preventing reuptake of serotonin sion or dysfunction in a specific area of the brain
into the terminal button (see axon) of the due to a degenerative process, such as dementia.
presynaptic neuron. This presumably results in The lesion may remain limited in focus or spread
higher levels of available neurotransmitter to in- into neighboring regions.
teract with postsynaptic receptors. Fluoxetine focal psychotherapy a form of brief psycho-
differs from other SSRIs in that it and its biologi- therapy in which a single problematic area
cally active metabolic product, norfluoxetine, (e.g., excessive anxiety) is made the target of the
have a prolonged half-life of 5–7 days after a entire course of treatment. The therapist contin-
single dose; thus it takes around 30 days (20–35 ually redirects the process so as to avoid devia-
days) for the drug to reach steady-state concen- tions from this specifically identified aim, for
trations. Like other SSRIs, it should not be used example, by preventing discussion of material
with monoamine oxidase inhibitors. U.S. trade he or she deems irrelevant to the intended thera-
names: Prozac; Sarafem. peutic goal.
fluphenazine n. a high-potency antipsy- focal therapy see focused analysis.
chotic of the piperazine phenothiazine class.
focused analysis a modification of orthodox
It is as potent as haloperidol and has similar
psychoanalysis in which interpretations are fo-
side effects, with neuromuscular and extra-
cused on a specific area of the patient’s problem
pyramidal symptoms predominating. Like halo-
or pathology (e.g., a particular symptom, a par-
peridol, it is also available in an oil-based
ticular aspect of the transference). Also called
injectable form. These so-called depot prepara-
directed analysis; focal therapy. Compare
tions are injected intramuscularly and are very
expectant analysis.
slowly absorbed, allowing periods of several weeks
between doses. U.S. trade name: Prolixin. focus group a small group of people, typically
8–12 in number, who share common character-
flurazepam n. a benzodiazepine derivative
istics (e.g., working parents with 5- to 8-year-old
used in the short-term treatment of insomnia.
children) and are selected to discuss a topic of
U.S. trade name: Dalmane.
which they have personal experience (e.g., their
flutamide n. see antiandrogen. children’s reading abilities and school perfor-
fluvoxamine n. a potent ssri (selective seroto- mance). A leader conducts the discussion and
nin reuptake inhibitor). Although its mecha- keeps it on target. Originally used in marketing
nism of action and antidepressant efficacy to determine consumer response to particular
match those of other SSRIs, it is marketed largely products, focus groups are now used for deter-
239
focusing
mining typical reactions, adaptations, and solu- may experience symptoms of withdrawal during
tions to any number of issues, events, or topics. attempts to reduce food intake or abstain from
focusing n. in experiential psychotherapy, a particular types of food. See also binge-eating
process in which the therapist guides a client to disorder; bulimia nervosa.
focus silently on his or her body-centered experi- food faddism any dietary practice based on ex-
ence of a problem or symptom in a relaxed and aggerated and often incorrect beliefs about the
nonjudgmental way, often with eyes closed. The effects of food or nutrition on health, particu-
client then invites his or her mind to explore larly for the prevention or cure of illness. This is
intuitively what the issue is about, without at- often expressed as strange or inappropriate eat-
tempting to analyze or control thought processes. ing habits and the adoption of cult diets; it may
The method is believed to lead the client to lead to unhealthy weight loss or side effects aris-
deeper feelings and greater insight about and ing from poor nutrition. It is sometimes associ-
peace with the problem or symptom. [developed ated with eating disorders, such as anorexia
F by Austrian-born U.S. psychologist Eugene T. nervosa.
Gendlin (1926– )] foot anesthesia see stocking anesthesia.
focus of convenience in the personality the- foot fetishism see retifism.
ory of U.S. psychologist George A. Kelly (1905–
1967), the set of phenomena to which a given
foramen magnum a large opening at the base
of the skull through which the spinal cord and
theory best applies.
the left and right vertebral arteries, as well as
folie à cinq a rare psychotic disorder in which other tissues, pass between the neck and the in-
five people, usually members of the same family, terior of the skull.
share similar or identical delusions (French, “in-
sanity of five”). It is an example of shared psy-
forced treatment therapy administered to an
individual with a mental disorder without his or
chotic disorder.
her informed consent, for example, court-
folie à deux a rare psychotic disorder in which ordered administration of psychotropic drugs to
two intimately related individuals simulta- a person to restore his or her competency to
neously share similar or identical delusions stand trial or the involuntary hospitalization
(French, “double insanity”). It is the most com- of a person considered dangerous to him- or her-
mon form of shared psychotic disorder. self or others. Many question the ethical accept-
folie à quatre a rare psychotic disorder in ability of the practice, citing its infringement of
which four people, usually members of the same autonomy and the right to refuse treatment
family, share similar or identical delusions and its lack of scientifically demonstrated effec-
(French, “insanity of four”). It is an example of tiveness, with such controversy intensifying in
shared psychotic disorder. recent decades. Also called coercive treat-
folie à trois a rare psychotic disorder in which ment.
three intimately related people simultaneously forebrain n. the part of the brain that develops
share similar or identical delusions (French, “tri- from the anterior section of the neural tube in
ple insanity”). It is an example of shared psy- the embryo, containing the cerebrum and the
chotic disorder. diencephalon. The former comprises the cere-
follow-up counseling 1. the measures taken bral hemispheres with their various regions (e.g.,
by a counselor or clinician in helping a client basal ganglia, amygdala, hippocampus); the
with ongoing problems or new manifestations of latter comprises the thalamus and hypothala-
the original problems. 2. an evaluation of a cli- mus. Also called prosencephalon.
ent’s progress and the effectiveness of counsel- foreclosure n. in development, see identity
ing to date. foreclosure. See also identity versus iden-
follow-up history see catamnesis; posttreat- tity confusion.
ment follow-up. foreconscious n. see preconscious.
follow-up study a long-term study designed to forensic assessment systematic evaluation by
examine the degree to which effects seen shortly a mental health practitioner of a defendant, wit-
after the imposition of a therapeutic interven- ness, or offender for the purpose of informing
tion persist over time. Follow-up studies are also the court about such issues as competency to
used for the long-term study of participants in a stand trial, criminal responsibility, and
laboratory experiment to examine the degree to risk assessment.
which effects of the experimental conditions are forensic neuropsychology the application of
lasting. clinical neuropsychology to issues of both
Folstein Mini-Mental State Examination civil and criminal law, particularly those relating
see mini-mental state examination. to claims of brain injury.
food addiction an eating disturbance charac- forensic psychiatry the branch of psychiatry
terized by a preoccupation with one’s body concerned with abnormal behavior and mental
image and weight, obsessive thoughts about disorders as they relate to legal issues, hearings,
food, the use of food as a source of pleasure, and and trials. Major areas of concern include insan-
compulsive eating. In addition, the individual ity pleas (see insanity defense) and the legal
240
fragile X syndrome
definition of insanity, procedures to commit in- alization hypothesized by Carl rogers in his
dividuals to mental hospitals, and questions of client-centered therapy.
criminal responsibility, competency to formication n. an acutely distressing sensation
stand trial, guardianship, conservatorship, of ants or other insects crawling on the skin. It is
and confidentiality. Also called legal psy- a tactile (haptic) hallucination that occurs in co-
chiatry. caine abuse and delirious states associated with
forensic psychology the application of psy- acute alcoholic hallucinosis, meningitis, rheu-
chological principles and techniques to situa- matic fever, scarlet fever, diphtheria, and other
tions involving the civil and criminal legal infectious disorders. See also acarophobia.
systems. Its functions include assessment and formicophilia n. sexual interest and pleasure
treatment services, provision of advocacy and derived from small animals, insects, or snails,
expert testimony, and research and policy which sometimes involves having these crea-
analysis. Also called legal psychology. See also tures placed on the genitals.
correctional psychology. F
fornication n. voluntary sexual intercourse be-
foreplay n. activity engaged in prior to coitus, tween any two people who are not married to
marked by psychological as well as physical each other. The legal definition varies in differ-
stimulation. The purpose of foreplay, which in- ent areas.
cludes kissing, stroking, fantasizing, and similar fornix n. (pl. fornices) any arch-shaped struc-
activities, is to encourage sexual arousal in the ture, especially the long tract of white matter in
participants. It may last from a few minutes to the brain arching between the hippocampus
several hours. and the hypothalamus, projecting chiefly to
forgetting n. the failure to remember material the mammillary bodies.
previously learned. Forgetting typically is a nor- foster care temporary care provided to children
mal phenomenon that plays an important adap- in settings outside their family of origin and by
tive role in restricting access to information that individuals other than their natural or adoptive
is likely to be needed in current interactions with parents, under the supervision of a public child
the environment, but may also be pathological, welfare agency. Foster care is intended to keep
as, for example, in amnesia. children whose parents are unavailable or inca-
forgiveness n. willfully putting aside feelings of pable of proper care safe from harm, with the ul-
resentment toward an individual who has com- timate goal being to find a secure and permanent
mitted a wrong, been unfair or hurtful, or other- home. Typically, a child is placed with a family
wise harmed one in some way. Forgiveness is not approved for foster care and paid a fee for such
equated with reconciliation or excusing another, by a public child welfare agency. Although these
and it is not merely accepting what happened or foster home arrangements are most common,
ceasing to be angry. Rather, it involves a volun- children may also be placed in group homes or
tary transformation of one’s feelings, attitudes, other institutions. See also adult foster care.
and behavior toward the individual, so that one foster-child fantasy the childhood belief or
is no longer dominated by resentment and can fantasy that the parents are actually adoptive or
express compassion, generosity, or the like to- foster parents. See family romance.
ward the individual. Forgiveness is often consid- foster home 1. a home for the temporary place-
ered an important process in psychotherapy or ment of children whose parents are unavailable
counseling. or incapable of proper care. 2. a home in which a
formal thought disorder disruptions in the person with a mental or physical impairment is
form or structure of thinking. Examples include placed by a social agency for purposes of care
derailment and tangentiality. It is distinct and sustenance. The foster family is usually paid
from thought disorder, in which the distur- by the agency, and the placement may be tem-
bance relates to thought content. porary or permanent. See adult foster care.
formative evaluation a process that is con- fostering n. the process of providing care in a
cerned with helping to improve or guide the de- family environment to children or others to
velopment of a program through the use of whom one is not related. See adult foster
qualitative or quantitative research methodol- care; foster care.
ogy. Ideally, the formative evaluator will repeat- foster placement see foster care.
edly interact, often informally, with the program
Four As see fundamental symptoms.
personnel from the outset of the work to clarify
goals, monitor implementation, and assess staff fragile X syndrome a genetic condition that
and resource requirements. Also called feed- differentially affects males and causes a range of
back evaluation. See also process evalua- developmental problems including learning dis-
tion; summative evaluation. abilities and mental retardation. The disorder is
so named because of alterations in the FMR1
formative spirituality see transcendence gene, on the arm of the X chromosome, that ab-
therapy. normally expand and destabilize it. Males with
formative tendency the general drive toward fragile X syndrome have characteristic physical
self-improvement, growth, and self-actu- features that become more apparent with age,
241
fragmentary delusion
such as large ears, prominent jaw and forehead, a object is to allow unconscious material, such as
long and narrow face, and enlarged testicles. traumatic experiences or threatening impulses,
Both males and females with fragile X may ex- and otherwise inhibited thoughts and emotions
hibit hyperactivity and attention deficits, while to come to the surface where they can be inter-
some males also show autistic behavior. preted. Free association is also posited to help
fragmentary delusion a disorganized, unde- the patient discharge some of the feelings that
veloped delusion or a series of disconnected de- have given this material excessive control over
lusions that is inconsistent and illogical. Also him or her. See basic rule; verbalization.
called unsystematized delusion. Compare free-association test a test in which partici-
systematized delusion. pants are offered a stimulus word and are ex-
fragmentation n. division or separation into pected to respond as quickly as possible with a
pieces or fragments. For example, fragmentation word they associate with the stimulus.
F of thinking (typically termed loosening of as- freebase 1. n. a highly concentrated, chemically

sociations) is a disturbance in which thoughts altered form of cocaine that is prepared by
become disjointed to such an extent as to no treating cocaine with ether. It is ingested by
longer be unified, complete, or coherent; frag- smoking. 2. vb. to smoke this form of cocaine.
mentation of personality (typically termed per- Freedom From Distractibility Index an
sonality disintegration) occurs when an index historically calculated on the wechsler
individual no longer presents a unified, predict- intelligence scale for children that mea-
able set of beliefs, attitudes, traits, and behav- sures short-term attention and concentration. In
ioral responses. recent years, this index has been renamed the
frame-of-orientation need the need to de- working memory index to be more consistent
velop or synthesize one’s major assumptions, with contemporary research and the adult ver-
ideas, and values into a coherent worldview. The sions of the Wechsler scales.
term was introduced by Erich fromm, who dis- freedom to withdraw the right of a research
tinguished between frames of reference based on participant to drop out of an experiment at any
reason and those based on subjective distortions, time.
superstition, or myth.
free energy in psychoanalytic theory, psychic
frame of reference 1. in social psychology, energy that is located in the id, is mobile, and is
the set of assumptions or criteria by which a per- associated with primary processes. Compare
son or group judges ideas, actions, and experi- bound energy.
ences. A frame of reference can often limit or
distort perception, as in the case of prejudice free-floating anxiety 1. a diffuse, chronic
and stereotypes. 2. in cognitive psychology, a sense of uneasiness and apprehension not di-
set of parameters defining either a particular rected toward any specific situation or object. It
mental schema or the wider cognitive struc- may be a characteristic of a number of anxiety
ture by which an individual perceives and eval- disorders, in particular generalized anxiety
uates the world. See also conceptual system; disorder. 2. in psychoanalysis, general feelings
perceptual set. of distress that have been set free from the origi-
nal circumstances that caused them.
framing n. the process of defining the context or
issues surrounding a question, problem, or event free-floating attention in psychoanalysis
in a way that serves to influence how the context and in other forms of psychodynamic psycho-
or issues are perceived and evaluated. Also called therapy, the analyst’s or therapist’s state of
framing effect. See also reframing. evenly suspended attention during the thera-
peutic session. This attention does not focus on
framing effect 1. see atmosphere effect. 2. any one thing the client says, but allows the ana-
see framing. lyst or therapist to listen to all the material being
Franschetti–Zwahlen–Klein syndrome see presented and tune into the client’s affects and
treacher collins syndrome. [Adolphe Fran- unconscious ideas. Also called evenly hover-
schetti (1896–1968), Swiss ophthalmologist] ing attention.
fraternal twins see dizygotic twins. free-floating emotion a diffuse, generalized
F ratio (symbol: F) in an analysis of variance emotional state that does not appear to be asso-
or a multivariate analysis of variance, the ciated with any specific cause. A common exam-
ratio of explained to unexplained variance; that ple is free-floating anxiety.
is, the ratio of between-groups variance to free-floating fear a generalized sense of fear
within-group variance. Also called F statis- that is not directed toward a particular object or
tic; F value. situation.
free association a basic process in psycho- free radical an atom or molecule that has at
analysis and other forms of psychodynamic least one “unpaired” electron in its outer shell.
psychotherapy, in which the patient is encour- This makes it highly reactive and able to engage
aged to verbalize without censorship or selection in rapid chain reactions that destabilize the mol-
whatever thoughts come to mind, no matter ecules around it, thus causing the formation of
how embarrassing, illogical, or irrelevant. The more free radicals. Free radicals can damage cells
242
Friedreich’s ataxia
and have been implicated in aging, inflamma- disorders, such as hysteria, after witnessing dem-
tion, and the progression of various pathological onstrations of hypnosis in Paris by French phy-
conditions, including cancer. sician Jean-Martin Charcot (1825–1893). After
free recall a type of memory task in which a list discarding hypnosis as a technique limited to re-
of items is presented one at a time and partici- moval of symptoms, Freud developed the
pants attempt to remember them in any order. method of free association, which led to rec-
The first and last items presented are best re- ognition of unconscious sexual conflicts and
membered: Proponents of the dual-store repression as the major factors in neuroses.
model of memory attribute this to the fact that These concepts became the cornerstones of the
the last items are still in short-term memory, new discipline that he called psychoanalysis.
and hence recoverable, while the first items re- This discipline focused on such procedures as (a)
ceived the most rehearsal and were transferred the interpretation of dreams in terms of hostile
to long-term memory. or sexual feelings stemming from childhood, (b)
analysis of resistances and the relationship be- F
Fregoli’s phenomenon a misidentification tween therapist and patient, and (c) a study of
syndrome in which an individual identifies a the patient’s present symptomatology in terms
persecutor successively in different people of psychosexual development and early experi-
known to him or her (e.g., a neighbor, doctor, at- ences. The goal of this process, which takes many
tendant), on the delusional assumption that the months or years, was not merely to eliminate
persecutor is capable of changing faces. [first symptoms, but to restructure the patient’s entire
identified in 1927 and named for Italian actor psyche. Freud also applied his psychoanalytic
Leopoldo Fregoli (1867–1936), who was re- method to the study of historical figures, such as
nowned for his ability to alter his appearance] Leonardo da Vinci, and to the exploration of
frenzy n. a temporary state of wild excitement primitive cultures, drawing a parallel between
and mental agitation, at times including violent the “childhood” of the individual and the child-
behavior. It has been associated with mania and hood of the human race. To disseminate his
is sometimes considered synonymous with this views, which were regarded as highly controver-
term. sial at the time (and have remained so), he taught
frequency distribution a plot of the fre- many disciples, was instrumental in establishing
quency of occurrence of scores of various sizes, the first psychoanalytic association, and pub-
arranged from lowest to highest score. lished a series of books, including The Interpreta-
tion of Dreams (1900), Three Essays on the Theory
Freud, Anna (1895–1982) Austrian-born British of Sexuality (1905), Totem and Taboo (1913), Be-
psychoanalyst. The youngest daughter of yond the Pleasure Principle (1920), and The Ego and
Sigmund freud, Anna Freud trained first as an the Id (1923). See also freudian theory of per-
elementary school teacher and then as a psycho- sonality; neo-freudian. —Freudian adj.
analyst in Vienna. She made many original con-
tributions to both the theory and practice of Freudian approach (Freudianism) see psy-
psychoanalysis, particularly through her studies choanalysis.
of defense mechanisms (The Ego and the Mecha- Freudian slip in the popular understanding of
nisms of Defense, 1936). She was a pioneer in the psychoanalytic theory, an unconscious error or
field of child analysis, especially through her oversight in writing, speech, or action that is
work at the Hampstead Clinic in England, to held to be caused by unacceptable impulses
which she moved after the Nazis invaded Austria breaking through the ego’s defenses and expos-
in 1938. Although an orthodox psychoanalyst in ing the individual’s true wishes or feelings. See
many respects, she devoted more attention than parapraxis; slip of the tongue; symptom-
most to the topic of normal development; this atic act. [Sigmund freud]
research resulted in her 1965 book, Normality
and Pathology in Childhood. Anna Freud held nu- Freudian theory of personality the general
merous administrative posts during her career; psychoanalytic concept that character and per-
among them, she served as chair of the presti- sonality are the product of experiences and fixa-
gious Vienna Psychoanalytic Society in the tions stemming from the early stages of
1920s and 1930s, until it disbanded at the time psychosexual development. See psycho-
of the Nazi invasion. See also metapsychologi- analysis. [Sigmund freud]
cal profile. Friedreich’s ataxia a hereditary, progressive
Freud, Sigmund (1856–1939) Austrian neurol- form of ataxia (muscular incoordination) that
ogist and psychiatrist, who invented the tech- results from the degeneration of nerves in the
nique of psychoanalysis. Freud earned a doc- spinal cord and nerves that connect the spinal
torate in medicine in 1881 from the University cord to the arms and legs. Symptoms typically
of Vienna, where he studied under psychologist appear in childhood or early adolescence and
Franz Brentano (1838–1917) and physiologist may include clumsiness, balance problems, diffi-
Ernst Brüecke (1819–1892). He began his profes- culty walking, unsteady gait, slurred speech,
sional life as a neurologist, making significant hearing and vision loss, and rapid involuntary
contributions to that field, but turned his full at- eye movements. [Nikolaus Friedreich (1825–
tention to the psychological approach to mental 1882), German neurologist]
243
friendship
friendship n. a voluntary relationship between frontal cortex the cerebral cortex of the
two or more people that is relatively long-lasting frontal lobe. See also prefrontal cortex.
and in which those involved tend to be con- frontal lobe one of the four main lobes of each
cerned with meeting the others’ needs and inter- cerebral hemisphere of the brain, lying in front
ests as well as satisfying their own desires. of the central sulcus. It is concerned with motor
Friendships frequently develop through shared and higher order executive functions. See
experiences in which the people involved learn also prefrontal lobe.
that their association with one another is mutu- frontal lobe syndrome deterioration in per-
ally gratifying. sonality and behavior resulting from lesions in
fright n. the emotional reaction that arises in the the frontal lobe. Typical symptoms include loss
face of a dangerous or potentially dangerous sit- of initiative, inability to plan activities, difficulty
uation or encounter. Fright differs from fear in with abstract thinking, perseveration, impair-
that the danger is usually immediate, physi- ments in social judgment and impulse control,
F and mood disturbances such as apathy or mania.
cal, concrete, and overwhelming. Physiological
changes in the body associated with fright in- frontal lobotomy see lobotomy.
clude trembling, widening of the eyes, and draw- frotteurism n. in DSM–IV–TR, a paraphilia in
ing away from the fear-producing stimulus. which an individual deliberately and persis-
frigidity n. a woman’s impairment of sexual de- tently seeks sexual excitement by rubbing
sire or inability to achieve orgasm. This obsoles- against other people. This may occur as appar-
cent term has largely been abandoned in favor of ently accidental contact in crowded public set-
female sexual dysfunction. —frigid adj. tings, such as elevators or lines. The person
displaying this type of behavior is called a
fringe consciousness aspects of experience frotteur or a rubber. Also called frottage.
that lack focal perceptual qualities (e.g., color,
texture, taste) but are nevertheless reported with frustration n. 1. the thwarting of impulses or
a high degree of confidence and accuracy. Fringe actions that prevents individuals from obtaining
experiences vary widely, from feelings of ef- something they have been led to expect based
fortfulness and the tip-of-the-tongue phe- on past experience, as when a hungry animal is
nomenon to mystical feelings. prevented from obtaining food that it can see or
smell or when a child is prevented from playing
fringe–focus structure a model of conscious- with a visible toy. Internal forces can include
ness in which the conscious contents typically motivational conflicts and inhibitions; external
have a focal component, with clear and forces can include the actions of other individu-
discriminable sensory features, and a “fringe- als, admonitions of parents or others, and the
conscious” component. rules of society. 2. the emotional state an indi-
Fröhlich’s syndrome a disorder caused by vidual experiences when such thwarting occurs.
underfunctioning of the anterior lobe of the pi- 3. in psychoanalytic theory, the damming up of
tuitary gland (hypopituitarism). Major symptoms psychic energy, which then seeks an outlet in
are underdeveloped genital organs and second- wish-fulfilling fantasies and dreams or in various
ary sexual characteristics, general sluggishness, neurotic symptoms. —frustrate vb.
obesity, and in some cases polyuria (frequent frustration–aggression hypothesis the
urination), polydipsia (frequent consumption of theory, advanced in 1939 by U.S. social scientist
liquids), and mild mental retardation. Also called John Dollard (1900–1980) and colleagues, that
adiposogenital dystrophy; adiposogeni- (a) frustration always produces an aggressive
talism; Launois–Cleret syndrome. [Alfred urge and (b) aggression is always the result of
Fröhlich (1871–1953), Austrian neurologist] prior frustrations. U.S. psychologist Neal miller,
one of the proponents of this theory, later noted
Fromm, Erich (1900–1980) German psychoan-
that frustration can lead to several kinds of ac-
alyst. Fromm earned a doctorate at the Univer-
tions, but maintained that the urge to aggression
sity of Heidelberg in 1922 before training as a
will become more dominant as the thwarting
psychoanalyst in Berlin and Munich. The bulk of
continues. In 1989 U.S. psychologist Leonard
his career was spent in the United States. Fromm
Berkowitz (1926– ) proposed that the frustra-
developed a broad cultural, yet personal, ap-
tion must be decidedly unpleasant in order to
proach focused on (a) the search for meaning, (b)
evoke an aggressive urge. Also called aggres-
the development of personality and socially pro-
sion–frustration hypothesis.
ductive relationships, and (c) the enrichment of
life through character, the need to belong, the frustration–regression hypothesis the
development of individuality, and the replace- theory that frustration often leads to behavior
ment of a commercial marketing orientation characteristic of a much earlier period of life (see
with a sane society. This enrichment of life, he regression). [proposed in 1941 by U.S. psychol-
believed, should be built around cooperation, ogists Roger G. Barker (1903–1990), Tamara
caring, and the ability to love. These concepts Dembo (1902–1993), and Kurt lewin]
were vividly expressed in such books as Man for frustration tolerance the ability of an indi-
Himself (1947), The Sane Society (1955), and The vidual to delay gratification or to preserve rela-
Art of Loving (1956). tive equanimity on encountering obstacles. The
244
functional behavioral assessment
growth of adequate frustration tolerance gen- is distinct from chronological age and
erally occurs as part of a child’s cognitive and represents a combination of physiological, psy-
affective development but may also be strength- chological, and social age. In older adults it is
ened to more adaptive levels later in life through calculated by measuring a range of variables that
therapeutic intervention. correlate closely with chronological age, such as
FSS abbreviation for fear survey schedule. eyesight, hearing, mobility, cardiopulmonary
function, concentration, and memory. Follow-
F statistic see f ratio.
ing the passing of the Age Discrimination in Em-
F test any of a class of statistical tests, notably in- ployment Act, functional age, rather than
cluding the widely used analysis of variance, chronological age, has been made a criterion for
that rely on the assumption that the test statis- employment in some jobs. The functional age of
tic—the f ratio—follows the f distribution a child is measured in terms of the developmen-
when the null hypothesis is true. F tests are tests tal level he or she has reached. It may be com-
of hypotheses about population variances. pared with his or her chronological age as a F
FTT abbreviation for failure to thrive. means of gauging the existence and extent of
fugue n. 1. see dissociative fugue. 2. a brief pe- any impairment or developmental problem.
riod in which an individual appears to be in a functional amnesia loss of memory for events
semiconscious state, sometimes engaging in rou- one has personally experienced in the absence of
tine activity, and subsequently has no memory any identifiable neurological pathology. While
for events during that period. This condition is loss of episodic memory about oneself is the
typically associated with epilepsy but may occur hallmark of functional amnesia, in some cases
in other conditions, such as alcohol intoxication semantic memory about the self may also be
and catatonic excitement. lost, as when a person forgets who he or she is.
fulfillment n. the actual or felt satisfaction of Functional amnesia is thought to arise as a de-
needs and desires, or the attainment of aspira- fense against anxiety and distress or as a way of
tions. See also wish-fulfillment. —fulfill vb. escaping from specific situations.
full inclusion the practice of providing chil- functional analysis 1. the detailed analysis of
dren with disabilities with services in their home a behavior to identify contingencies that sustain
school and of educating them in a regular class- the behavior. 2. a synthesis of a client’s behavior
room on a permanent, full-time basis. See also problems and the variables that are associated
least restrictive environment; mainstream- with or hypothesized to cause them.
ing.
functional analytic causal model (FACM)
fully functioning person a person with a a vector diagram of a functional analysis of an
healthy personality, who experiences freedom of individual client that visually presents a clini-
choice and action, is creative, and exhibits the cian’s conjectures or theories about the client’s
qualities of existential living. [as defined in maladaptive behaviors, the objectives of those
the client-centered therapy of Carl rogers] behaviors, and the variables affecting them. Use
function n. 1. in biology, an activity of an organ of FACM graphically organizes and elucidates
or an organism that contributes to the organ- contingencies affecting the design of therapeutic
ism’s fitness, such as the secretion of a sex hor- interventions and provides an alternative or sup-
mone by a gonad to prepare for reproduction or plement to clinical case conceptualization.
the defensive behavior of a female with young functional autonomy 1. the ability of a per-
toward an intruder. 2. (symbol: f) a mathemati- son to perform independently the various tasks
cal procedure that relates one number, quantity, required in daily life, a core concept in such areas
or entity to another according to a defined rule. as rehabilitation and successful aging. For exam-
For example, if y = 2x + 1, y is said to be a func- ple, decline in functional autonomy is a major
tion of x. This is often written y = f(x). Here y is component of symptoms in severe dementia.
the dependent variable and x is the independent Very few instrumental activities of daily
variable. living remain, and there is a gradual loss of self-
functional adj. 1. denoting or referring to a dis- care, or basic activities of daily living. 2. as
order for which there is no known organic or defined in 1973 by Gordon Willard allport, a
structural basis. In psychology and psychiatry, general principle of motivation stating that dur-
functional disorders are improperly considered ing the performance of purposeful, goal-oriented
equivalent to psychogenic disorders. 2. based behavior, various derivative drives emerge as in-
on or relating to use rather than structure. dependent units from the original drive that in-
functional activities actions associated with spired the behavior. For example, studying
basic daily home and work requirements: an um- motivated by the desire to obtain high grades
brella term encompassing both activities of may be gradually replaced by the desire for (and
daily living and instrumental activities of therefore pursuit of) knowledge for its own sake.
daily living. functional behavioral assessment (FBA)
functional age an individual’s age as deter- 1. an assessment approach that identifies the
mined by measures of functional capability in- functions fulfilled by a particular maladaptive
dexed by age-normed standards. Functional age or problematic behavior by examining the cir-
245
functional blindness
cumstances and consequences associated with functional encopresis see encopresis.

its occurrence. The circumstances (called ante- functional enuresis see enuresis.
cedents), behavior, and consequences are typi-
cally defined in measurable terms, and com- functional family therapy a type of family
binations of particular types of antecedents and therapy that focuses on both family interaction
consequences may be presented systematically patterns and on the benefits family members
as part of the assessment. Thus circumstances may derive from problem behavior. Using re-
and consequences (i.e., motivational factors) as- framing and cognitive behavior therapy
sociated with increases or decreases in the partic- methods, functional family therapy focuses pri-
ular behavior can be identified. Results of these marily on at-risk and behaviorally troubled
assessments provide information of immediate youth and their families.
utility in designing interventions or treatments Functional Independence Measure (FIM)
to address the behavior. 2. any of a wide variety an instrument used in rehabilitation to evaluate
F of assessment methods used in applied behav- specific routine motor, cognitive, and self-care
ior analysis. skills and provide a measure of functional sta-
functional blindness visual deterioration tus. It consists of 18 items related to eating,
without any apparent change or disease affect- grooming, bathing, dressing, toileting, bladder
ing the structural integrity of the visual system: and bowel management, transfers, locomotion,
one of the most frequent symptoms in comprehension, expression, social interaction,
somatization disorder. In addition to loss of problem solving, and memory that are each
acuity, visual functional phenomena may in- rated on a 7-point scale ranging from “depend-
clude photophobia, burning eyes, painful eyes, ent” to “independent.”
tired eyes, monocular diplopia (double vision), functionalism n. a general psychological ap-
and severe concentric visual field constriction in proach that views mental life and behavior in
one or both eyes. Despite the symptoms, the pu- terms of active adaptation to environmental
pils continue to react to light, and the patient au- challenges and opportunities. Functionalism
tomatically avoids objects that would cause was developed at the University of Chicago by
injury. Complete functional blindness is rare. psychologists John dewey, James R. angell,
The condition was formerly known as hysterical and Harvey A. Carr (1878–1954) at the begin-
blindness or psychic blindness. ning of the 20th century as a revolt against the
functional brain imaging the use of brain atomistic point of view of structuralism,
imaging techniques to localize areas of cog- which limited psychology to the dissection of
nitive activation. See functional magnetic states of consciousness and the study of mental
resonance imaging; positron emission to- content rather than mental activities. This focus
mography. reveals the debt of functionalism to evolutionary
concepts, to the act psychology of German
functional communication training a be- psychologist Franz Brentano (1838–1917), and
havior therapy technique used with children to the approach detailed by William james.
and adults diagnosed with developmental im- Functionalism emphasized the causes and con-
pairments, such as autism or mental retardation, sequences of human behavior; the union of the
who are exhibiting aggressive, self-injurious, or physiological with the psychological; the need
highly disruptive behavior. The technique as- for objective testing of theories; and the applica-
sesses the function that the negative behavior tions of psychological knowledge to the solution
serves and uses positive reinforcement to replace of practical problems, the evolutionary continu-
it with more appropriately adaptive communica- ity between animals and humans, and the
tion or behavior that meets the same need. improvement of human life. Also called func-
functional deafness loss of hearing that is not tional psychology. See also chicago school.
associated with any known structural abnormal- functional limitation restriction or lack of
ity. ability in performing an action or activity that
functional disorder a disorder for which arises as a result of a disability. For example, a
there is no known organic basis. In psychology person who is unable to move safely about his or
and psychiatry, functional disorders are improp- her home or community or is otherwise unable
erly considered equivalent to psychogenic dis- to travel independently has a functional limita-
orders. tion with regard to mobility.
functional dyspareunia a sexual dysfunc- functional magnetic resonance imaging
tion of men or women in which there is recur- (fMRI; functional MRI) a form of magnetic
rent and persistent genital pain during coitus. It resonance imaging used to localize areas of
does not include conditions caused exclusively cognitive activation, based on the correlation
by a physical disorder or due to lack of lubrica- between brain activity and blood property
tion, functional vaginismus, or another men- changes linked to local changes in blood flow to
tal disorder. the brain. During periods of cognitive activa-
tion, blood flow is always increased to a greater
functional dyspepsia see dyspepsia. extent than oxygen extraction. In consequence,
functional dyspnea see dyspnea. the proportion of oxygenated hemoglobin in the
246
F value
red blood cells transiently increases in an active dence bias; overattribution bias. [identified
region, leading to a local increase in the signal by U.S. psychologist Lee D. Ross]
detected by fMRI. fundamental interpersonal relations
functional pain pain with no known organic orientation theory (FIRO theory) a theory
cause. explaining the pattern of interactions among
members of a group in terms of three interper-
functional plasticity the ability of the brain sonal needs of the group members: the need for
to adapt to loss of or damage to tissue by trans-
inclusion (i.e., to belong to and be accepted by
ferring all or part of the functions previously per-
the group), the need for control (i.e., to direct
formed by those injured areas to other regions.
the group’s activities), and the need for affec-
The degree to which the brain is able to do this
tion. [proposed by U.S. psychologist William
successfully is called functional reserve and is
Schutz (1925–2002)]
thought to depend on several factors, including
age and the physical status of the brain. fundamental lexical hypothesis see lexi-
cal hypothesis. F
functional psychosis 1. a psychotic state for
fundamental need see physiological need.
which no specific neurological or other physical
pathology has been demonstrated. 2. an obso- fundamental rule see basic rule.
lete name for any severe mental disorder for fundamental symptoms according to Swiss
which no specific neurological or other physical psychiatrist Eugen Bleuler (1857–1939), the four
pathology has been demonstrated. primary symptoms of schizophrenia: abnormal
associations in thinking, autistic behavior and
functional reorganization changes that
thinking, abnormal affect (including flat and
occur after a brain injury to enable other areas of
inappropriate affect), and ambivalence. These
the brain to take over all or part of the functions
symptoms are also known as the Four As. Com-
performed by the injured area.
pare secondary symptoms.
functional status a measure of an individual’s furor n. a sudden outburst of rage or excitement
ability to perform activities of daily living during which an irrational act of violence may
and instrumental activities of daily living be committed. In rare cases of epilepsy, the oc-
independently, used as an assessment of the se- currence of furor takes the place of a tonic–clonic
verity of that individual’s disability. or complex partial seizure; this is known as furor
functional types in Carl jung’s analytic psy- epilepticus or epileptic furor. See also explosive
chology, four personality types based on func- personality; intermittent explosive disor-
tions of the ego. Jung identified four functions, der; isolated explosive disorder.
one of which typically dominates the conscious fusion n. the blending into one unified whole of
ego while the others remain unconscious. The two or more components or elements. This gen-
individuated person (see individuation) will eral meaning is applied in a variety of different
have integrated all the functions into his or her psychological contexts. In perception, for exam-
conscious personality. The functional types are: ple, it may denote a blending of sounds received
(a) the feeling type; (b) the thinking type; (c) by the two ears (binaural fusion) or of images
the sensation type; and (d) the intuitive type. falling on the two retinas (binocular fusion),
See quaternity. See also attitudinal types. while in psychoanalytic theory it denotes in-
functional vaginismus a sexual dysfunction stinctual fusion, the merging of different in-
characterized by recurrent and persistent invol- stincts, as in the union of sexual and aggressive
untary spasms of the musculature of the outer drives in sadism. The term is also sometimes
third of the vagina, which interfere with coitus applied to a state in which the normal dif-
and are not caused exclusively by a physical dis- ferentation between the self and the environ-
order or due to another mental disorder. ment seems to recede or disappear, so that the
individual experiences a sense of being united
function pleasure the pleasure that results with other individuals or with nature. —fuse vb.
from doing something well and that motivates
people to do their best at a task even when there future-mindedness n. the ability to engage in
is no other reward. means–ends thinking about the future, that is, to
think ahead to what the future may hold and
fundamental attribution error in attri- how it might come to pass.
bution theory, the tendency to overestimate
future orientation a time perspective that is
the degree to which an individual’s behavior is
focused on the future, especially on how to
determined by his or her abiding personal char-
achieve one’s future goals.
acteristics, attitudes, or beliefs and, correspond-
ingly, to minimize the influence of the future shock the personal confusion and social
surrounding situation on that behavior (e.g., fi- disorientation that accompany very rapid tech-
nancial or social pressures). There is evidence nological and social change. [defined by U.S. fu-
that this tendency is more common in some so- turist Alvin Toffler (1928– )]
cieties than in others. Also called correspon- F value see f ratio.
247
Gg
g symbol for general factor. receptor in the central nervous system (CNS), it
functions as a chloride channel (see ion chan-
GA abbreviation for gamblers anonymous.
nel). gaba agonists, such as the barbiturates
GABA abbreviation for gamma-aminobutyric and benzodiazepines, enhance the binding of
acid. GABA to GABAA receptors, allowing for in-
GABA agonists compounds that exert an creased conductance of chloride through the ion
agonistic (augmentative) effect at gamma- channel and thereby hyperpolarizing the neu-
aminobutyric acid (GABA) receptor sites (see ron and inhibiting its activity. gaba antago-
gabaa receptor; gabab receptor) or on the ac- nists, such as bicuculline and picrotoxin, block
tion of GABA. Several classes of GABA receptor the inhibitory effects of GABA at this receptor.
agonists exist. Direct GABA agonists (e.g., Many other substances, including alcohol (etha-
muscimol) act at the GABA binding-site on the nol), are thought to exert at least part of their ef-
receptor; indirect GABA agonists facilitate, in fect via interaction at the GABAA receptor.
various ways, the release or activity of GABA. Of GABAB receptor one of the two main types of
the indirect GABA agonists, the benzodiaze- receptor protein that bind the neurotransmitter
pines, which act as allosteric modulators (see gamma-aminobutyric acid (GABA), the other
allosteric modulation) at the GABA receptor being the gabaa receptor. GABAB receptors,
complex, are in the most common clinical use. which are g protein-coupled receptors, are less
GABA antagonists substances that exert an plentiful in the brain than GABAA receptors and
antagonistic (inhibitive) effect at gamma- do not have binding sites for benzodiazepine or
aminobutyric acid (GABA) receptor sites (see barbiturate GABA agonists. Activation of GABAB
gabaa receptor; gabab receptor) or on the ac- receptors results in relatively long-lasting
tion of GABA. Like gaba agonists, GABA antag- neuronal inhibition, but few psychotropic sub-
onists can be direct or indirect. Direct GABA stances exert their effect at these receptors:
antagonists block the GABA receptor; the best baclofen is a relatively selective agonist at
known of these is bicuculline, which acts as a GABAB receptors and is used clinically as a skele-
competitive antagonist for GABA at its receptor tal-muscle relaxant.
site. Indirect GABA antagonists include picro- GAD abbreviation for generalized anxiety dis-
toxin, which is a noncompetitive antagonist at order.
the GABAA receptor complex and blocks the ef-
fects of GABA on the receptor complex. GAF scale abbreviation for global assessment
of functioning scale.
gabapentin n. a drug used for the treatment of
seizures (see anticonvulsant) and for the relief GAI abbreviation for guided affective imag-
of pain associated with shingles. Its mechanism ery.
of action is unknown: It is a chemical analog of galactorrhea n. abnormal expression of breast
the neurotransmitter gamma-aminobutyric acid milk, which may occur either in women at times
(GABA) and may be involved in the increased other than when nursing or in men. Lactation is
synthesis or release of GABA. Gabapentin is cur- stimulated by the pituitary hormone prolac-
rently being investigated for the treatment of tin, and the neurotransmitter dopamine nor-
certain psychological disorders: It may be of mally acts to inhibit the release of prolactin.
some use in managing mania associated with bi- Therefore administration of dopamine-receptor
polar disorders, but this has not yet been con- antagonists (e.g., conventional antipsychotics),
clusively established and gabapentin has been which inhibit the effects of dopamine, may
reported to induce excitation or increase the fre- cause galactorrhea. Pituitary tumors or injury to
quency of episodes in bipolar disorders. Side ef- the pituitary gland, causing excessive secretion
fects are primarily sedation, dizziness, ataxia, of prolactin, may also result in galactorrhea. The
and fatigue; abrupt withdrawal may precipitate dopamine-receptor agonist bromocriptine
seizures. U.S. trade name: Neurontin. may be used to treat the condition.
GABAA receptor one of the two main types of galantamine n. an inhibitor of the enzyme
receptor protein that bind the neurotransmitter acetylcholinesterase that is used for the treat-
gamma-aminobutyric acid (GABA), the other ment of mild to moderate Alzheimer’s disease
being the gabab receptor. It is located at most (see nootropic). Although galantamine and
synapses of most neurons that use GABA as a other acetylcholinesterase inhibitors do
neurotransmitter. The predominant inhibitory not reverse symptoms of dementia, they have
248
gasoline intoxication
been demonstrated to temporarily slow progres- type of low-amplitude brain wave ranging from
sion of the disease. U.S. trade name: Razadyne. 31 to 80 Hz (with power peaking near 40 Hz) and
Gamblers Anonymous (GA) an organization associated with higher-level cognitive activities,
of men and women who share experiences, such as memory storage. Also called gamma
strength, and hope with each other to recover rhythm.
from compulsive gambling, following the gamonomania n. an abnormally strong desire
twelve-step program. See pathological or urge to marry.
gambling. ganglionic blocking agents drugs that in-
gambler’s fallacy a failure to recognize the inhibit the action of the neurotransmitter acetyl-
dependence of chance events, leading to the choline at synapses in the ganglia of the
mistaken belief that one can predict the out- autonomic nervous system (autonomic gan-
come of a chance event on the basis of the out- glia). Among other effects, this causes a decrease
comes of past chance events. For example, a in heart rate and a lowering of blood pressure,
person might think that the more often a tossed and these drugs were formerly widely used in the
coin comes up heads, the more likely it is to treatment of hypertension. However, because of
come up tails in subsequent tosses, although the severity of their side effects, this use is now G
each coin toss is independent of the other, and rare. See mecamylamine.
the true probability of the outcome of any toss is ganja n. one of the more potent forms of can-
still just 0.5. nabis, made from the dried flowering tops of
gambling n. see pathological gambling. female plants. Smokers of this substance report-
game n. 1. in psychotherapy, a situation in edly experience respiratory disorders at a rate
which members of a group take part in some ac- twice that of the average for cannabis smokers.
tivity designed to elicit emotions or stimulate re- Ganser syndrome a condition in which psy-
vealing interactions and interrelationships. In chotic illness is simulated or a dissociated
play therapy games are often used as a projec- state occurs purportedly as a result of an uncon-
tive or observational technique. 2. in transac- scious effort by the individual to escape from an
tional analysis, a recurrent and often deceitful intolerable situation. It is typically seen in psy-
ploy adopted by an individual in his or her deal- chiatric hospitals and, historically, in prisons (it
ings with others. 3. in gestalt therapy, an exis referred to in the older literature as prison psy-
ercise or experiment designed to increase self- chosis). The most prominent feature is the giving
awareness, for example, acting out frightening of approximate answers to simple or familiar
situations or participating in the hot-seat questions (e.g., “3 + 3 = 7”; “a horse has five
technique. legs”). Some other features include clouding of
gamma alcoholism one of the five types of al- consciousness, inattentiveness or drowsiness,
coholism defined by U.S. physician Elvin M. conversion symptoms (e.g., conversion paral-
Jellinek (1890–1963), the others being alpha alysis), hallucinations, and, frequently, loss of
coholism, beta alcoholism, delta alcohol- memory for events subsequent to the episode.
ism, and epsilon alcoholism. It is character- The syndrome has been variously categorized as
ized by physical and psychological dependence, a malingering process, a psychotic disorder,
tolerance, loss of control over drinking, and and a consequence of a head injury. In DSM–IV–
withdrawal symptoms if use is suspended. TR, it is classified as a dissociative disorder
Jellinek considered gamma alcoholism the pre- not otherwise specified. Also called pseudo-
dominant form of alcoholism in the United dementia. [first described in 1898 by Sigbert
States. Although similar to delta alcoholism, Ganser (1853–1931), German psychiatrist]
gamma alcoholism is distinguished by the per- Gardner–Diamond syndrome a condition
son’s complete loss of control, as opposed to his in which an individual bruises easily (purpura
or her inability to abstain. simplex) and black and blue patches (ecchymoses)
gamma-aminobutyric acid (GABA) a major tend to enlarge and result in pain in the affected
inhibitory neurotransmitter in the mamma- tissue. Also called autoerythrocyte sensitiza-
lian nervous system and found widely distrib- tion syndrome; painful bruising syn-
uted in both invertebrate and vertebrate nervous drome; psychogenic purpura. [Louis Klein
systems. It is synthesized from the amino acid Diamond (1902–1995) and Frank H. Gardner
glutamic acid. See also gabaa receptor; (1919– ), U.S. physicians]
gabab receptor. gargoylism n. the facial appearance of people
gamma-aminobutyric acid agonists see with hurler’s syndrome. The features include
gaba agonists. an abnormally long and narrow skull due to pre-
mature closure of the sagittal suture, a broad
gamma-aminobutyric acid antagonists nose bridge, an open mouth with a large pro-
see gaba antagonists. truding tongue, thick lips, and clouded corneas.
gamma-cystathionase deficiency see GAS abbreviation for general adaptation syn-
cystathioninuria. drome.
gamma-hydroxybutyrate n. see ghb. gasoline intoxication a euphoric reaction in-
gamma wave in electroencephalography, a duced by inhalation of gasoline vapor. It also re-
249
gate-control theory
sults in headache, weakness, depression of the community”): a spirit of equality, belonging,

central nervous system, confusion, nausea, and and unity.
respiratory disorders. See inhalant; inhalant gender n. the condition of being male, female, or
abuse. neuter. In a human context, the distinction be-
gate-control theory the hypothesis that the tween gender and sex reflects usage of these
subjective experience of pain is modulated by terms: Sex usually refers to the biological aspects
large nerve fibers in the spinal cord that act as of maleness or femaleness, whereas gender im-
gates, such that pain is not the product of a sim- plies the psychological, behavioral, social, and
ple transmission of stimulation from the skin or cultural aspects of being male or female (i.e.,
some internal organ to the brain. Rather, sensa- masculinity or femininity). See also sex role.
tions from noxious stimulation impinging on gender assignment classification of an infant
pain receptors have to pass through these spinal at birth as either male or female. Children born
gates to the brain in order to emerge as pain per- with ambiguous genitalia are usually assigned a
ceptions. The status of the gates, however, is sub- gender by parents or physicians. See also gen-
ject to a variety of influences (e.g., drugs, injury, der reassignment.
G emotions, possibly even instructions coming
gender coding assigning particular traits or be-
down from the brain itself), which can operate
haviors exclusively or predominantly to males or
to shut them, thus inhibiting pain transmission,
females.
or cause them to be fully open, thus facilitating
transmission. [first proposed in 1965 by Cana- gender concept an understanding of the so-
dian psychologist Ronald Melzack (1929– ) and cially constructed distinction between male and
British neuroscientist Patrick D. Wall (1925– female, based on biological sex but also includ-
2001)] ing the roles and expectations for males and fe-
males of a culture. Children begin to acquire
gatekeeper n. a health care professional, usually
concepts of gender, including knowledge of the
a primary care provider associated with a
activities, toys, and other objects associated with
managed care organization, who determines a
each gender and of how they view themselves as
patient’s access to health care services and whose
male or female in their culture, possibly from as
approval is required for referrals to specialists.
early as 18 months of age.
gateway drug any chemical substance whose gender dysphoria discontent with the physi-
chronic use leads to the subsequent use of more
cal or social aspects of one’s own sex. See also
harmful substances that have significant poten-
dysphoria; gender identity disorder.
tial for abuse and dependence. For example,
alcohol, tobacco, and cannabis are often con- gender identification the process of identify-
sidered a gateway to such drugs as heroin, co- ing oneself as male or female and adopting the
caine, lsd, and pcp. Introduced in the 1950s, roles and values of that gender. See also gender
the concept has become the most popular frame- concept; gender schema.
work for understanding drug use among adoles- gender identity a recognition that one is male
cent populations, guiding prevention efforts and or female and the internalization of this knowl-
even shaping governmental policy. edge into one’s self-concept. Although the domi-
Gaussian distribution see normal distribu- nant approach in psychology for many years
tion. [Karl Friedrich Gauss (1777–1855), Ger- had been to regard gender identity as residing in
man mathematician] individuals, the importance of societal struc-
tures, cultural expectations, and personal inter-
gay 1. adj. denoting individuals, especially males, actions in its development is now recognized as
who are sexually attracted to and aroused by well. Indeed, significant evidence now exists to
members of their own sex. 2. n. a gay individual. support the conceptualization of gender identity
See also homosexuality. as influenced by both environmental and bio-
gay bashing see homophobia. logical factors. See also gender role.
GBBB syndrome see telecanthus-hypo- gender identity disorder in DSM–IV–TR, a
spadias syndrome. disorder characterized by clinically significant
GCS abbreviation for glasgow coma scale. distress or impairment of functioning due to
cross-gender identification (i.e., a desire to be or
GDS 1. abbreviation for geriatric depression
actual insistence that one is of the opposite sex)
scale. 2. abbreviation for global deteriora-
and persistent discomfort arising from the belief
tion scale. 3. abbreviation for gordon diag-
that one’s sex or gender is inappropriate to one’s
nostic system.
true self (see transsexualism). The disorder is
gelasmus n. spasmodic laughter in individuals distinguished from simple dissatisfaction or
with certain psychogenic disorders, schizophre- nonconformity with gender roles. In children,
nia, and some diseases of the brain (especially of the disorder is manifested as aversion to physical
the medulla oblongata). When occurring as an aspects of their sex and rejection of traditional
aspect of a psychomotor seizure, this type of gender roles. In adolescents and adults, it is man-
spasmodic laughter is termed gelastic epilepsy. ifested as the persistent belief that one was born
Gemeinschaftsgefühl n. social interest or the wrong sex and preoccupation with altering
community spirit (German, literally: “feeling for primary and secondary sex characteristics. The
250
general adaptation syndrome
category gender identity disorder not otherwise ject have done much to illuminate the mecha-
specified is used to classify gender-related disor- nism of gene action and have pinpointed genes
ders distinct from gender identity disorder, such responsible for various inherited diseases. This
as gender dysphoria related to congenital will greatly enhance knowledge of physical and
intersexuality, stress-related cross-dressing be- mental disease in coming decades. See also dom-
havior (see transvestism), or preoccupation inant allele; recessive allele.
with castration or penectomy (removal of the gene–environment interaction an interac-
penis). tion between one or more genes and factors in
gender nonconformity behavior that differs the environment, such as may be needed to trig-
from that of others of the same sex or from cul- ger the onset of a disease, condition, or charac-
tural expectations of male and female behavior. teristic.
It sometimes is a developmental marker of adult gene–gene interaction an interaction be-
sexual orientation. tween two or more genes, such as may be respon-
gender orientation see sexual orientation. sible for the development of a disease, condition,
gender reassignment 1. the changing of an or characteristic.
individual’s gender label because of incorrect gene knockout the deliberate inactivation of a G
gender assignment at birth, due to the presence particular gene in order to understand better the
of anomalous genitalia (as in intersexuality). function of that gene. Using genetic engineer-
2. see sex reassignment. ing, scientists replace a normal gene (in an or-
gender role the pattern of behavior, personality ganism such as a mouse) with a defective gene
traits, and attitudes that define masculinity or and assess the impact of the defect on the organ-
femininity in a particular culture. It frequently is ism.
considered the external manifestation of the in- gene linkage the tendency for genes or ge-
ternalized gender identity, although the two netic markers that are located physically close
are not necessarily consistent with one another. to each other on a chromosome to be inherited
gender schema the organized set of beliefs and together. Linkage data can provide high-risk
expectations that guides one’s understanding of family members with estimates of their individ-
maleness and femaleness. ual risk for the disease or condition conveyed by
gender stereotype a relatively fixed, overly the gene.
simplified concept of the attitudes and behaviors general ability a measurable ability believed to
considered normal and appropriate for a person underlie skill in handling all types of intellectual
in a particular culture, based on his or her biolog- tasks. See also general factor.
ical sex. Research indicates that these stereo- general ability tests tests designed to measure
types are prescriptive as well as descriptive. the general factor of intelligence. They usu-
Gender stereotypes often support the social con- ally require, among other things, understanding
ditioning of gender roles. and applying relations among relatively abstract
gender typing expectations about people’s be- stimuli, such as geometric forms.
havior that are based on their biological sex or general adaptation syndrome (GAS) the
the process through which children acquire and physiological consequences of severe stress. The
internalize such expectations. syndrome has three stages: alarm, resistance,
gene n. the basic unit of heredity, responsible for and exhaustion. The first stage, the alarm reac-
storing genetic information and transmitting it tion (or alarm stage), comprises two substages:
to subsequent generations. The observable char- the shock phase, marked by a decrease in body
acteristics of an organism (i.e., its phenotype) temperature, blood pressure, and muscle tone
are determined by numerous genes, which con- and loss of fluid from body tissues; and the
tain the instructions necessary for the function- countershock phase, during which the sympa-
ing of the organism’s constituent cells. Each thetic nervous system is aroused and there is an
gene consists of a section of dna, a large and increase in adrenocortical hormones, triggering
complex molecule that, in higher organisms, is a defensive reaction, such as the fight-or-
arranged to form the chromosomes of the cell flight response. The resistance stage (or adap-
nucleus. Instructions are embodied in the chem- tation stage) consists of stabilization at the in-
ical composition of the DNA, according to the creased physiological levels. High blood pressure
genetic code. In classical genetics, a gene is de- can develop into hypertension, with risk of car-
scribed in terms of the trait that it determines diovascular disturbance. Resources may be de-
and is investigated largely by virtue of the varia- pleted, and permanent organ changes produced.
tions brought about by its different forms, or al- The exhaustion stage is characterized by break-
leles. At the molecular level, most genes encode down of acquired adaptations to a prolonged
proteins, which carry out the functions of the stressful situation; it is evidenced by sleep distur-
cell or act to regulate the expression of other bances, irritability, severe loss of concentration,
genes. A minority encode vital components of restlessness, trembling that disturbs motor coor-
the cell’s protein-assembling apparatus, such as dination, fatigue, jumpiness, low startle thresh-
ribosomes. Recent advances in genetic technol- old, vulnerability to anxiety attacks, depressed
ogy and the work of the human genome pro- mood, and crying spells. [first described by Aus-
251
general arousal
trian-born Canadian physician Hans Seyle halstead–reitan neuropsychological bat-

(1907–1982)] tery to generate an overall estimate of cognitive
general arousal level of energy expenditure, impairment: The higher the score, the greater
proposed as one of the two dimensions in terms the impairment.
of which all human behavior can be explained general paresis dementia associated with ad-
(see arousal), the other being approach–with- vanced neurosyphilitic infection of the brain
drawal. (neurosyphilis), a condition that is now ex-
general factor (symbol: g) a hypothetical tremely rare because syphilis is usually diag-
source of individual differences in general abil- nosed and treated in its early stages. The first
ity, which represents individuals’ abilities to symptoms of general paresis appear 5–30 years
perceive relationships and to derive conclusions after the primary infection. Psychological signs
from them. The general factor is said to be a basic are irritability, confusion, fatigue, and forgetful-
ability that underlies the performance of differ- ness, followed by headaches, confabulation, and
ent varieties of intellectual tasks, in contrast to deterioration in behavior and judgment. If un-
specific factors, which are alleged each to be treated with antibiotics, physical signs gradually
G unique to a single task. Even theorists who posit develop, including sagging facial muscles, va-
multiple mental abilities have often suggested cant expression, slurred speech, and poor hand-
that a general factor may underlie these (corre- writing, followed by inability to dress, paralysis,
lated) mental abilities. [postulated in 1904 by convulsions, loss of bladder and bowel control,
British psychologist Charles Spearman (1863– and gradual deterioration to a vegetative state.
1945)] General paresis was formerly known as general
paralysis of the insane, dementia paralytica, par-
generalizability n. the accuracy with which re- alytic dementia, and paretic psychosis. Also
sults or findings can be transferred to situations called general paralysis.
or people other than those originally studied.
general psychology the study of the basic
generalization n. 1. the process of deriving a principles, problems, and methods underlying
concept, judgment, principle, or theory from a the science of psychology, including such areas
limited number of specific cases and applying it as the physiological basis of behavior, human
more widely, often to an entire class of objects, growth and development, emotions, motiva-
events, or people. See inductive reasoning. 2. tion, learning, the senses, perception, thinking
a judgment or principle derived and applied in processes, memory, intelligence, personality
this way. —generalize vb. theory, psychological testing, behavior disor-
generalized anxiety disorder (GAD) exces- ders, social behavior, and mental health. The
sive anxiety and worry about a range of events study is viewed from various perspectives, in-
and activities (e.g., world events, finances, cluding physiological, historical, theoretical,
health, appearance, activities of family members philosophical, and practical.
and friends, work, or school) accompanied by general systems theory an interdisciplinary
such symptoms as restlessness, fatigue, impaired conceptual framework focusing on wholeness,
concentration, irritability, muscle tension, and pattern, relationship, hierarchical order, integra-
disturbed sleep. The anxiety occurs on more days tion, and organization. It was designed to move
than not and is experienced as difficult to con- beyond the reductionistic and mechanistic tradi-
trol. tion in science (see reductionism) and inte-
generalized seizure a seizure in which abnor- grate the fragmented approaches and different
mal electrical activity involves the entire brain classes of phenomena studied by contemporary
rather than a specific focal area. The two most science into an organized whole. An entity or
common forms are absence seizures and some phenomenon should be viewed holistically as a
tonic–clonic seizures. set of elements interacting with one another
(i.e., as a system), and the goal of general systems
general linear model a large class of statistical theory is to identify and understand the princi-
techniques, including regression analysis, ples applicable to all systems. The impact of each
analysis of variance, and correlational anal- element in a system depends on the role played
ysis, that describe the relationship between a de- by other elements in the system and order arises
pendent variable and one or more inde- from interaction among these elements. Also
pendent variables. Most statistical techniques called systems theory. [formulated by Austrian
employed in the behavioral sciences can be sub- biologist Ludwig von Bertalanffy (1901–1972)]
sumed under the general linear model.
generativity versus stagnation the seventh
general medical condition a disorder that stage of erikson’s eight stages of develop-
has known physical causes and observable phys- ment. Generativity is the positive goal of middle
ical psychopathology. Examples include hyper- adulthood, interpreted in terms not only of pro-
tension and diabetes. Such disorders are creation but also of creativity and fulfilling one’s
classified on Axis III of the DSM–IV–TR (see full parental and social responsibilities toward
axis). the next generation, in contrast to a narrow in-
General Neuropsychological Deficit Scale terest in the self, or self-absorption. Also called
a scale that combines a series of tests from the generativity versus self-absorption.
252
genetic marker
generic name the nonproprietary name for a and screening related to diseases with poten-
pharmaceutical compound. In the United States, tially inherited causes. Genetic counseling is
the name is adopted by the United States most often provided by geneticists or genetic
Adopted Name Council and, if recognized by the counselors, who are trained to discuss hereditary
United States Pharmacopoeia (USP), becomes disease with individuals, take pedigrees, and
the official name of the compound. Compare help individuals and families make decisions
proprietary drug; trademark. about the options open to them with regard to
genetic disease. Genetic testing may or may not
generosity n. the quality of freely giving one’s
be a part of genetic counseling. Genetic counsel-
support or resources to others in need. See also
ors also assess the psychological implications of
kindness. —generous adj.
risk notification to the individual being coun-
gene splicing the technique of inserting genetic seled and the need for further psychological
material, in the form of dna, into an existing counseling following disclosure of test results.
DNA molecule. This is commonly performed in Also called genetic guidance. See also pretest
genetic engineering when genetic material counseling; posttest counseling.
from one organism is introduced into another genetic determinism the doctrine that
organism, usually of a different species. The re- G
human and nonhuman animal behavior and
sultant recombinant dna may create new mental activity are largely (or completely) con-
sources of drugs or similar organic substances trolled by the genetic constitution of the indi-
from microorganisms or correct genetic defects vidual and that responses to environmental
in organisms. influences are for the most part innately deter-
gene therapy the insertion of segments of mined. See biological determinism; deter-
healthy dna into human body cells to correct minism; nature–nurture.
defective segments responsible for disease devel- genetic disorder any disease or condition that
opment. A carrier molecule called a vector is is due to an abnormality of a gene or chromo-
used to deliver the therapeutic gene to the pa- some (see mutation). Also called inherited
tient’s target cells, restoring them to a normal disorder.
state of producing properly functioning pro-
teins. Though experimental, current gene ther- genetic engineering techniques by which the
apy holds significant promise as an effective genetic contents of living cells or viruses can be
treatment for a variety of pathological condi- deliberately altered, either by modifying the ex-
tions, including neurodegenerative disorders. It isting genes or by introducing novel material
is, however, not without its share of problems: (e.g., a gene from another species). This is under-
(a) difficulties integrating therapeutic DNA into taken for many different reasons, including basic
the genome and the rapidly dividing nature of research on genetic mechanisms, the large-scale
many cells have prevented any long-term bene- production of particular gene products (e.g.,
fits; (b) avoiding the stimulation of the immune medically useful proteins), and the genetic mod-
system response to foreign objects; and (c) con- ification of crop plants. There have also been at-
ditions that arise from mutations in a single gene tempts to modify defective human body cells in
are the best candidates for gene therapy, yet the hope of treating certain genetic diseases.
some the most commonly occurring disorders However, considerable public concern focuses
(e.g., heart disease, high blood pressure, Alzhei- on the effects and limits of genetic engineering
mer’s disease, arthritis, diabetes) are caused by of plants and animals, including humans. See
the combined effects of variations in many also gene splicing; recombinant dna.
genes. Additionally, there are ethical, legal, and geneticism n. the concept that behavior is in-
social concerns associated with the practice. See born, as in Sigmund freud’s theory of instincts
also genetic engineering. and psychosexual development. See also ge-
netic determinism.
genetic code the instructions in genes that
“tell” the cell how to make specific proteins. The geneticist n. a health professional who special-
code resides in the sequence of bases occurring izes in the study of genetics. A geneticist may
as constituents of the genetic material, dna or be a member of the staff of a medical services de-
rna. These bases are represented by the letters A, partment of a hospital, medical college, or re-
T, G, and C (which stand for adenine, thymine, search institution.
guanine, and cytosine, respectively). In messen- genetic map a chromosome map of a species
ger RNA, uracil (U) replaces thymine. Each unit, that shows the position of its known genes, ge-
or codon, of the code consists of three consecu- netic markers, or both relative to each other. In
tive bases. Hence, there are 64 possible triplet humans, genetic mapping entails examining the
combinations of the four bases, which specify pattern of inheritance of numerous traits or
the amino acids that make up each protein mol- other markers, over many generations, to estab-
ecule. lish the degree of gene linkage.
genetic counseling an interactive method of genetic marker a gene or segment of DNA with
educating a prospective parent about genetic an identifiable location on a chromosome and
risks, benefits and limitations of genetic testing, whose inheritance can be readily tracked
reproductive risks, and options for surveillance through different generations. Because DNA seg-
253
genetic predisposition
ments that lie near each other on a chromosome genital intercourse sexual intercourse involv-
tend to be inherited together, markers are often ing insertion of the penis into the vagina, as op-
used to determine the inheritance of a gene that posed to other forms of sexual activity.
has not yet been identified but whose approxi- genitality n. the capacity to experience erotic
mate location is known. sensation in the genital organs, starting with
genetic predisposition a tendency for certain childhood masturbation and culminating in
physical or mental traits to be inherited, includ- adult sexuality.
ing physical and mental conditions and disor- genitalization n. 1. in psychoanalytic theory,
ders. Schizophrenia, for example, is a mental the focusing of the genital libido on nonsexual
disorder with a genetic predisposition that af- objects that resemble or symbolize the sex
fects less than 1% of the general population but organs, such as knives, shoes, or locks of hair.
increasingly larger percentages of distant rela- See also fetish. 2. in psychoanalytic theory,
tives, siblings, and identical twins of individuals the achievement of a genital personality.
affected. Also called hereditary predisposi- —genitalize vb.
tion.
genital love in psychoanalytic theory, sexually
G genetics n. the branch of biology that is con- mature love of another person achieved during
cerned with the mechanisms and phenomena of the genital stage of psychosexual develop-
heredity and the laws that determine inherited ment. See also genital personality.
traits. See also behavioral genetics; biogene-
genital mutilation the destruction or physical
sis.
modification of the external genitalia, especially
genetotropic disease any disease due to an in- when done for cultural reasons (as in circumci-
herited enzyme defect or deficiency. Phenyl- sion or female genital mutilation) or as a
ketonuria and other inborn errors of metabolism form of self-punishment.
are examples of such disorders. genital personality in psychoanalytic theory,
genital adj. relating to the sex organs. The exter- the sexually mature, adult personality that ide-
nal genital organs are the penis and scrotum ally develops during the last stage (the genital
for men and the vulva for women. The internal stage) of psychosexual development. Indi-
genital organs are the vagina, uterus, and ovaries viduals who have reached this stage of develop-
for women and the testicles and prostate for ment are posited to have fully resolved their
men. oedipus complex and to exhibit a mature sexu-
genital arousal in sleep penile erection in ality that involves true intimacy and expresses
men and clitoral enlargement and vaginal lubri- equal concern for their own and their partner’s
cation in women that occur during rem sleep satisfaction. Also called genital character. See
(in which dreams occur). It is the result of an in- also genital love.
crease in pelvic blood flow and occurs with all genital stage in psychoanalytic theory, the
dream content; it is not associated only with sex- final stage of psychosexual development, ide-
ual dreams. The phenomenon is used as part of ally reached in puberty, when the oedipus com-
the diagnostic procedures for male erection plex has been fully resolved and erotic interest
problems, as absence of nocturnal penile tumes- and activity are focused on intercourse with a
cence is a measure of physical problems involved sexual partner. Also called genital phase. See
in erectile dysfunction. also genital love; genital personality.
genital character see genital personality. genital stimulation a complex set of factors
genital eroticism the arousal of sexual excite- associated with sexual arousal in mammals, in-
ment by stimulation of the genital organs. cluding integration of male and female genital
reflexes, odors, hormone secretions, sights,
genital herpes a herpes infection that in- sounds, and tactile and kinesthetic cues. Each
volves the genitals, caused by herpes simplex factor contributes to genital stimulation, which
Type 2. Although genital herpes is usually trans- still may occur in the absence of one or more of
mitted by sexual contact, some epidemiologists the cues.
believe that because of extreme human suscepti-
genital zones the external reproductive or-gans
bility to the virus it is possible for transmission
and adjacent areas that are capable of producing
to occur through other means (e.g., hand-to-
genital sensations. See also erogenous zone.
hand contact), especially in cities or other areas
of high population density. genome n. all of the genetic material contained
in an organism or cell. Mapping of the estimated
genitalia pl. n. the reproductive organs of the 20,000–25,000 genes in human DNA was one of
male or female. The male genitalia include the
several goals of the human genome project.
penis, testes and related structures, prostate
gland, seminal vesicles, and bulbourethral genotype n. the genetic composition of an indi-
glands. The female genitalia consist of the va- vidual organism as a whole or at one or more
gina, uterus, ovaries, fallopian tubes, and related specific positions on a chromosome. Compare
structures. The external genitalia comprise the phenotype. —genotypic adj.
vulva in females and the penis and testicles in genotype–environment effects the effects
males. Also called genitals. of genetic constitution on experience, based on
254
gestalt principles of organization
the proposal that an individual’s genotype in- of age-related and cohort-related differences in
fluences which environments he or she encoun- symptoms and behavior.
ters and the type of experiences he or she geriatric rehabilitation the process of restor-
has. Three types of genotype–environment ef- ing, to the fullest extent possible, the functional
fects are proposed: passive (through environ- abilities of older adults following an illness or in-
ments provided by biologically related parents); jury that resulted in loss of the ability to live in-
evocative (through responses elicited by individ- dependently.
uals from others); and active (through the selec-
geriatrics n. the branch of medicine that deals
tion of different environments by different
with the diagnosis and treatment of disorders in
individuals). [proposed by U.S. psychologists
older adults. —geriatric adj.
Sandra Scarr (1936– ) and Kathleen McCartney
(1955– )] geriatric screening a program or system ad-
ministered by a hospital, community center,
genotype–phenotype correlation a corre- county health center, or other such agency to
lation between the location or nature of a muta- provide qualified staff who evaluate the needs of
tion in a gene and the expression of that older adults by providing physical examinations
mutation in the individual, based on observa- and care, psychological evaluations, and finan- G
tions of affected individuals and their genotypes. cial counseling.
Attempts at such correlations are made to eluci-
date which characteristics of a mutation affect gerontology n. the scientific interdisciplinary
the age of onset or severity of diseases with a ge- study of old age and the aging process. Those in-
netic etiology. volved in gerontology include psychologists, bi-
ologists, sociologists, medical scientists, medical
Geodon n. a trade name for ziprasidone. practitioners, geriatric service providers, and
geophagy n. the eating of dirt or clay. It is most scholars from the humanities and social sci-
commonly seen in individuals with mental re- ences. —gerontological adj. —gerontologist
tardation, young children, and occasionally in n.
pregnant women. It is usually a symptom of gerophilia n. sexual attraction to much older
pica but in some cultures it is an accepted prac- partners. Also called gerontophilia.
tice. geropsychology n. a branch of psychology
Geriatric Depression Scale (GDS) an assess- dealing with enhancing the welfare and mental
ment instrument specifically designed for use health of older adults via the provision of va-
with adults aged 65 years and over. It is self- rious psychological services. Also called geri-
administered and comprises a series of 30 yes–no atric psychology. —geropsychological adj.
questions (e.g., “Do you often get bored?”, “Is it —geropsychologist n.
easy for you to make decisions?”, “Do you enjoy Gesamtvorstellung n. the act of holding in
getting up in the morning?”) about depressive mind the entire content of a sentence before the
symptoms that excludes somatic disturbances first word is spoken. [German, literally: “com-
often experienced by older adults. [originally de- plete concept”; coined by Wilhelm wundt]
veloped in 1982 by psychologist T. L. Brink Geschwind’s theory the hypothesis that ex-
(1949– ), psychiatrist Jerome A. Yesavage, and cessive intrauterine exposure to androgens in-
colleagues] hibits development of the thymus gland and
geriatric disorder any disease or chronic con- left cerebral hemisphere, explaining why auto-
dition that occurs commonly, but not exclu- immune disorders tend to be associated with
sively, among older people. Examples of geriatric learning disabilities (including dyslexia) and
disorders include glaucoma, arthritis, and Alz- are more frequent in males than in females. [pro-
heimer’s disease and other dementias. posed in 1984 by U.S. neuroscientists Norman
Geschwind (1926–1984) and Albert Galaburda
geriatrician n. a physician, psychologist, or
(1948– )]
other health care provider who specializes in the
biopsychosocial treatment and management of gestalt n. an entire perceptual configuration
older adults. See also geriatrics. (from German: “shape,” “configuration,” “total-
ity,” “form”), made up of elements that are inte-
geriatric psychology see geropsychology. grated and interactive in such a way as to confer
geriatric psychopharmacology the branch properties on the whole configuration that are
of pharmacology that deals with issues related to not possessed by the individual elements. See
the use of and response to psychoactive agents perceptual organization. See also gestalt
in older adults, as well as the mechanisms re- principles of organization; gestalt psy-
sponsible. Metabolic changes associated with chology.
aging can affect a drug’s biological activity and gestaltism n. the belief system of gestalt psy-
may increase the sensitivity of the patient’s cen- chology.
tral nervous system to drugs.
gestalt principles of organization princi-
geriatric psychotherapy the use of therapy ples of perception, derived by the Gestalt psy-
to treat the mental disorders of older adults. Ge- chologists, that describe the tendency to
riatric psychotherapy requires an understanding perceive and interpret certain configurations at
255
Gestalt psychology
the level of the whole, rather than in terms of ghost sickness a culture-bound syndrome
their component features. See also goodness of found in Native American communities and at-
configuration; prägnanz. tributed to ghosts or sometimes witchcraft.
Gestalt psychology a psychological approach Symptoms include recurring nightmares, weak-
that focuses on the dynamic organization of ex- ness, loss of appetite, fear, anxiety, hallucina-
perience into patterns or configurations (from tions, confusion, and a sense of suffocation.
German Gestalt [pl. Gestalten]: “shape,” “form,” giftedness n. the state of possessing a great
“configuration,” “totality”). This view was es- amount of natural ability, talent, or intelligence,
poused by German psychologists Wolfgang which usually becomes evident at a very young
köhler, Kurt koffka, and Max wertheimer in age. Giftedness in intelligence is often catego-
the early 20th century as a revolt against rized as an iq of two standard deviations above
structuralism, which analyzed experience the mean or higher (130 for most IQ tests), ob-
into static, atomistic sensations, and also against tained on an individually administered IQ test.
the equally atomistic approach of behaviorism, Many schools and service organizations now use
which attempted to dissect complex behavior a combination of attributes as the basis for as-
G into elementary conditioned reflexes. Gestalt sessing giftedness, including one or more of the
psychology holds, instead, that experience is an following: high intellectual capacity, academic
organized whole of which the pieces are an inte- achievement, demonstrable real-world achieve-
gral part. A crucial demonstration (1912) is that ment, creativity, task commitment, proven tal-
of Wertheimer with two successively flashed ent, leadership skills, and physical or athletic
lights, which gave the illusion of motion be- prowess. The combination of several attributes,
tween them rather than of individually flashing or the prominence of one primary attribute,
lights. Later experiments gave rise to principles may be regarded as a threshold for the identifi-
of perceptual organization (see, for example, cation of giftedness. Unfortunately, many schools
closure; prägnanz), which were then applied and program administrators have created po-
to the study of learning, insight, memory, social licies that require multiple indicators for iden-
psychology, and art. tifying and teaching gifted individuals, and—
gestalt therapy a form of psychotherapy in as a group—these people have received less
which the central focus is on the totality of the attention and fewer special services than indi-
client’s functioning and relationships in the viduals with disabilities who require special ed-
here and now, rather than on investigation of ucation. —gifted adj.
past experiences and developmental history. gigolo n. a man who is paid to be a woman’s so-
One of the themes is that growth occurs by as- cial companion or escort, or to provide sexual
similation of what is needed from the environ- services for her, or both.
ment and that psychopathology arises as a Gilles de la Tourette’s syndrome see
disturbance of contact with the environment. tourette’s disorder.
Gestalt techniques, which can be applied in ei-
ther a group or an individual setting, are de- Gillespie syndrome see aniridia-oligophre-
signed to bring out spontaneous feelings and nia-cerebellar ataxia syndrome. [described
self-awareness and promote personality growth. in 1965 by F. D. Gillespie (1927– ), U.S. oph-
Examples of such techniques are role play, the thalmologist]
empty-chair technique, and the hot-seat Gindler method a series of exercises involving
technique. [first proposed in the 1940s by Ger- breathing, gentle touch, and posturing intended
man-born U.S. psychiatrist Frederick (Fritz) S. to foster personal growth and enhance sensory
Perls (1893–1970)] awareness. [Elsa Gindler (1885–1961), German
GHB gamma-hydroxybutyrate: a potent cns de- gymnastics teacher]
pressant that is a metabolic product of the ginkgo n. a tree, Ginkgo biloba, that is indigenous
inhibitory neurotransmitter gamma-aminobu- to Asia but now cultivated widely. An extract of
tyric acid (GABA). It is currently used for treat- the leaves has been used for centuries by Chinese
ment of narcolepsy and management of alcohol herbalists and is reputed to possess medicinal
withdrawal, and in some countries (although and psychotropic properties. It is also a popular
not the United States) has been used as an intra- dietary supplement primarily used to improve
venous general anesthetic. It is commonly en- mental acuity, although clinical evidence sup-
countered as a drug of abuse that produces porting this effect is largely lacking. The active
euphoria and sedation and purportedly en- compounds in ginkgo extract have anticoagu-
hances sexual arousal. Its ability to induce amne- lant properties, and ginkgo has been investi-
sia or unconsciousness has led it to be gated as a treatment for vascular disorders, both
characterized as a date-rape drug. Signs of se- peripheral and cerebral (e.g., vascular dementia),
vere toxicity may occur at levels greater than 40– the latter with equivocal results. Gingko may
60 mg/kg, and deaths have been reported, usu- also have neuroprotective properties and cur-
ally when the substance is mixed with alcohol. rently is under investigation as a treatment for
Withdrawal syndromes, characterized by anxi- the symptoms of Alzheimer’s disease, with re-
ety, tremor, confusion, and rarely seizures, have sults suggesting a potential cognition stabilizing
also been reported. U.S. trade name: Xyrem. effect. Data, however, suggest continual long-
256
glutamate
term use of ginkgo may be associated with exces- grade amnesia). It is a very rare condition of un-
sive bleeding or spontaneous hemorrhage. Addi- known etiology. See also transient global am-
tionally, there are several known and potential nesia.
interactions of ginkgo with other agents, includ- Global Assessment of Functioning Scale
ing anticoagulants, anticonvulsants, monoamine (GAF scale) a scale used for treatment planning
oxidase inhibitors, and nsaids. Ginkgo may and outcome evaluation on Axis V of DSM–IV–
also lower seizure thresholds and should not be TR’s multiaxial evaluation system. Scores (1–
used by people who have a history of seizures. 100) reflect the clinician’s judgment of a pa-
ginseng n. the root of various plants of the genus tient’s overall level of psychological, social, and
Panax, valued for its medicinal properties, partic- occupational functioning at the time of assess-
ularly in Oriental cultures. It has a reputation as ment. The GAF scale is also used to measure the
an aphrodisiac and is also used to enhance over- highest level of such functioning in the past
all physical and mental well-being, enhance year.
strength, boost energy, and relieve stress, but Global Deterioration Scale (GDS) a seven-
there is little clinical evidence supporting its ef- point scale used to indicate the severity of a pri-
fectiveness for any of these purposes. Some stud- mary degenerative dementia, such as alzhei- G
ies, however, have suggested that ginseng may mer’s disease, in an older adult, based on
help regulate blood glucose levels, which has caregivers’ observations of behaviors in the indi-
prompted investigation of its potential use as a vidual. The scale ranges from no cognitive de-
treatment for diabetes, and may improve im- cline (1) to very severe cognitive decline (7).
mune function. Side effects of ginseng use are in- [developed in 1982 by U.S. geriatric psychiatrist
frequent but may include nausea and vomiting, Barry Reisberg (1947– )]
diarrhea, insomnia, headaches, nosebleeds, and
globus pallidus one of the basal ganglia. It is
blood pressure abnormalities. Additionally, gin-
the main output region of the basal ganglia: Its
seng may interact with anticoagulants, caffeine,
output neurons terminate on thalamic neurons,
monoamine oxidase inhibitors, and oral
which in turn project to the cerebral cortex.
hypoglycemics.
globus pharyngeus a sensation of having a
Glasgow Coma Scale (GCS) a rating scale, lump in the throat for which no medical cause
with scores ranging from 3 to 15, that is used to can be identified. It can be a symptom of con-
assess levels of consciousness following a head version disorder and was formerly called glo-
injury. It is the sum of three ratings: eye-opening bus hystericus.
response (graded 1–4), motor response (1–6),
and verbal response (1–5). Scores of 8 or below glossolalia n. unintelligible utterances that sim-
are indicative of severe brain injury and coma, ulate coherent speech, which may have meaning
scores of 9 to 12 are indicative of moderate in- to the utterer but do not to the listener. Glossola-
jury, and scores of 13 or higher are indicative of lia is found in religious ecstasy (“speaking in
mild injury. [originally developed in 1974 by tongues”), hypnotic or mediumistic trances, and
neurologists Graham M. Teasdale and Bryan J. occasionally in schizophrenia. See also neolo-
Jennett at the University of Glasgow, Scotland] gism.
Glasgow Outcome Scale (GOS) a rating scale glove anesthesia a sensory conversion
to assess social activity and independent func- symptom in which there is a functional loss of
tioning after traumatic brain injury. The five cat- sensitivity in the hand and part of the forearm
egories of the original scale are death, persistent (i.e., areas that would be covered by a glove). See
vegetative state, severe disability, moderate dis- also stocking anesthesia.
ability, and good recovery. An extended GOS glucocorticoid n. any corticosteroid hor-
that divides each of the latter three levels into an mone that acts chiefly on carbohydrate metabo-
upper and lower degree of disability is also avail- lism. Glucocorticoids include cortisol, cortico-
able. [originally developed in 1975 by neurolo- sterone, and cortisone.
gist Bryan J. Jennett and psychiatrist Michael R. glucuronidation n. a metabolic process by
Bond at the University of Glasgow, Scotland] which drugs or other substances are combined
glia n. nonneuronal tissue in the nervous system with glucuronic acid to form more water-soluble
that provides structural, nutritional, and other compounds, which are more readily excreted by
kinds of support to neurons. It may consist of the kidneys or in bile. Glucuronidation is the
very small cells (microglia) or relatively large most prevalent of the Phase II reactions of drug
ones (macroglia). The latter include astrocytes, metabolism.
ependymal cells, and the two types of cells that glue sniffing a form of substance abuse in
form the myelin sheath around axons: oligo- which the fumes of certain adhesives, particu-
dendrocytes in the central nervous system and larly plastic model glue, are inhaled for their
Schwann cells in the peripheral nervous system. stimulant effect and euphoria. toluene is the
Also called neuroglia. —glial adj. ingredient with psychoactive effects; other hy-
global amnesia loss of memory for recent drocarbons used for this purpose include xylene
events (retrograde amnesia) combined with an and benzene. See inhalant; inhalant abuse.
inability to remember new information (antero- glutamate n. a salt or ester of the amino acid
257
glutamate hypothesis
glutamic acid that serves as the predominant glycosaminoglycan n. see mucopolysac-

excitatory neurotransmitter in the brain. charidosis.
Glutamate plays a critical role in cognitive,
goal-directed behavior behavior that is ori-
motor, and sensory functions; its role in the
ented toward attaining a particular goal. It is typ-
pathogenesis of schizophrenia is the subject of
ically identifiable by observing that the animal
investigation. It exerts its effects by binding to
or person ceases search behavior and engages in
glutamate receptors on neurons. Excessive
detour behavior when it encounters obstacles to
activity of glutamate at these receptors is associ-
the goal.
ated with damage to nerve tissue (neurotoxicity)
and cell death, possibly the result of calcium goal-limited adjustment therapy see sec-
ions flooding into the cell following overstimu- tor therapy.
lation of nmda receptors. goal object that which an individual is seeking
glutamate hypothesis the theory that de- to attain, particularly the final, ultimate goal fol-
creased activity of the excitatory neurotransmit- lowing a series of subgoals.
ter glutamate is responsible for the clinical goal orientation 1. the tendency to physically
G expression of schizophrenia. The hypothesis de- or mentally position oneself toward a goal. 2.
veloped from observations that administration the characteristic of individuals who tend to di-
of NMDA receptor antagonists, such as pcp rect their behaviors toward attaining goals, par-
(phencyclidine) and ketamine, produce psy- ticularly long-term goals.
chotic symptoms in humans and is supported by
a number of recent studies. See also dopamine goal response the final response in a chain of
hypothesis. behavior directed toward obtaining a goal. In
conditioning, it specifically refers to the re-
glutamate receptor any of various receptors sponse given to a positive reinforcing stimulus.
that bind and respond to the excitatory neuro-
transmitter glutamate. Glutamate receptors are goal stimulus a proprioceptive or other intero-
found on the surface of most neurons. There are ceptive stimulus arising from goal-directed
two main divisions of glutamate receptors: the behavior.
ionotropic and metabotropic. Ionotropic gluta- go-around n. a technique used in group psycho-
mate receptors are further divided into three therapy in which each member in turn is re-
classes: nmda receptors, ampa receptors, and quested to react to another member, a discussion
kainate receptors. Metabotropic glutamate re- theme, or a described or enacted situation.
ceptors (mGlu or mGluR) are subdivided into
several classes denoted by subscript numbers
godemiche n. see dildo.
(i.e., mGlu1, mGlu2, etc.). goldenseal n. a shrub, Hydrastis canadensis, with
glutamic acid an amino acid that is regarded medicinal properties. Indigenous to the eastern
as nonessential in diets but is important for nor- United States, it has a long history as a folk rem-
mal brain function. It is converted into gamma- edy to control uterine bleeding, and its leaves are
aminobutyric acid in a reaction catalyzed by commonly used as a poultice and antibacterial
the enzyme glutamic acid decarboxylase and re- agent. There are few clinical studies evaluating
quiring pyridoxal phosphate, formed from vita- the efficacy of goldenseal but its active ingredi-
min B6 (pyridoxine), as a coenzyme. ents, the alkaloids berberine and hydrastine,
have been studied extensively. Berberine has
glutamic acid decarboxylase the enzyme been shown to have antimicrobial properties
responsible for the formation of the neurotrans- and may also be effective in preventing the
mitter gamma-aminobutyric acid (GABA) from growth of cancer cells. Hydrastine has vasocon-
glutamic acid. strictive and abortifacient effects and has been
glutethimide n. one of the nonbarbiturate sed- shown to induce labor in pregnant women when
atives introduced in the early 1950s. Structurally taken orally. At recommended doses, goldenseal
similar to and pharmacologically interchange- appears to have minimal adverse effects (e.g., ir-
able with the barbiturates, glutethimide of- ritation of the mouth, throat, and stomach; tin-
fered no advantages for treatment of anxiety or gling of the skin) but at higher doses it may cause
insomnia. Now rarely used clinically, it is some- hypertension and increase heart rate; it has also
times encountered as a drug of abuse. U.S. trade been associated with seizures and other evidence
name: Doriden. of overstimulation of the central nervous sys-
glycine n. an amino acid that serves as one of tem, and at very high doses may be toxic, poten-
the two major inhibitory neurotransmitters in tially causing paralysis, respiratory failure, and
the central nervous system (particularly the spi- death.
nal cord), the other being gamma-aminobuty- Goltz syndrome a congenital disorder marked
ric acid (GABA). Glycine synthesis occurs via by eye anomalies, absent or extra digits, and skin
two different pathways; in the most important lesions, particularly nodules of herniated subcu-
of these, glycine is synthesized from the amino taneous fat in thin skin areas. About 5% of af-
acid serine in a single reaction catalyzed by the fected individuals tested have been found to
enzyme serine hydroxymethyltransferase. Also have mental retardation. Also called focal der-
called aminoacetic acid. mal hypoplasia; Goltz–Gorlin syndrome.
258
Graefenberg spot
[Robert William Goltz (1923– ) and Robert choanalyst Harry Stack Sullivan (1892–1949),
James Gorlin (1923–2006), U.S. physicians] the child’s personification of behaviors and
gonad n. either of the primary male and female impulses that meet with the approval of the par-
sex organs, that is, the testis or the ovary. —go- ents. The good me is posited to develop as a part
nadal adj. of the socialization process and to protect the
child from anxiety about himself or herself.
gonadal dysgenesis see turner’s syndrome. Compare bad me. See also not me.
gonadotropin n. any of several hormones that goodness of configuration the quality of a
stimulate functions of the gonads. Gonadotro- shape or form that has high levels of simplicity,
pins include follicle-stimulating hormone and regularity, symmetry, or continuity. Gestalt psy-
luteinizing hormone, produced by the anterior chologist Wolfgang köhler speculated that the
pituitary gland in response to gonadotro- mind tends to perceive more goodness of config-
pin-releasing hormone, and chorionic gonad- uration than may actually exist in a shape. See
otropin, which is produced by the placenta (see also closure; gestalt principles of organi-
human chorionic gonadotropin). Also called zation; prägnanz.
gonadotropic hormone. See also human
menopausal gonadotropin. —gonadotropic goodness of fit any index that reflects the de- G
adj. gree to which values predicted by a model agree
with empirically observed values.
gonadotropin-releasing hormone (GnRH)
a hypothalamic hormone that controls the good object in the object relations theory of
release of luteinizing hormone and follicle- Melanie klein, an introjected part-object that
stimulating hormone from the anterior pituitary is perceived as benevolent and satisfying (see
gland. See also releasing hormone. introjection). It is an early object representa-
tion that derives from of the object splitting
gonorrhea n. a sexually transmitted disease into parts containing positive and negative qual-
caused by the bacterium Neisseria gonorrhoeae ities. The good object forms the core of the in-
(the gonococcus). The primary focus of infection fant’s immature ego. Compare bad object.
is the genital tract; untreated, it can lead to steril-
ity. The bacterium can later infect the eyes and Gordon Diagnostic System (GDS) an assess-
cause gonococcal conjunctivitis, a serious condi- ment device that aids in the diagnosis of atten-
tion that can lead to blindness. See also ure- tion deficits. It provides information about an
thritis. individual’s ability to sustain attention and exert
self-control on a continuous performance test.
good breast in the psychoanalytic theory of The GDS is a microprocessor-based, portable
Melanie klein, the internalized representation unit that administers a series of tasks in the form
(see introjection) of the mother’s breast as of games. [Michael Gordon (1952– ), U.S. psy-
nourishing and satisfying. According to Klein, chologist]
the infant first experiences the mother and the
nourishing breast as part-objects with positive GOS abbreviation for glasgow outcome scale.
qualities—the good breast—and negative quali- G protein any of a class of proteins that are cou-
ties—the bad breast. pled to the intracellular portion of a type of
good enough mother in the object rela- membrane receptor (G-protein-coupled recep-
tions theory of British psychoanalyst Donald tors) and are activated when the receptor binds
Winnicott (1896–1971), the ordinary, devoted an appropriate ligand (e.g., a neurotransmitter)
mother who provides an adequate or good on the extracellular surface. G proteins thus
enough environment for the growth of the in- have a role in signal transduction, being in-
fant’s ego to express its true self. The good volved, for example, in indirect chemical
enough mother begins mothering by adapting neurotransmission. They work in conjunc-
entirely to the infant and providing an environ- tion with the nucleotides guanosine diphos-
ment free of impingements, but later gradually phate (GDP) and guanosine triphosphate (GTP)
creates small failures of adaptation to teach the and serve to transmit the signal from the recep-
infant to tolerate the frustrations of reality. tor to other cell components (e.g., ion channels)
in various ways, for example by controlling the
good enough parent a parent who cares for synthesis of second messengers within the
his or her child in any way that is adequate for cell.
proper development. [proposed by U.S. psychol-
ogist Sandra Scarr (1936– )] Graefenberg spot (G-spot) an area on the an-
terior wall of the vagina, about 4 cm (1–2 in.)
good gestalt the quality possessed by an ar- into the vagina. Some women experience plea-
rangement of stimuli that is complete, orderly, sure from stimulation of this area and may have
and clear with a high degree of goodness of an ejaculation from a gland there. However, it is
configuration. Although this is related to the not clear how many women have this gland, or
principle of prägnanz, it is distinct in that the find this area to be especially responsive during
arrangement of stimuli need not be the simplest sexual activity, and some research suggests that
one possible. See also gestalt; gestalt princi- the ejaculation may be urine, expelled from the
ples of organization. bladder. [Ernst Graefenberg (1881–1957), Ger-
good me in the self-system theory of U.S. psy- man gynecologist]
259
grandiose delusion
grandiose delusion see delusion of gran- Greig syndrome see hypertelorism. [David
deur. M. Greig (1864–1936), Scottish physician]
grandiosity n. an exaggerated sense of one’s grief n. the anguish experienced after significant
greatness, importance, or ability. In extreme loss, usually the death of a beloved person. Grief
form, it may be regarded as a delusion of gran- is often distinguished from bereavement and
deur. mourning. Not all bereavements result in a
grand mal see tonic–clonic seizure. strong grief response; nor is all grief given public
grand mean a mean (numerical average) of a expression (see disenfranchised grief). Grief
group of means. often includes physiological distress, separa-
tion anxiety, confusion, yearning, obsessive
graphoanalysis n. see graphopathology. dwelling on the past, and apprehension about
graphology n. the study of the physical charac- the future. Intense grief can become life-
teristics of handwriting, particularly as a means threatening through disruption of the immune
of inferring the writer’s psychological state or system, self-neglect, and suicidal thoughts. Grief
personality characteristics. For example, it is may also take the form of regret for something
G sometimes used in personnel selection as a pre- lost, remorse for something done, or sorrow for a
dictor of job performance. Graphology is based mishap to oneself.
on the premise that writing is a form of expres-
grief counseling the provision of advice, infor-
sive behavior, although there is little empirical
mation, and psychological support to help indi-
evidence for its validity. Also called handwrit-
viduals whose ability to function has been
ing analysis. —graphological adj. —gra-
impaired by someone’s death, particularly that
phologist n.
of a loved one or friend. It includes counseling
graphomania n. a pathological impulse to for the grieving process and practical advice con-
write. In its most severe form, it may degenerate cerning arrangements for the funeral and burial
into graphorrhea. of the loved one. Grief counseling is sometimes
graphopathology n. the interpretation of per- offered by staff in specialized agencies (e.g., hos-
sonality disorders by studying handwriting. Also pices) or it may be carried out in the context of
called graphoanalysis. other counseling. See also bereavement ther-
graphorrhea n. the writing of long lists of inco- apy.
herent, meaningless words, which sometimes griefwork n. the theoretical process through
occurs in the context of a manic episode. which bereaved people gradually reduce or
graphospasm n. a rare name for writer’s transform their emotional connection to the
cramp. person who has died and thereby refocus appro-
priately on their own ongoing lives. It is not nec-
grasp reflex an involuntary grasping by an in-
essary to sever all emotional connections with
dividual of anything that touches the palm. This
the dead person. Instead, adaptive griefwork will
reflex is typical of infants but in older individu-
help transform the relationship symbolically, as
als it may be a sign of frontal lobe damage.
a continuing bond that provides a sense of
gratification n. the state of satisfaction follow- meaning and value conducive to forming new
ing the fulfillment of a desire or the meeting of a relationships.
need. See delay of gratification; immediate
gratification. grisi siknis a culture-bound syndrome
found in Nicaragua and characterized by head-
gratification of instincts see satisfaction ache, anxiety, anger, and the sudden onset of an
of instincts. episode of hyperactivity and potentially danger-
Graves’ disease a disorder characterized by en- ous behavior in the form of running or fleeing.
largement and overactivity of the thyroid gland There is ensuing exhaustion, sleep, and amnesia
and marked by a swelling in the neck (goiter), for the episode. The syndrome, which has some
abnormal protrusion of the eyeballs (exophthal- similarities to piblokto, is usually classified as a
mos), and rapid pulse and other symptoms of dissociative trance disorder.
thyrotoxicosis. Also called exophthalmic grooming n. a basic function of self-care that in-
goiter. [Robert J. Graves (1796–1853), Irish phy- cludes cleaning and maintaining one’s body,
sician] hair, clothes, and general appearance. In ani-
gray matter any area of neural tissue that is mals, grooming has both hygienic functions,
dominated by cell bodies and is devoid of my- such as picking parasites or dirt from the fur, and
elin, such as the cerebral cortex and the H- social functions, including the provision of re-
shaped periaqueductal gray of the spinal ward through activation of endogenous
cord. Compare white matter. opioids in the recipients. Training or retraining
Great Mother see magna mater. in grooming can be a central aspect in the reha-
greeting behavior a form of attachment be- bilitation of individuals with mental or physical
havior that in humans begins to manifest itself impairments.
clearly at about 6 months of age, when the in- gross motor describing activities or skills that
fant responds to the arrival of a parent or care- use large muscles to move the trunk or limbs and
giver. control posture to maintain balance. Examples
260
group identification
of gross motor skills include waving an arm, ance and support for clients organized as a
walking, hopping, and running. Compare fine group, as opposed to individual counseling.
motor. Group counseling can be used, for example, to
grounded theory a set of procedures for the assist high school students in choosing a college
systematic analysis of unstructured qualitative or to assist employees of an organization in stat-
data so as to derive by induction a theory that ing dissatisfactions and proposing solutions to
explains the observed phenomena. managers and employers.
ground rules in psychotherapy, the elements group difference any observed variation be-
of the contract for therapy, including but not tween groups of participants in an experiment
limited to the fee; the time, location, and fre- when considering each group as a single entity.
quency of the sessions; and therapist confidenti- group dynamics 1. the dynamic rather than
ality. static processes, operations, and changes that
occur within social groups, which affect patterns
group n. 1. in social psychology, two or more
of affiliation, communication, conflict, confor-
interdependent individuals who influence one
mity, decision making, influence, leadership,
another through social interaction. Common
features of groups include joint activities that ei-
norm formation, and power. The term, as used G
by Kurt lewin, emphasizes the power of the
ther focus on the task at hand or concern the in-
fluid, ever-changing forces that characterize in-
terpersonal relations between group members,
terpersonal groups. Also called group process.
structures involving roles and norms, a degree of
2. the field of psychology devoted to the study of
cohesiveness, and shared goals. Also called so-
groups and group processes. 3. a conceptual and
cial group. 2. a collection of participants in a
clinical orientation in group psychotherapy that
research study whose responses are to be com-
explicitly recognizes and explores group-level
pared to the responses of one or more other col-
processes in the treatment group.
lections of research participants. Participants in
a particular group all experience the same exper- group experience in group psychotherapy and
imental conditions or receive the same treat- group counseling, the interactions that give the
ment, which differs from the experimental client an opportunity to gain insight into his or
conditions or treatments participants in other her problems by sharing with and learning from
groups experience or receive. 3. in the psychol- other members. The group experience is particu-
ogy of perception, a configuration of individual larly valuable in helping clients understand how
objects that are perceived to form a unified they are perceived by other people. When group
whole, or gestalt. therapy or counseling is given in addition to in-
dividual intervention, it allows the therapist or
group analysis the study of the pathological counselor to observe the client’s emotional diffi-
behavior of a group. culties as revealed in group interactions.
group-analytic psychotherapy a type of group G monosomy a rare chromosomal dis-
group psychotherapy that focuses on the com- order involving the absence of all or part of a G-
munication and interaction processes taking group chromosome (i.e., chromosome 21 or 22).
place in the group as a whole. Interventions Affected individuals have short spadelike hands
make use of group rather than individual forces and severe mental retardation. Because of varied
as the principal therapeutic agent. Also called effects, more than one chromosomal defect may
therapeutic group analysis. [originated in be involved. Chromosome 21 is often involved
the 1940s by Sigmund Heinrich Foulkes (1898– in translocations and aberrations related to
1976)] down syndrome.
group climate the relative degree of accep- group health plan see indemnity plan.
tance, tolerance, and freedom of expression that
group home a residential facility that offers
characterizes the relationships within a counsel-
housing and personal care services, such as
ing or therapy group. Interpersonal behavioral
meals, supervision, and transportation. Also
boundaries are generally freer and broader than
called group residence.
in social contexts, and the meaning of interper-
sonal behavior is often the specific focus of group hypnosis see collective hypnotiz-
group discussion. ation.
group cohesion see cohesion. group identification 1. the act or process of
associating oneself so strongly with a group and
group consciousness 1. the awareness of the its members that one imitates and internalizes
group, its members, and their commonalities ex- the group’s distinctive features (actions, beliefs,
hibited by individual members of the group. Just standards, objectives, etc.). This process can lead
as self-consciousness pertains to awareness of not only to an enhanced sense of group belong-
the self, so group consciousness pertains to ing, group pride, and group commitment but
awareness of the collective. 2. a group’s total also to autostereotyping, in which one accepts as
awareness of itself, suggested in some cases to be self-descriptive certain stereotypical qualities at-
greater than the sum of individual members’ tributed to the group as a whole, and a reduced
awareness. sense of individuality (see deindividuation). 2.
group counseling a method of providing guid- in the psychoanalytic theory of Sigmund freud,
261
group marriage
the process by which individuals become emo- ing and sharing” community to help members
tionally attached to social groups. Just as chil- attain emotional maturity, personal responsibil-
dren bond with and imitate their parents, adults ity, and recovery from mental illness. GROW,
bond with, and take on the characteristics of, INC., originated in Australia.
their groups. 3. more rarely, the act of consider- growth group a group that focuses on the
ing another group’s perspective or outlook even growth and development of its individual mem-
though one is not a member of that group. bers. See also encounter group; marathon
group marriage a family pattern found in group; t-group.
some indigenous cultures and certain minority growth motivation see metamotivation.
religious groups in which several men and
women live together, sharing the burdens of the growth principle the concept that in an atmo-
household, the rearing of children, and a com- sphere free of coercion and distortion an indi-
mon sexual life. See also polygamy. vidual’s creative and integrative forces will
lead to fuller adaptation, insight, self-esteem,
group medical practice the practice of medi- and realization of potential. [formulated by Carl
cine by a group of physicians, typically various rogers]
G specialists, associated not only for administra-
tive reasons but also for such clinical purposes as
G-spot abbreviation for graefenberg spot.
cooperative diagnosis, treatment, and preven- guanfacine n. a drug used for the treatment of
tion. Also called group practice. hypertension. It acts as an agonist at alpha-
adrenergic receptors, directly stimulating α2-
group practice see group medical practice.
adrenoreceptors to restrict the flow of impulses
group process 1. see group dynamics. 2. the in peripheral sympathetic nerves supplying the
interpersonal component of a group session, in arteries, thus causing them to relax (widen);
contrast to the content (such as decisions or in- most of the other commonly prescribed
formation) generated during the session. antihypertensive drugs act as beta blockers or as
group relations theory the view that behav- diuretics. Guanfacine is also a sedating agent
ior is influenced not only by one’s unique pat- that is occasionally used as an adjunct in the
tern of traits but also by one’s need to conform treatment of attention-deficit/hyperactivity dis-
to social demands and expectations. Social deter- order and similar behavior disorders in children,
minants become particularly evident in group although it is not officially approved by the U.S.
therapy, which tends to challenge attitudes, Food and Drug Administration for these condi-
such as prejudices, that are based on conformity tions and may cause excess sedation and
and restricted thinking. [proposed by Gordon hypotension (low blood pressure). The drug has
W. allport] also been investigated for the management of
group residence see group home. posttraumatic stress disorder, Tourette’s disor-
der, and Alzheimer’s disease. U.S. trade name:
group sex sexual activity among a group of het- Tenex.
erosexual people, gay men, or lesbians, who usu-
ally meet with the express purpose of obtaining guarana n. a shrub (Paullinia cupana) indigenous
maximum satisfaction through such means as to the Brazilian Amazon, the seeds of which were
observing each other, experimenting with differ- originally thought to contain guaranine, a
ent techniques, and exchanging partners. methylxanthine compound that is essentially
indistinguishable from caffeine. It is now
group superego in psychoanalytic theory, the known that guarana in fact contains a signifi-
portion of the superego acquired from peer cant amount of caffeine, which is its primary ac-
groups as opposed to the part derived from pa- tive ingredient, as well as lesser amounts of the
rental identifications. methylxanthines theophylline (the active ingre-
group therapy treatment of psychological dient in tea) and theobromine. Used as a stimu-
problems in which two or more participants in- lant and appetite suppressant, guarana is
teract with each other on both an emotional and available in many over-the-counter preparations
a cognitive level, in the presence of one or more in the United States and other Western nations.
psychotherapists who serve as catalysts, facilita- At recommended doses it appears to have the
tors, or interpreters. The approaches of groups same mild adverse effects known to be associated
vary, but in general they aim to provide an envi- with other sympathomimetic stimulants (e.g.,
ronment in which problems and concerns can restlessness, increased urination, gastrointesti-
be shared in an atmosphere of mutual respect nal distress) but may interact with medications,
and understanding. Group therapy seeks to en- particularly monoamine oxidase inhibitors.
hance self-respect, deepen self-understanding, Additionally, additive effects and potential tox-
and improve interpersonal relationships. Also icity may occur when guarana is combined with
called group psychotherapy. Compare indi- other caffeine-containing products, and there is
vidual therapy. growing concern that use of guarana-containing
GROW, INC. a mutual-help organization devel- products may cause such serious adverse events
oped to provide help for individuals with depres- as chest pain, irregular heartbeat, seizures, coma,
sion, anxiety, and other mental health problems. and possibly death.
Using a twelve-step program, it offers a “car- guardian ad litem an individual appointed by
262
gynecomastia
the court to represent in a lawsuit someone who Medal of the American Psychological Founda-
is incapacitated, either by age or by mental or tion.
physical disability. The individual’s status as Guilford dimensions of intelligence three
guardian ad litem is temporary and is dissolved dimensions of intelligence postulated to under-
upon resolution of that lawsuit. lie individual differences in scores on intelli-
guardianship n. a legal arrangement that gence tests, namely, contents, operations, and
places the care of a person and his or her prop- products. Each mental ability represents a com-
erty in the hands of another. When people are bination of these three facets. For example, a
deemed incompetent by the court, and therefore verbal-analogies test would represent a combina-
unable to make decisions about their own care or tion of cognition (operation) of verbal (content)
to manage their own affairs, a guardian is ap- relations (product). The number of mental abili-
pointed by the court to manage their property, ties initially proposed by Guilford was 120; this
make personal decisions on their behalf, and was later increased to 150. The validity of this
provide for their care and well-being. See also theory was subsequently called into question
conservatorship. by the work of U.S. psychologist John L. Horn
(1928–2006), which suggested that the existence G
guided affective imagery (GAI) in psycho- of the proposed factors is not supported by re-
therapy, the drawing out of emotional fantasies, search results. [Joy Paul guilford]
or waking dreams, a technique used to ease ca-
tharsis and work on emotions that are present Guilford–Zimmerman Temperament
but painful for the client to discuss. The thera- Survey (GZTS) a personality inventory for use
pist suggests concentration on past images that with individuals aged 16 years and over, measur-
would bring up the emotional state or, in some ing 10 traits identified by factor analysis:
cases, images of desired future successes. The ascendance, sociability, friendliness, thoughtful-
technique is often used in brief psychother- ness, personal relations, masculinity, objectiv-
apy and group therapy. Also called guided ity, general activity, restraint, and emotional
imagery. See also visualization. stability. It comprises 300 descriptive statements
(e.g., “You tend to lose your temper”) to which
guiding fiction a personal principle that serves participants respond “yes,” “no,” or “?”. [origi-
as a guideline by which an individual can under- nally developed in 1949 by U.S. psychologists
stand and evaluate his or her experiences and de- Joy Paul guilford and Wayne S. Zimmerman
termine his or her lifestyle. In individuals (1916– )]
considered to be in good or reasonable mental
guilt n. a self-conscious emotion character-
health, the guiding fiction is assumed to ap-
ized by a painful sense of having done (or
proach reality and be adaptive. In those who are
thought) something that is wrong and often by a
not, it is assumed to be largely unconscious, un-
readiness to take action designed to undo or mit-
realistic, and nonadaptive. [term originally used
igate this wrong. —guilty adj.
by Alfred adler]
guilty but mentally ill (GBMI) a court judg-
Guilford, Joy Paul (1897–1987) U.S. psycholo- ment that may be made in some states when de-
gist. Guilford received his doctorate in psychol- fendants plead insanity (see insanity defense).
ogy from Cornell University, studying under Defendants found guilty but mentally ill are
Edward B. titchener, Karl Dallenbach (1887– treated in a mental hospital until their mental
1971), and Gestalt psychologists Kurt koffka health is restored; they then serve the remainder
and Harry Helson (1898–1977). After teaching at of their sentence in the appropriate correctional
the University of Nebraska, he moved in 1940 to facility.
the University of Southern California, where he
remained for the rest of his career. Guilford is Gulf War syndrome a collection of unex-
best known for his contributions to psychomet- plained symptoms experienced by some veter-
rics, publishing the first edition of the widely ans of the 1991 Gulf War. Symptoms may
used Psychometric Methods in 1936, and also for include headaches, fatigue, joint pain, skin
his use of factor analysis in studying person- rashes, and memory loss.
ality and intelligence. Important works on these gynecomastia n. abnormal development of
topics include Personality (1959) and The Nature breast tissue in males. In young men the condi-
of Human Intelligence (1967). Countering the tion usually occurs on both sides, whereas in
view that intelligence could be characterized by men over 50 gynecomastia tends to be unilat-
a single, immutable rating, such as the iq, eral. Gynecomastia may occur as a result of hor-
Guilford argued that intelligence was multifac- monal imbalance related to a tumor or as a side
eted and that its components could be improved effect of therapy with antiandrogens or with
through education. He developed an important dopamine-receptor antagonists, which in-
model, known as the structure of intellect clude many antipsychotic drugs. Dopamine in-
model, to classify the many components of inhibits the release from the anterior pituitary of
telligence that he and other researchers had the hormone prolactin; therefore, inhibition
named. Among his honors were the Distin- of dopaminergic activity may result in excess se-
guished Scientific Contributions Award from the cretion of prolactin, leading to engorgement of
American Psychological Association and the Gold breast tissue and possibly expression of breast
263
gynecomimesis
milk (see galactorrhea). Gynecomastia may 19th centuries for patients diagnosed as “torpid
also be observed (though rarely) with adminis- and melancholic” and whose condition was at-
tration of ssris. tributed to depletion of blood in the brain. The
patient was placed in a revolving device in the
gynecomimesis n. sexual interest and arousal
belief that the rotation would drive out the ill-
obtained by a man from impersonating a
ness by inducing vertigo, perspiration, and nau-
woman.
sea and would restore the blood supply to the
gynemimetophilia n. sexual interest in and brain by centrifugal force. Also called rotation
arousal by men who are cross-dressing and play- treatment. [devised by U.S. physician Ben-
ing the role of women. jamin Rush (1745–1813)]
gyrator treatment a form of alternative psy- GZTS abbreviation for guilford–zimmerman
chiatric treatment used in the late 18th and early temperament survey.
264
Hh
habilitation n. the process of enhancing the in- that interfere with learning a skill through repe-
dependence, well-being, and level of function- tition and practice.
ing of an individual with a disability or disorder hair pulling see trichotillomania.
by providing appropriate resources, such as halazepam n. a benzodiazepine used for the
treatment or training, to enable that person to management of anxiety disorders and the short-
develop skills and abilities he or she had not had term treatment of insomnia. As with most of the
the opportunity to acquire previously. Compare long-acting benzodiazepines, halazepam is me-
rehabilitation. tabolized to the active intermediate compound,
habit n. a well-learned behavior or automatic se- desmethyldiazepam (nordiazepam), which has a
quence of behaviors that is relatively situation- very long half-life (and therefore duration of
specific and over time has become motorically action). This allows halazepam to be taken only
reflexive and independent of motivational or once a day but also is associated with its accumu-
cognitive influence, that is, it is performed with lation in older adults and others with reduced
little or no conscious intent. For example, the ability to metabolize the long-acting benzo-
habit of hair twirling may eventually occur with- diazepines. U.S. trade name: Paxipam.
out the individual’s conscious awareness. —ha- Halcion n. a trade name for triazolam.
bitual adj.
Haldol n. a trade name for haloperidol.
habit disorder any repetitive maladaptive be-
havior that may interfere with social, educa- half-life (symbol: t½) n. in pharmacokinetics,
tional, or other important areas of functioning. the time necessary for the concentration in the
In DSM–IV–TR, this has been subsumed under blood of an administered drug to fall by 50%.
the diagnostic category of stereotypic move- Half-life is a function of the rate of clearance of
ment disorder. a drug and its volume of distribution in vari-
ous body systems; it is expressed by the equation
habit formation the process by which, t½ = (0.7 × volume of distribution)/clearance.
through repetition or conditioning, animals or
Clinically, half-life varies among individuals as a
humans acquire a behavior that becomes regular
result of age, disease states, or concurrent admin-
and increasingly easy to perform.
istration of other drugs. Half-life is useful in pre-
habit-forming drug a drug with abuse po- dicting the duration of effect of a drug and the
tential. time required for a drug to reach a state of equi-
habit regression the act of returning to a previ- librium (steady state) in the body, that is, when
ously discontinued habit or pattern of behavior, the amount of drug administered is equal to that
often as a result of emotional distress. excreted. Generally, steady state is predicted to
habit reversal a technique of behavior ther- be achieved after 4–5 half-lives of a drug; for ex-
apy in which the client must learn a new correct ample, if a drug has a measured half-life of 8
response to a stimulus and stop responding to a hours (and its dosing schedule remains the
previously learned cue. Habit reversal is used in same), steady state would be anticipated within
behavioral conditioning, for example, to control 32–40 hours.
such unwanted habits as overeating, smoking, half-show n. a form of child psychotherapy in
hair pulling (trichotillomania), and nail biting. which a psychological problem is presented as a
habit tic a brief, recurrent movement of a psy- puppet-show drama, which is stopped at a cru-
chogenic nature, as contrasted with tics of or- cial moment. The child is then asked to suggest
ganic origin. Examples are grimacing, blinking, how the story should end.
and repeatedly turning the head to one side. halfway house a transitional living arrange-
habituation n. 1. in general, the process of ment for people, such as individuals recovering
growing accustomed to a situation or pattern of from alcohol or substance abuse, who have com-
behavior. 2. the weakening of a response to a pleted treatment at a hospital or rehabilitation
stimulus, or the diminished effectiveness of a center but still require support to assist them in
stimulus, following repeated exposure to the restructuring their lives.
stimulus. Compare dishabituation. 3. the pro- Hall, Granville Stanley (1844–1924) U.S.
cess of becoming psychologically dependent on psychologist. Hall is best known as a founder
the use of a particular drug, such as cocaine, but and organizer of psychology in the United
without the increasing tolerance and physiologi- States. He received what was probably the first
cal dependence that are characteristic of addic- PhD in psychology in America (Harvard, 1878).
tion. 4. the elimination of extraneous responses He founded the first U.S. psychology journal, the
265
Hallermann–Streiff syndrome
American Journal of Psychology (1887), as well as ethylamines and their derivatives, such as mes-
several other journals, and became the first presi- caline, dom, mda, and mdma. Both classes in
dent of the American Psychological Association, general produce visual hallucinations via activ-
which he helped to organize, in 1892. As an early ity on subtypes of serotonin receptors. Other
advocate of child study, he gathered informa- hallucinogens include pcp and various natural
tion on children’s interests and attitudes substances, including ayahuasca. See hallu-
through the use of questionnaires, stimulated in- cinogen abuse; hallucinogen dependence.
terest in child guidance, and published widely —hallucinogenic adj.
read texts on Adolescence (1904), human devel- hallucinogen abuse in DSM–IV–TR, a pattern
opment, and educational problems. His research of hallucinogen use manifested by recurrent
was underpinned throughout by an interest in significant adverse consequences related to
evolutionary theory and a belief that the devel- the repeated ingestion of hallucinogens. This
opment of individual humans recapitulated the diagnosis is preempted by the diagnosis of hal-
development of the human race (recapitulation lucinogen dependence: If the criteria for hal-
theory). He became the first president of the lucinogen abuse and hallucinogen dependence
newly founded Clark University in 1889 but are both met, only the latter diagnosis is given.
maintained an active research and writing career See also substance abuse.
and was mentor to a number of graduate stu-
hallucinogen-affective disorder see hal-
H dents who rose to prominence within psychol-
lucinogen-induced mood disorder.
ogy. As a side interest, Hall introduced Sigmund
freud, Carl jung, and other leading European hallucinogen dependence in DSM–IV–TR, a
psychoanalysts to the American public by invit- cluster of cognitive, behavioral, and physiolog-
ing them to a special conference celebrating ical symptoms indicating continued use of hal-
Clark University’s 20th anniversary in 1909. See lucinogens despite significant hallucinogen-
also storm-and-stress period. related problems. There is a pattern of repeated
hallucinogen ingestion resulting in tolerance,
Hallermann–Streiff syndrome a congenital withdrawal symptoms (agitation, mood lability,
disorder marked by craniofacial anomalies, in- and craving) if use is suspended, and an uncon-
cluding a small, beaked nose, small eyes, and trollable drive to continue use. See also halluci-
low-set ears. In many affected individuals, the nogen abuse; substance dependence.
skull sutures are slow to close and may remain
open into puberty. Mental retardation is present hallucinogen hallucinosis see hallucino-
in about 15% of these individuals. [reported in gen-induced psychotic disorder.
1948 by Wilhelm Hallermann (1901–1976), Ger- hallucinogen-induced mood disorder a
man physician, and in 1950 by Enrico Bernardo prominent and persistent disturbance of mood
Streiff (1908–1988), Swiss ophthalmologist] experienced during and after hallucinogen in-
hallucination n. a false sensory perception that toxication. It may be characterized by depres-
has a compelling sense of reality despite the ab- sion or anxiety, self-reproach, feelings of guilt,
sence of an external stimulus. It may affect any and tension. Also called hallucinogen-affec-
of the senses, but auditory hallucinations tive disorder.
and visual hallucinations are most common. hallucinogen-induced psychotic disor-
Hallucination is typically a symptom of a psy- der prominent hallucinations, delusions, or
chotic disorder, particularly schizophrenia, both due to hallucinogen intoxication that
but also may result from substance use, neuro- are not recognized by the individual as having
logical abnormalities, and other conditions. It is been induced by hallucinogens. The hallucina-
important to distinguish hallucinations from il- tions and delusions exceed those usually associ-
lusions, which are misinterpretations of real ated with such intoxication, being sufficiently
sensory stimuli. severe to warrant clinical attention. Also called
hallucinogen hallucinosis.
hallucinogen n. a substance capable of produc-
ing a sensory effect (visual, auditory, olfactory, hallucinogen intoxication a reversible syn-
gustatory, or tactile) in the absence of an actual drome due to the recent ingestion of a specific
stimulus. Because they produce alterations in hallucinogen. Clinically significant behavioral
perception, cognition, and mood, hallucinogens or psychological changes include marked anxi-
are also called psychedelic drugs (from the Greek, ety or depression, delusion of reference, diffi-
meaning “mind-manifesting”). Hallucinogens are culty focusing attention, fear of losing one’s
a group of heterogeneous compounds, many of mind, paranoia, and impaired judgment. These
which are naturally occurring; others are pro- are accompanied by one or more signs of phys-
duced synthetically. Many hallucinogens are iological involvement, for example, subjective
structurally similar to one of several neurotrans- intensification of perceptions, hallucinations,
mitters, which may be used as a mechanism of synesthesias, pupillary dilation, increased
categorization. For example, serotonin-like hal- heart rate, sweating, palpitations, blurring of vi-
lucinogens include the indolealkylamines, ex- sion, tremors, or incoordination. See also sub-
emplified by lysergic acid diethylamide (see lsd), stance intoxication.
psilocin, dmt, det, and bufotenin; catechol- hallucinosis n. a pathological condition charac-
amine-like hallucinogens include the phenyl- terized by prominent and persistent hallucina-
266
harmine
tions without alterations of consciousness, and mental development are retarded in half of
particularly when due to the direct physiological affected individuals. Also called Schüller–
effects of a substance or associated with neuro- Christian–Hand disease. [Alfred Hand (1868–
logical factors. 1949), U.S. pediatrician; Henry A. Christian
haloperidol n. a high-potency antipsychotic (1876–1951), U.S. physician; Arthur Schüller
of the butyrophenone class, in use in Europe in (1874–1958), Austrian neurologist]
the 1950s and in the United States from 1965. handicap 1. n. any disadvantage or characteris-
Haloperidol and other high-potency antipsychot- tic that limits or prevents a person from perform-
ics were preferred over lower potency pheno- ing various physical, cognitive, or social tasks or
thiazines because of their lack of cardiovascular from fulfilling particular roles within society. For
and anticholinergic effects; however, they example, a nonaccessible building entry or exit
were associated more with extrapyramidal for a person in a wheelchair would be considered
symptoms and tardive dyskinesia than lower a handicap, as would the person’s inability to
potency agents. The increased safety profile walk. The term generally is considered pejorative
of the second-generation atypical antipsy- nowadays and its use has fallen into disfavor. See
chotics has led to a decline in use of halo- also disability. 2. vb. to place an individual or
peridol, although it is still used individually and group of individuals at a disadvantage, or to hin-
in conjunction with newer agents. Some argue der or impede progress. —handicapped adj.
that few differences exist between the newer handicapping strategy see self-handicap-
H
agents and haloperidol if the latter is used in ping.
much lower doses than has been customary. U.S.
hand-washing obsession a persistent and ir-
trade name: Haldol.
rational preoccupation with washing the hands,
Halstead–Reitan Impairment Index see also called ablutomania (although this name is
impairment index. [Ward C. Halstead (1908– now seldom used). It is characteristic of obses-
1969) and Ralph M. Reitan (1922– ), U.S. psy- sive-compulsive disorder. See obsession.
chologists] handwriting analysis see graphology.
Halstead–Reitan Neuropsychological Bat- Hans n. see little hans.
tery (HRNB) a set of tests designed to diagnose
haploid adj. describing a nucleus, cell, or organ-
and localize brain damage by providing a com-
ism that possesses only one representative of
prehensive assessment of cognitive functioning.
each chromosome, as in a sperm or egg cell. In
The battery includes five core subtests and five
most organisms, including humans, fusion of
optional subtests purportedly measuring ele-
the haploid sex cells following fertilization re-
ments of language, attention, motor dexterity,
stores the normal diploid condition of body
sensory–motor integration, abstract thinking,
cells, in which the chromosomes occur in pairs.
and memory. Additionally, the minnesota
Hence for humans, the haploid number is 23
multiphasic personality inventory and ei-
chromosomes, that is, half the full complement
ther the wechsler adult intelligence scale
of 46 chromosomes.
or the wechsler intelligence scale for chil-
dren are often administered as well. There is a happiness n. an emotion of joy, gladness, satis-
version of the HRNB for adults, for children aged faction, and well-being. —happy adj.
5 to 8 years, and for children aged 9 to 14 years. haptic hallucination see tactile halluci-
[Ward C. Halstead and Ralph M. Reitan] nation.
Hamilton Rating Scale for Depression hard drug a colloquial name for a drug of abuse,
(HAM-D; HRSD) an interview-based, clinician- especially one that produces physical depend-
administered measure of the severity of depres- ence. See substance abuse; substance de-
sive symptoms, such as dysphoria, insomnia, pendence.
and weight loss. It is the most widely used mea- hardiness n. an ability to adapt easily to unex-
sure of the effectiveness of antidepressant medi- pected changes combined with a sense of pur-
cation in clinical trials, and its use is most pose in daily life and of personal control over
appropriately restricted to individuals in whom what occurs in one’s life. Hardiness dampens
depression has been diagnosed, rather than as a the effects of a stressful situation through infor-
general measure of depressive symptoms. A 38- mation gathering, decisive actions, and learn-
item self-report version, the Hamilton Depres- ing from the experience. A hardy athlete, for
sion Inventory (HDI), was developed in 1995. example, is less prone to morbidity or injury.
Also called Hamilton Depression Scale. —hardy adj.
[originally published in 1960 by Max Hamilton
(1912–1988), British psychiatrist]
hard of hearing having difficulty in distin-
guishing sounds at normal levels of intensity.
Hand–Christian–Schüller syndrome a rare hard-wired adj. in neurophysiology, referring
disturbance of lipid metabolism marked by the to fixed, inflexible neural circuits.
presence of large phagocytic blood cells and an
accumulation of cholesterol plus a triad of symp- harmaline n. see ayahuasca.
toms: membranous bone defects, diabetes harmine n. a naturally occurring hallucinogen
insipidus, and protrusion of the eyes. Growth derived from the plant Peganum harmala, native
267
harm reduction
to the Middle East, and Banisteriopsis caapi, na- heads, usually human, through the application
tive to the South American tropics. Harmine is a of heat or herbal liquids, as practiced among var-
potent monoamine oxidase inhibitor and is ious indigenous societies, mainly in southeast
a principal ingredient in ayahuasca, a psycho- Asia and South America. The heads are used for
active beverage. various ritual purposes, including healing ritu-
harm reduction a theoretical approach in pro- als. The slang shrink (short for headshrinker),
grams designed to reduce the adverse effects of meaning a psychiatrist or psychologist, is proba-
risky behaviors (e.g., alcohol use, drug use, indis- bly derived from this practice.
criminate sexual activity), rather than to elimi- healing group broadly, any of a variety of
nate the behaviors altogether. Programs focused groups formed for the purpose of improving or
on alcohol use, for example, do not advocate ab- promoting the mental and emotional health
stinence but attempt instead to teach people to and well-being or interpersonal relationships of
anticipate the hazards of heavy drinking and the members, as in group therapy, self-help
learn to drink safely. groups, encounter groups, and conscious-
hashish n. the most potent cannabis prepara- ness-raising groups.
tion. It contains the highest concentration of health activities questionnaire any ques-
delta-9-tetrahydrocannabinol (THC) because tionnaire designed to measure an individual’s
it consists largely of pure resin from one of the current repertoire of health-related behaviors.
H species of the Cannabis plant from which it is de- There is an increased emphasis on prevention in
rived. health care, and many inventories exist to mea-
hate n. a hostile emotion combining intense feel- sure an individual’s compliance with physical
ings of detestation, anger, and often a desire to activity, dietary control, preventive inocula-
do harm. Also called hatred. tions, and screening for potential health prob-
lems, such as mammography and prostate or
hate crime a crime of violence that is motivated colon cancer testing.
by bias or hatred against the group to which the
victims of the crimes belong. Examples of hate health anxiety excessive or inappropriate anxi-
crimes are killing a man because he is (or is ety about one’s health, based on misinterpreta-
thought to be) gay and bombing a place of wor- tion of symptoms (e.g., pain, gastrointestinal
ship of a religious minority. distress) as indicative of serious illness. Health
anxiety is regarded as a less severe form of
HCBS abbreviation for home and community- hypochondriasis.
based services.
health–belief model a model that identifies
HCFA abbreviation for Health Care Financing Ad- the relationships of the following to the likeli-
ministration. See centers for medicare and hood of taking preventive health action: (a) indi-
medicaid services. vidual perceptions about susceptibility to and
HD abbreviation for huntington’s disease. seriousness of a disease, (b) sociodemographic
HDI abbreviation for Hamilton Depression In- variables, (c) environmental cues, and (d) per-
ventory. See hamilton rating scale for de- ceptions of the benefits and costs. See also exer-
pression. cise–behavior model.
head banging the act or habit of repeatedly health care services and delivery related to
striking the head on a crib, wall, or other object, the health and well-being of individuals and
observed in infants and young children as a ste- communities, including preventive, diagnostic,
reotyped behavior (see stereotypy) or during a therapeutic, rehabilitative, maintenance, moni-
temper tantrum. See also stereotypic move- toring, and counseling services. In its broadest
ment disorder. sense, health care relates to both physical and
mental health and is provided by medical and
head injury any physical injury to the scalp or
mental health professionals. See also mental
skull or any brain damage that may result. Head
health care; mental health services.
injuries are usually caused by blunt force, such as
a blow to the head, but may result from signifi- Health Care Financing Administration
cant acceleration or deceleration in the absence (HCFA) see centers for medicare and
of physical contact (an acceleration–decelera- medicaid services.
tion injury). They are commonly classified as ei- health education 1. instruction in the care
ther closed, in which the head strikes an object and hygiene of the human body, with emphasis
(e.g., a concussion), or open (penetrating), in on how to prevent illness. 2. any type of educa-
which a foreign object passes through the skull tion regarding physical, mental, and emotional
and enters the brain (e.g., a gunshot wound). health. Conducted in school, institutional, and
A variety of transient or permanent neuropsy- community settings, this education may cover
chological consequences may result, including stress management, smoking cessation, nutri-
emotional, behavior, and personality changes; tion and fitness, reproductive health, self-
disturbances of executive functions; memory esteem, relationship issues, health risks, per-
and attention difficulties; and sensory and sonal safety (e.g., self-defense and rape preven-
motor deficits. Also called head trauma. tion), and minority health issues.
headshrinking n. the shrinking of severed health insurance a contractual relationship in
268
hellebore
which an insurance company undertakes to restate. Thus, a frightened animal that reacts with
imburse the insured for health care expenses in tonic immobility (death feigning) and limpness
exchange for a premium. Such payment pro- will show a reduction in heart rate in its reaction
tections might include, for example, medical to a threat, whereas an animal that is immobile
expense, outpatient mental health, accident, but poised for flight typically shows acceleration
dental, disability income, and accidental death of heart rate. States of laughter, although plea-
and dismemberment insurances. surable, are typically associated with an acceler-
health locus of control the perceived source ated heart rate owing to the involvement of large
of control over health, that is, either personal be- muscle groups in the act of laughing.
haviors or external forces. heatstroke n. a serious condition caused by a
health maintenance organization see breakdown of the body’s temperature-regulation
hmo. ability following exposure to excessive heat.
Since the body is no longer able to cool itself by
Health Opinion Survey see krantz health
sweating, the skin feels hot and dry and the per-
opinion survey.
son may experience convulsions or seizures and
health plan an organized program that pro- potentially lose consciousness. The elevated
vides a defined set of health care benefits. Health body temperature may cause brain damage or
plans may be hmos, ppos, insured plans, self- death. Emergency treatment involving cooling
insured plans, or other plans that cover health the patient must be started immediately. H
care services.
hebephrenia n. see disorganized schizo-
health professional an individual who has re- phrenia.
ceived advanced training or education in a
health-related field, such as direct patient care, hebetude n. a state of severe emotional dullness,
administration, or ancillary services. lethargy, and lack of interest.
health psychology the subfield of psychology hedonic contingency hypothesis a theory
that focuses on (a) the examination of the rela- of affect and information processing postulating
tions between behavioral, cognitive, psycho- that people consider the hedonic implications of
physiological, and social and environmental information when determining whether to elab-
factors and the establishment, maintenance, orate information. When people are in positive
and detriment of health; (b) the integration of mood states, they tend to be highly attentive to
psychological and biological research findings in the impact information will have on their mood.
the design of empirically based interventions for If the information is seen as uplifting, they will
the prevention and treatment of illness; and (c) engage in extensive elaboration to maintain
the evaluation of physical and psychological sta- their positive mood, but if it is seen as unpleas-
tus before, during, and after medical and psycho- ant, they will engage in little elaboration. When
logical treatment. people are in negative mood states, they tend
to elaborate information with little attention to
health risk appraisal the perception by indi- its hedonic consequences because such infor-
viduals of the extent to which they believe that mation is unlikely to make their mood more
they are susceptible to a health threat. See also negative and might make it more positive. [ori-
perceived risk; perceived susceptibility. ginally proposed by U.S. social psychologists
health visitor a health professional, usually as- Duane T. Wegener (1966– ) and Richard E. Petty
sociated with a visiting nurse association, who (1951– )]
visits families where health supervision is
hedonic level the degree of pleasantness or un-
needed, for example, to ensure that children are
pleasantness aroused by an interaction or a
not abused or neglected.
thought.
hearing mute an obsolescent and pejorative
hedonic psychology a psychological perspec-
name for an individual who is unable or unwill-
tive that focuses on the spectrum of experiences
ing to speak but is able to hear.
ranging from pleasure to pain and includes bio-
heart attack sudden, severe chest pain that oc- logical, social, and phenomenological aspects
curs when one of the coronary arteries becomes and their relationship to motivation and action.
blocked. The condition may result in a myocar-
dial infarction (i.e., death of a section of heart hedonics n. the branch of psychology concerned
muscle), depending upon the extent of damage with the study of pleasant and unpleasant sensa-
to the surrounding muscle. tions and thoughts, especially in terms of their
role in human motivation.
heart rate in emotion changes in heart rate
associated with particular emotional states. It is height phobia see acrophobia.
usually held that heart rate increases in states of hellebore n. any plant of the genus Veratrum but
fear, anger, and scorn and decreases in states of particularly Veratrum viride, a poisonous plant
attentiveness, positive emotional reaction, and indigenous to North America that has a history
interest. However, the actual relation between of use by Native Americans for various medicinal
heart rate and emotion is complex and largely purposes. It contains more than 20 alkaloids, in-
mediated by the energy demands of the bodily cluding veratrine, which has analgesic proper-
musculature of the organism in an emotional ties when used topically but produces prolonged
269
helping
muscle contractions when ingested. The helle- der in which the person is unable to vocalize
bore alkaloids were also used medicinally in Eng- during the day but may be able to speak nor-
land as well as America in the 18th and 19th mally at night.
centuries in the treatment of numerous condi- hemianopia n. a visual defect marked by loss of
tions, including seizures, neuralgia, headaches, vision in half the normal visual field. Hemia-
and respiratory problems. They have been used nopia may result from a lesion in the optic chiasm
more recently to lower blood pressure but gener- or the optic radiations. Also called hemian-
ally are avoided because of their potential toxic- opsia; hemiopia. —hemianopic adj. —he-
ity. The name “hellebore” is also given to mianoptic adj.
poisonous ornamental plants of the Eurasian
genus Helleborus. hemicrania n. pain or aching on only one side
of the head, characteristic of a typical migraine.
helping n. a type of prosocial behavior that
involves one or more individuals acting to im- hemidecortication n. surgical removal of the
prove the status or well-being of another or oth- cerebral cortex on one side of the brain.
ers. Although much helping behavior is typically hemispherectomy n. surgical removal of ei-
in response to a small request that involves little ther one of the cerebral hemispheres of the
individual risk, all helping behavior incurs some brain.
cost to the individual providing it. Also called
H helpfulness. See also altruism; altruistic hemispheric lateralization the processes
behavior; egoistic helping. whereby some functions, such as handedness or
language, are controlled or influenced more by
helping professions those professions that one cerebral hemisphere than the other and
provide health and education services to indi- each hemisphere is specialized for particular
viduals and groups, including occupations in the ways of working. Researchers now prefer to
fields of psychology, psychiatry, counseling, speak of hemispheric lateralization or hemi-
medicine, nursing, social work, physical and oc- spheric specialization for particular functions,
cupational therapy, teaching, and education. rather than hemispheric dominance or lateral
helping relationship a relationship in which dominance (see dominance).
at least one of the parties intends to promote the
hemlock n. see sorcery drugs.
growth, development, maturity, or improved
functioning of the other. The parties may be ei- hemorrhage n. bleeding; any loss of blood from
ther individuals or groups. [defined in 1961 by an artery or vein. A hemorrhage may be external,
Carl rogers] internal, or within a tissue, such as the skin; a
bruise is a sign of bleeding within the skin.
helplessness n. a state of incapacity, vulnerabil-
A hemorrhage from a ruptured artery is bright
ity, or powerlessness defined by low problem-
red in color and erupts in spurts that coincide
focused coping potential and low future ex-
with heart contractions; it is generally more seri-
pectancy. It results from the realization that one
ous than hemorrhage from a vein, which shows
cannot do much to improve a negative situation
as a relatively slow, steady flow of dark red
and that the situation is not going to get better
blood. Brain hemorrhages may arise from head
on its own; it often involves anxiety and de-
injuries or aneurysms, causing widespread
pendence on others. A recognition of one’s help-
damage in some cases (see cerebral hemor-
lessness in a situation can lead one to withdraw
rhage). —hemorrhagic adj.
and become sad or demoralized. See also
learned helplessness. —helpless adj. hemorrhagic stroke a stroke resulting from
helplessness theory the theory that learned rupture of a cerebral vessel, causing intracranial
helplessness explains the development of or bleeding. Intracerebral hemorrhage accounts for
vulnerability to depression. According to this approximately 10% of strokes and tends to occur
theory, people repeatedly exposed to stressful deep in the basal ganglia, internal capsule, and
situations beyond their control develop an in- brainstem.
ability to make decisions or engage effectively in hemothymia n. a lust for blood and a morbid
purposeful behavior. desire to commit murder. See also homicido-
help-seeking behavior actions directed tomania.
ward searching for or requesting help from others hemp n. see cannabis.
via formal or informal mechanisms, especially
henbane n. a poisonous plant, Hyoscyamus niger,
through mental health services. See treatment-
native to the Mediterranean and southern Eu-
seeking behavior.
rope and a source of the anticholinergic alkaloids
hematoma n. an abnormal accumulation of atropine, hyoscyamine, and scopolamine. Al-
blood as a result of vessel leakage or rupture. In though traditionally used in small doses as an
the brain, hematomas can cause substantial be- analgesic, sedative, and smooth muscle relaxant,
havioral deficits, and even death, by increasing henbane in larger quantities is highly toxic, pro-
intracranial pressure. Although some may ducing effects similar to those of poisoning with
spontaneously reabsorb and disappear, others belladonna alkaloids, including delirium,
must be surgically evacuated. hallucinations, convulsions, coma, and possibly
hemeraphonia n. a psychogenic speech disor- death. It has long been associated in folklore
270
heroin dependence
with witchcraft and magic and even enjoyed a genetic code carried by the dna of which the
reputation for a time as an aphrodisiac. chromosomes are composed.
heparitinuria n. see sanfilippo’s syndrome. heredity–environment controversy see
hepatitis n. inflammation of the liver, marked nature–nurture.
by diffuse or patchy areas of dead liver cells in heritability n. 1. the capacity to be inherited. 2.
the liver lobules. Symptoms range from mild, an estimate of the contribution of inheritance to
flulike symptoms to liver failure, which can be a given trait or function. Heritabilities can range
fatal. Jaundice and orange bile pigment (biliru- from 0, indicating no contribution of heritable
bin) coloring of the urine are usual signs. The factors, to 1, indicating total contribution of her-
causes include viruses, alcohol and drug abuse, itable factors. The heritability of intelligence
infectious mononucleosis, and other infectious is believed to be roughly .5, although research
agents. The different forms of viral hepatitis are indicates that heritability tends to increase with
identified by letters, indicating the virus respon- age and may rise to .7 or above in adulthood.
sible. Hepatitis A is contracted by ingesting con- Heritability is determined using a variety of
taminated food or water, while hepatitis B is behavior-genetic methods, such as studies of
usually transmitted by transfusions of contami- identical twins raised apart or adoption stud-
nated blood, through group use of dirty hypo- ies in which IQs of children are compared to the
dermic needles, or by sexual contact with an IQs of both their biological and their adoptive
infected person. The hepatitis C virus (HCV) is parents. Heritability is not the same as genetic
H
one of the most important causes of chronic contribution, because heritability is sensitive
liver disease in the United States, having similar only to sources of individual differences. More-
modes of transmission to hepatitis B. over, a trait can be heritable and yet modifiable.
herbal Ecstasy an over-the-counter stimulant For example, intelligence is heritable in some de-
purchased through mail-order catalogs and gree, but also has risen in recent generations.
often confused with mdma. Also called heritability estimate.
here and now the immediate situation. In psy- hermaphroditism n. the condition of possess-
chotherapy, it comprises the cognitive, affective, ing both male and female sex organs (in hu-
and behavioral material arising at any given mans, for example, possessing both ovarian and
point in a session, as well as the relationship be- testicular tissue). Hermaphroditism is very rare
tween the therapist and client at the correspond- and should not be confused with the more com-
ing point in time. When the here-and-now mon pseudohermaphroditism, in which the
approach is used in psychotherapy, the empha- gonads are of one sex but the external genitalia
sis is placed on understanding present feelings are either ambiguous or of the opposite sex. See
and interpersonal reactions as they occur in an also intersexuality. —hermaphrodite n.
ongoing treatment session, with little or no em- hero n. in psychodrama, the person (protago-
phasis on or exploration of past experience or nist) who is portraying a problem.
underlying reasons for the client’s thoughts,
heroin n. a highly addictive opioid that is a syn-
emotions, or behavior. The approach is often
thetic analog of morphine and three times more
used in psychodynamic psychotherapy with
potent. In many countries, including Great Brit-
regard to the therapeutic relationship, gestalt
ain and Canada, it is used clinically for pain
therapy, and many forms of family therapy to
management (see diacetylmorphine), but it is
heighten the client’s awareness.
not legally available in the United States due to
hereditarianism n. the view that genetic in- concerns about its potential for abuse. Its rapid
heritance is the major influence on behavior. onset of action leads to an intense initial high,
Opposed to this view is the belief that environ- followed by a period of euphoria and a sense of
ment and learning account for the major differ- well-being. As a street drug, heroin is commonly
ences between people. The question of heredity injected intravenously or subcutaneously (“skin
versus environment or “nature versus nurture” popping”). Injection using shared needles is a
continues to be controversial, especially as it ap- common mechanism of transmission of HIV,
plies to human intelligence. See genetic deter- hepatitis, and other disease agents. It can also be
minism; nature–nurture. —hereditarian insufflated (snorted) or smoked.
adj.
heroin abuse in DSM–IV–TR, a pattern of her-
hereditary hyperuricemia (hereditary oin use manifested by recurrent significant ad-
choreoathetosis) see lesch–nyhan syn- verse consequences related to the repeated
drome. ingestion of the substance. This diagnosis is pre-
hereditary predisposition see genetic preempted by the diagnosis of heroin depend-
disposition. ence: If the criteria for heroin abuse and heroin
heredity n. the transmission of traits from par- dependence are both met, only the latter diagno-
ents to their offspring. Study of the mechanisms sis is given.
and laws of heredity is the basis of the science of heroin dependence in DSM–IV–TR, a cluster of
genetics. Heredity depends upon the character cognitive, behavioral, and physiological symp-
of the genes contained in the parents’ chromo- toms indicating continued use of heroin despite
somes, which in turn depends on the particular significant heroin-related problems. There is a
271
heroin intoxication
pattern of repeated heroin ingestion resulting in tionships, for example, a feeling that one is not
tolerance, characteristic withdrawal symptoms if sexually attractive in appearance or perfor-
use is suspended (see opioid withdrawal), and mance.
an uncontrollable drive to continue use. heterosexuality n. sexual attraction to or activ-
heroin intoxication a reversible syndrome ity between members of the opposite sex. —het-
that develops following recent ingestion of her- erosexual adj.
oin, characterized by euphoria, psychomotor
heterosociality n. relationships on a social
retardation, drowsiness, and impaired atten-
(rather than a sexual or romantic) level between
tion or memory.
people of opposite sexes.
heroin withdrawal see opioid withdrawal.
heterozygous adj. possessing two different
herpes infection a disease produced by one of forms of a gene (i.e., different alleles) at a given
the strains of herpes virus. A herpes infection genetic locus on each of a pair of homologous
may be manifested as chicken pox, cold sores, chromosomes. One allele is inherited from the
shingles, ulceration of the cornea, encephalitis, mother, and the other from the father. In such
stomatitis, or vulvovaginitis (genital herpes). individuals, the dominant allele is expressed,
The major strains are herpes varicella-zoster, and the recessive allele is not. Compare ho-
which causes both chicken pox and shingles; mozygous. —heterozygote n.
H herpes simplex Type 1, the cause of cold sores;
and herpes simplex Type 2, the cause of genital heuristic n. 1. in cognition, a strategy for solv-
herpes. See also perinatal herpes-virus infec- ing a problem or making a decision that provides
tion. an efficient means of finding an answer but can-
not guarantee a correct outcome. By contrast, an
hetaeral fantasy a fantasy in which a woman algorithm guarantees a solution to a problem (if
plays the role of a courtesan. In the male version there is one) but may be much less efficient. Also
of the fantasy, the man possesses a courtesan. called cognitive heuristic. See also availabil-
Also called courtesan fantasy. ity heuristic; representativeness heuristic.
heteroeroticism n. an attraction toward the 2. in the social sciences, a conceptual device,
opposite sex, as in heterosexuality. Also called such as a model or working hypothesis, that is
heteroerotism. Compare homoeroticism. intended to explore or limit the possibilities of a
—heteroerotic adj. question rather than to provide an explanation
heterohypnosis n. a state of suggestibility in- of the facts. See also as-if hypothesis; con-
duced in one person by another. Compare self- struct.
hypnosis. HGPRT abbreviation for hypoxanthine–
heterolalia n. see heterophemy. guanine phosphoribosyltransferase.
heteronomous superego in psychoanalytic 5-HIAA abbreviation for 5-hydroxyindole-
theory, a superego that demands that the indi- acetic acid.
vidual behave in whatever manner is expected at
hidden observer the phenomenon whereby
the moment in order to secure the approval of
highly hypnotizable people (see hypnotic sus-
others.
ceptibility) who are asked to block certain stim-
heteronomy n. a state of dependence on others uli (e.g., pain) can sometimes register the blocked
and lack of self-determination. Compare auton- pain or other sensation via hand signals, as if a
omy. dissociated observer is simultaneously taking
heterophemy n. the act of saying or writing a part in events that are disavowed by the domi-
word or phrase other than the words intended. nant observer. Such individuals can later recall
Often, the substitution conveys the opposite auditory, visual, or tactile stimuli to which they
meaning to what the individual intended. Also appeared oblivious at the time.
called heterolalia; heterophasia; hetero- hidden variable an undiscovered causative
phemia. See also freudian slip; slip of the variable. When a relationship is found between
tongue. variables A and B, variable A may erroneously be
heterophilia n. love of, or attraction to, mem- thought to be the cause of B. However, the cause
bers of the opposite sex. of B may be a hidden variable C (sometimes
heterosexism n. prejudice against any non- called a third variable) that is correlated with
heterosexual form of behavior, relationship, or variable A.
community, in particular the denigration of gay hierarchical model of personality a model
men and lesbians. Whereas homophobia gener- of either within-person psychology dynamics or
ally refers to an individual’s fear or dread of gay individual differences in personality in which
men or lesbians, heterosexism denotes a wider some psychological constructs are viewed as
system of beliefs, attitudes, and institutional high-level variables that organize or govern the
structures that attach value to heterosexuality functioning of lower-level variables. For exam-
and denigrate same-sex behavior and orienta- ple, a hierarchical model of personality traits
tion. might view the construct sociability as being at
heterosexual anxiety persistent and irratio- a lower level in a hierarchy than the construct
nal anxiety that is related to heterosexual rela- extraversion: Sociability would be seen as a
272
hippotherapy
form or example of the higher level trait of Later in his career Hilgard’s research interests fo-
extraversion. cused on hypnosis, culminating in a number of
hierarchy of motives (hierarchy of needs) books including Hypnotic Susceptibility (1965)
see maslow’s motivational hierarchy. and Divided Consciousness (1977). After his retire-
ment, Hilgard became increasingly interested in
high n. slang for the subjective feelings of intoxi-
the history of psychology and published Psychol-
cation experienced following ingestion of psy-
ogy in America: A Historical Survey (1987). His
choactive drugs.
many honors included the Award for Distin-
high blood pressure see hypertension. guished Scientific Contributions from the Amer-
higher level skill a work method or skill that ican Psychological Association, the Gold Medal
can be applied to many tasks rather than one Award from the American Psychological Foun-
particular task. dation, and membership in the National Acad-
higher mental process any of the more com- emy of Sciences, the American Academy of Arts
plex types of cognition, such as thinking, judg- and Sciences, and the American Philosophical
ment, imagination, memory, and language. Society.
higher order consciousness a type of con- hindbrain n. the posterior of three bulges that
sciousness that goes beyond sensory contents appear in the embryonic brain as it develops
(see sensory consciousness) to include ab- from the neural tube. The bulge eventually be-
stract ideas, language-dependent thinking, and comes the medulla oblongata, pons, and H
self-consciousness. [proposed by U.S. neurosci- cerebellum. Also called rhombencephalon.
entist Gerald M. Edelman (1929– ) and others] hindsight bias the tendency, after an event has
higher order interaction in the analysis of occurred, to overestimate the extent to which
variance, the joint effect of three or more inde- the outcome could have been foreseen.
pendent variables on the dependent variable.
hippocampal formation a region of the
higher response unit any integration of sim- brain located in the medial temporal lobe and
ple responses into a more complex response. concerned with the consolidation of long-term
higher states of consciousness see memory. It comprises the dentate gyrus, hippo-
transpersonal psychology. campus, and subiculum and communicates with
high-potency antipsychotic any of various areas of neocortex via the entorhinal cortex.
conventional antipsychotics that have either hippocampus n. (pl. hippocampi) a seahorse-
a relatively high degree of affinity for the dopa- shaped part of the forebrain, in the basal medial
mine D2 receptor or significant extrapyramidal region of the temporal lobe, that is important
symptoms. High-potency antipsychotics include for declarative memory and learning. Because
fluphenazine, haloperidol, thiothixene (see of its resemblance to a ram’s horn, 19th-century
thioxanthenes), trifluoperazine, and pimo- neuroanatomists named it Ammon’s horn (cornu
zide. ammonis; CA) for the horn of the ram that rep-
high risk significantly heightened vulnerability resented the Egyptian deity Ammon. Parts of
to a disorder or disease. An individual’s risk sta- the hippocampus were then labeled CA1, CA2,
tus is influenced by genetic, physical, and behav- CA3, and CA4; these designations are still used
ioral factors or conditions. For example, children for the different regions of the hippocampus.
of a parent with bipolar disorder have a much See hippocampal formation; papez circuit.
greater risk of developing the disorder than —hippocampal adj.
other children, and individuals who engage in
hippotherapy n. the therapeutic use of horses
unprotected sex are at high risk of contracting
to help people with physical and developmental
HIV and other sexually transmitted diseases.
disabilities improve their balance, coordination,
highway hypnosis a colloquial name for acci- posture, and mobility. During each 30-minute
dent proneness resulting from a state of drowsy hippotherapy session, the client sits or lies on
inattention experienced during long-distance the horse, and a therapist evaluates and posi-
driving on monotonous roads. tively influences the client’s neuromuscular re-
Hilgard, Ernest R. (1904–2001) U.S. psycholo- sponses to the animal’s movement while an
gist. Hilgard earned his doctorate in psychology equine handler adjusts its gait, tempo, and direc-
in 1930 from Yale University, where he studied tion. One or two sidewalkers next to the horse
under Raymond Dodge (1871–1942). He taught accompany the client for safety purposes. The
at Yale until 1933, when he accepted a joint ap- therapists who conduct such sessions are spe-
pointment in psychology and education at Stan- cially trained physical, occupational, and speech
ford University. Throughout his career Hilgard and language therapists who offer hippotherapy
was a masterful synthesizer and organizer of re- as part of their broader, occupation-specific spec-
search in the fields of conditioning, learning trum of therapeutic activities. The handlers
theory, and hypnosis. His early research led to themselves are hippotherapy-certified. The ther-
publication of the classic text Conditioning and apy is most commonly used for people with au-
Learning (1940) with Donald G. Marquis (1908– tism, cerebral palsy, Down syndrome, multiple
1973). Hilgard’s subsequent Theories of Learning sclerosis, muscular dystrophy, spina bifida, spi-
(1948) also became a standard text in the field. nal cord injury, stroke, and traumatic brain in-
273
histamine
jury. In addition to its physical benefits, it often the myriad associated psychological and social
improves the client’s affect, self-confidence, issues.
communication skills, spatial awareness, sen- HIV/AIDS counseling see aids counseling.
sory integration, and social interaction. It is a
type of animal-assisted therapy. Hi-Wa itck a culture-bound syndrome found
in Mohave American Indian populations that
histamine n. a compound that is synthesized would be categorized as a mood disorder by
from the amino acid histidine by the enzyme DSM–IV–TR standards. Symptoms include depres-
histidine decarboxylase. Most histamine in hu- sion, insomnia, loss of appetite, and sometimes
mans is localized in peripheral tissues, where it is suicide associated with unwanted separation from
involved in allergic reactions or the inflamma- a loved one; it generally affects the young wife of
tory response to injury, causing dilation of blood an older Mohave male.
vessels. In the brain, histamine acts as a neuro-
transmitter to modulate such functions as HM the initials of a patient who became amnesic
arousal, appetite, and regulation of autonomic after undergoing bilateral temporal lobectomy
functions. Histamine receptors can be divided in 1953 for the relief of intractable seizures. The
into three categories, designated H1, H2, and H3 case of HM, who was a patient of U.S. neurolo-
receptors. Many antidepressants and antipsy- gist William Beecher Scoville (1906–1984), dem-
chotics may block histamine receptors in the onstrated the critical role of the hippocampus
H brain, causing sedation and other side effects. and surrounding structures in the process of
memory formation and storage. The analysis of
histamine antagonist see antihistamine. his memory disorder has also contributed greatly
historical method the technique of analyzing, to understanding of the existence of various
counseling, or otherwise offering therapy by fo- forms of memory mediated by distinct neural
cusing on a client’s personal history. systems.
historical psychoanalysis see psycho- HMO health maintenance organization: a health
history. plan that offers a range of services through a
specified network of health professionals and fa-
history taking the process of compiling the cilities to subscribing members for a fixed fee.
history of a patient or research participant from Members select a primary care provider who
the individual directly and from other sources, coordinates all care and is required to use ap-
such as the patient’s family, hospitals or clinics, proved providers for all services. Services may
psychiatrists or psychologists, neurologists, so- need further approval from the HMO utilization
cial workers, and others who have direct knowl- program. The HMO is reimbursed through fixed,
edge of the individual. See anamnesis. periodic prepayments (capitated rates) by, or on
histrionic personality disorder in DSM– behalf of, each member for a specified period of
IV–TR, a personality disorder characterized by time. HMOs may subcapitate, or carve out, cer-
a pattern of long-term (rather than episodic) self- tain services, such as mental health, to other
dramatization in which individuals draw at- groups. See capitation.
tention to themselves, crave activity and excite- hoarding n. a compulsion, characteristic of
ment, overreact to minor events, experience obsessive-compulsive disorder, that involves
angry outbursts, and are prone to manipulative the persistent collection of useless or trivial
suicide threats and gestures. Such individuals
items (e.g., old newspapers, garbage, maga-
appear to others to be shallow, egocentric, in-
zines) and an inability to organize or discard
considerate, vain, demanding, dependent, and
these. The accumulation of items (usually in
helpless. The disorder was formerly known as
hysterical personality disorder.
piles) leads to the obstruction of living space,
causing distress or impairing function. Any at-
HIV human immunodeficiency virus: a parasitic tempt or encouragement by others to discard
agent in blood, semen, and vaginal fluid that de- hoards causes extreme anxiety. —hoard vb., n.
stroys a class of lymphocytes with a crucial role
in the immune response. HIV infection can hoarding orientation in the existential psy-
occur by various routes—unprotected sexual in- choanalysis of Erich fromm, a character pattern
tercourse, administration of contaminated in which the individual doubts that personal
blood products, sharing of contaminated nee- needs can ever be completely satisfied and bases
dles and syringes by intravenous drug users, or his or her sense of security on what he or she can
transmission from an infected mother to her save and own. The character is thought to be
child in utero or through breast feeding—and is rigid, stubborn, and obsessively orderly. Also
characterized by a gradual deterioration of im- called hoarding character. See also anal per-
mune function that can progress to aids. Be- sonality. Compare exploitative orienta-
cause the diagnosis of HIV infection is stigma- tion; marketing orientation.
tizing and can result in considerable emotional hold functions cognitive abilities—such as
stress and social ostracism, counseling is avail- those involved in vocabulary and verbal knowl-
able in which guidance, advice, and information edge, object assembly, and picture completion—
are provided to individuals on topics related to that typically remain stable or improve with
HIV infection and AIDS, including managing adult aging as observed on intellectual or cogni-
274
homeostasis
tive tests (e.g., the wechsler adult intelli- brain theory. [originated by Austrian-born U.S.
gence scale). neurophysiologist Karl Harry Pribram (1919– )]
holding environment in the object rela- holy anorexia see anorexia mirabilis.
tions theory of British psychoanalyst Donald home and community-based services
Winnicott (1896–1971), that aspect of the (HCBS) care or services provided in a patient’s
mother experienced by the infant as the envi- place of residence or in a noninstitutional set-
ronment that literally—and figuratively, by ting located in the community. The aim is to
demonstrating highly focused attention and help individuals of all ages with disabilities to
concern—holds him or her comfortingly during live in the community, thereby avoiding more
calm states. This is in contrast to the mother who costly residential placements. In the United
is experienced as the object of the infant’s ex- States, the primary means by which such services
cited states. are funded is the Home and Community-Based
holiday syndrome sadness, anxiety, and pessi- Services Waiver (or Medicaid Waiver) program.
mism that tend to occur during major holiday Through this waiver, the federal government re-
periods. Severe depression, serious injuries, sui- imburses states for a percentage of their spend-
cides, and fatal accidents tend to increase during ing on designated community services, such as
the holiday season. Also called holiday blues. day habilitation, residential habilitation,
holistic education a form of psychotherapy, and service coordination. These services are de- H
fined in a flexible manner; they can be tailored
derived from the approach of holistic medi-
to the specific needs of individuals enrolled in
cine, in which the therapist serves as a teacher
the waiver, allowing appropriate services to be
and the client as student. The therapist aims to
provided to people with greatly varying require-
create conditions within which the student may
ments.
choose to learn. For maximum growth, all as-
pects of the client’s physical, spiritual, emo- home care patient care in the home for people
tional, and intellectual life should be explored with physical or mental disabilities, including
and developed. [developed by U.S. psychologist older adults with dementia or physical infirmity.
William C. Schutz (1925–2002)] Home care is an alternative to institutionaliz-
ation, enabling the patient to live in familiar sur-
holistic healing a health care concept based on
roundings and preserve family ties. Such services
the premise that body, mind, and spirit function
as nursing care, administration of medication,
as a harmonious unit and that an adverse effect
therapeutic baths, physical therapy, and occu-
on one also adversely affects the others, requir-
pational therapy are provided by visiting pro-
ing treatment of the whole to restore the harmo-
fessionals or paraprofessionals connected with
nious balance.
clinics, hospitals, or health agencies. Also called
holistic medicine a branch of medicine that, home health care.
in the prevention and treatment of disease, fo-
cuses on the whole person—including physical, home health aide a specially trained person
mental, spiritual, social, and environmental as- who works with a social services agency or a
pects—rather than on disease symptoms alone. local visiting nurse association to provide per-
Major features of holistic medicine include pa- sonal care services, such as bathing, light meal
tient education about behavioral and attitudinal preparation, and dressing, to people with dis-
changes that promote and maintain good health abilities.
and well-being, and patient self-help and partici- home health care see home care.
pation in the healing process through diet, exer-
homeopathy n. a system of medicine based on
cise, and other measures. It is often practiced in
the belief that “like cures like.” Small, highly di-
tandem with both conventional medicine (e.g.,
luted quantities of substances are given to cure
medication, surgery) and with complementary
symptoms when the same substances given at
and alternative medicine.
higher or more concentrated doses would ac-
holistic psychology an approach to psychol- tually cause those symptoms. Homeopathy is
ogy based on the view that psychological phe- considered a form of complementary and al-
nomena must be studied as wholes, or that ternative medicine. Compare allopathy. [first
individuals are biological, psychological, and given practical application by German physician
sociocultural totalities that cannot be fully ex- Christian Friedrich Samuel Hahnemann (1755–
plained in terms of individual components or 1843)] —homeopathic adj.
characteristics. Holistic psychology is not a spe-
homeostasis n. 1. the regulation by an organ-
cific school but a perspective that informs the
ism of all aspects of its internal environment, in-
theories, methodologies, and practice of certain
cluding body temperature, salt–water balance,
approaches, such as humanistic psychology
acid–base balance, and blood sugar level. This
and client-centered therapy.
involves monitoring changes in the external and
holographic brain theory a brain theory internal environments by means of receptors
suggesting that neuronal processes operate by and adjusting bodily processes accordingly. [first
means of fieldlike states of wave interference described by U.S. physiologist Walter Brad-
similar to holograms. Also called holonomic ford Cannon (1871–1945)] 2. maintenance of a
275
home-service agency
stable balance, evenness, or symmetry. —homeo- cused on them. This results in discrimination on
static adj. such issues as employment, housing, and legal
home-service agency a group, which may be a rights and may also lead to violence (gay bash-
public health, social service, or voluntary organi- ing). Extreme homophobia may lead to murder.
zation, that provides home health aides for homosexual behavior 1. sexual impulses,
people with mental or physical disabilities. The feelings, or relations directed toward members of
personnel generally are paraprofessionals who one’s own sex. 2. sexual acts, such as mutual
are recruited, trained, and supervised by another genital caressing, cunnilingus, fellatio, and anal
agency, such as the visiting nurse association intercourse, that are practiced by gay men and
or a hospital with a home-care unit. lesbians but also may be practiced by heterosex-
home visit a visit to an individual at home by a ual couples.
professional or paraprofessional, such as a psy- homosexuality n. sexual attraction or activity
chologist, physician, nurse, social worker, or re- between members of the same sex. Although the
habilitation therapist, for crisis intervention, term can refer to such sexual orientation in both
aftercare, or other assistance in solving personal men and women, current practice distinguishes
problems. between gay men and lesbians, and homosexu-
homework n. tasks assigned to a client to be per- ality itself is now commonly referred to as same-
formed between sessions of therapy. Assign- sex sexual orientation or activity. —homosex-
H ual adj., n.
ments may require reading, research, or
practicing new behaviors (e.g., attending a lec- homosexual love a sexual relationship with a
ture, speaking to a specific person). member of one’s own sex involving the full
homicidomania n. a mental or emotional dis- range of erotic, emotional, and sexual feelings.
turbance characterized by a desire to kill others, homosexual marriage see same-sex mar-
often including actual attempts to do so. riage.
homicidophilia n. sexual interest and arousal homosexual panic a sudden, acute anxiety at-
obtained from murder. In the extreme form, this tack precipitated by (a) the unconscious fear that
paraphilia results in what are called lust mur- one might be gay or lesbian or will act out gay or
ders, or cases of murder and rape. Less extreme lesbian impulses, (b) the fear of being sexually at-
cases may consist of the use of murder fantasies tacked by a person of the same sex, or (c) loss of
or murder-related pornographic materials dur- or separation from a same-sex partner.
ing masturbation. homovanillic acid (HVA) the end product of
homocystinuria n. a genetic metabolic disor- the catabolism of the neurotransmitter dopa-
der characterized by a deficiency of an enzyme mine, produced by the action either of catechol-
needed to convert L-homocystine to L-cystath- O-methyltransferase (COMT) on 3,4-dihydroxy-
ionine. Mental retardation often occurs, along phenylacetic acid (DOPAC) or of aldehyde
with a shuffling, ducklike gait and, in some in- dehydrogenase on 3-methoxy-4-hydroxyphenyl-
stances, seizures or hemiplegia. Brain abnormali- acetaldehyde (MHPA). Levels of homovanillic
ties are often due to arterial or venous throm- acid are typically reduced in individuals with
boses. Also called cystathionine synthetase Parkinson’s disease.
deficiency. homozygous adj. possessing identical forms of
homoeroticism n. an erotic desire for people a gene (i.e., identical alleles) at a given genetic
of one’s own sex. Also called homoerotism. locus on each of a pair of homologous chromo-
—homoerotic adj. somes. Either autosomal dominant (see domi-
homogeneity n. see linear system. nant allele) or autosomal recessive (see reces-
sive allele) conditions are expressed when the
homogenitality n. an interest in the genitalia
individual is homozygous for that condition.
of one’s own sex.
Compare heterozygous. —homozygote n.
homologous adj. 1. exhibiting resemblance
homunculus n. (pl. homunculi) 1. a putative
based on common ancestry. 2. describing chro-
process or entity in the mind or the nervous sys-
mosomes that are identical in terms of their visi-
tem whose operations are invoked to explain
ble structure and location of gene segments,
some aspect of human behavior or experience.
although they may carry different alleles. dip-
2. in neuroanatomy, a figurative representation,
loid organisms, such as humans, possess ho-
in distorted human form, of the relative sizes of
mologous pairs of chromosomes (see autosome)
motor and sensory areas in the brain that corre-
in the nuclei of their body cells. 3. describing
spond to particular parts of the body. For exam-
any segment of a nucleic acid (DNA or RNA) or
ple, the brain area devoted to the tongue is much
protein whose sequence of, respectively, bases or
larger than the area for the forearm, so the ho-
amino acids is similar to that of another seg-
munculus has a correspondingly larger tongue.
ment.
3. a completely formed minute human figure
homophile n. a person who loves others of his (Latin, “little man”) thought by some 16th- and
or her own sex, that is, a gay man or a lesbian. 17th-century theorists to exist in the spermato-
homophobia n. dread or fear of gay men and zoon and simply to expand in size in the transi-
lesbians, associated with prejudice and anger fo- tion from zygote to embryo to infant to adult.
276
hostile–engaged marriage
This idea is an example of “preformism” and is U.S. psychologist William McDougall (1871–
contrary to the epigenetic principle of cumula- 1938)]
tive development and successive differentiation. hormone n. a substance secreted into the blood-
—homuncular adj. stream by an endocrine gland or other tissue
honesty n. in psychotherapy, the ability of an or organ to regulate processes in distant target
individual to express true feelings and commu- organs and tissues. These secretions include the
nicate immediate experiences, including con- posterior and anterior pituitary hormones (see
flicting, ambivalent, or guilt-ridden attitudes. pituitary gland); the corticosteroids and
—honest adj. epinephrine, secreted by the adrenal glands;
ho’oponopono n. in Hawaiian culture, a type of and the sex hormones released by the repro-
group process, similar to family therapy, in ductive glands. Other organs that secrete hor-
which the ‘ohana or a similar group addresses mones include the hypothalamus and the
its personal and family problems in order to re- stomach. —hormonal adj.
store harmony within the group. hormone replacement therapy (HRT) 1.
hope n. an emotion characterized by the expecta- the administration of female sex hormones—
tion that one will have positive experiences (or usually an estrogen (see estrogen replace-
that a potentially threatening or negative situa- ment therapy) or a combined estrogen–
tion will not materialize or will ultimately result progestin preparation—to postmenopausal H
in a favorable state of affairs) and by the belief women to relieve menopausal symptoms. The
that one can influence one’s experiences in a use of HRT for other purposes is controversial,
positive way. See also optimism. since long-term use may increase the risk of
breast cancer, cardiovascular disease, stroke, and
hopelessness n. the feeling that one will not ex- other conditions associated with the aging pro-
perience positive emotions or an improvement
cess. 2. the administration of any other hormone
in one’s condition. Hopelessness is common in
to treat a hormone deficiency, for example, thy-
severe major depressive episodes and other
roid hormone to treat hypothyroidism.
depressive disorders and is often implicated
in attempted and completed suicides. —hope- Horner effect see fear of success. [Matina
less adj. Horner (1939– ), U.S. psychologist]
Hopkins Symptom Checklist (HSCL) a 58- horticultural therapy the use of gardening as
item self-report inventory designed to identify an auxiliary intervention for therapeutic or
symptom patterns along five dimensions that rehabilitational purposes. It is typically used for
yield a total distress score: obsessive-compulsive individuals with physical or mental illness or
behavior, anxiety, depression, somatization, and disability but may also be used to improve the
interpersonal sensitivity. Developed at Johns social, educational, psychological, and physical
Hopkins University in the 1970s, the HSCL pro- well-being of older adults as well as those recov-
vided a much-needed standard for self-report ering from injury. Also called horticulture
measurement of psychological distress and, ul- therapy.
timately, provided a sound foundation for the HOS abbreviation for Health Opinion Survey. See
development of more comprehensive and so- krantz health opinion survey.
phisticated outcome measures that followed. See hospice n. a place or form of care for terminally
also symptom checklist-90-revised. ill individuals, often those with life expectancies
Hopkins Verbal Learning Test (HVLT) a of less than a year as determined by medical per-
standardized brief individual test used to assess sonnel. Instead of curing disease and prolonging
verbal learning and memory (specifically, imme- life, the emphases of the hospice concept are pa-
diate recall, delayed recall, and delayed recogni- tient comfort, psychological well-being, and
tion) in individuals aged 16 years and over. The pain management. Care is provided by medical,
examiner reads aloud 12 nouns, and participants volunteer, and family caregivers, either in spe-
must first repeat them (both immediately and 25 cial facilities or in the patient’s home. See also
min following their presentation) and then terminal care.
identify them from among a verbally presented hospitalitis n. the state of mind of patients who
list of distractor words. Originally published in are so dependent psychologically on hospital life
1991, the HVLT subsequently was revised in that their symptoms suddenly recur when they
2001 (HVLT–R). [developed by U.S. medical psy- learn that they are about to be discharged.
chologist Jason Brandt (1954– ) and U.S. clini-
cal psychologist Ralph H. B. Benedict (1960– ) hospital phobia a persistent and irrational fear
at Johns Hopkins University, Baltimore] of hospitals. In DSM–IV–TR, hospital phobia is
classified as a form of specific phobia, situa-
hormic psychology a school of psychology, tional type.
originating in the 1920s, that emphasizes goal
seeking, striving, and foresight, with the instincts hostile–detached marriage an unstable
serving as the primary motivation for behavior. marriage in which there are short but hostile dis-
It is particularly concerned with explaining so- agreements between the partners.
cial psychological phenomena in terms of in- hostile–engaged marriage an unstable mar-
stinctive behavior. [introduced by British-born riage in which the partners have long and fre-
277
hostile work environment
quent arguments without the balance of love HSCL abbreviation for hopkins symptom
and humor found in long-lasting volatile mar- checklist.
riages. hsieh-ping n. a culture-bound syndrome ob-
hostile work environment a situation in served in China and Taiwan, characterized by
which the workplace is made intimidating, abu- temporary trancelike states in which the individ-
sive, or offensive to an employee as a conse- ual supposedly becomes possessed by ancestral
quence of another’s conduct within it (e.g., spirits. It is often accompanied by tremors, dis-
inappropriate comments, remarks, or gestures, orientation, delirium, and visual or auditory
unwanted sexual attention) or characteristics of hallucinations.
the setting (e.g., displays of distasteful, insulting, 5-HT abbreviation for 5-hydroxytryptamine. See
or otherwise inappropriate material). See also serotonin.
meritor savings bank v. vinson; sexual ha- hubris n. arrogant pride or presumption. In
rassment. Greek tragedy, hubris is specifically the over-
hostility n. the overt expression of intense ani- weening pride that leads to the destruction of
mosity or antagonism in action, feeling, or atti- the protagonist. —hubristic adj.
tude. —hostile adj. Hull, Clark Leonard (1884–1952) U.S. psy-
hot cognition an enlightened comprehension chologist. Hull earned his doctorate in 1918 at
H of the self, others, and events that engenders the University of Wisconsin under Joseph Jas-
strong emotional reactions. See also abreac- trow (1863–1944). He was the originator of the
tion. influential drive-reduction theory, which states
that all behavior, including conditioning and
hot flash a typical menopausal symptom, learning, is initiated by needs and directed to
caused by decreased levels of estrogen, experi- need reduction. Activities that reduce need re-
enced as a sudden rush of heat to the neck, face, inforce specific responses called habits; for ex-
and possibly other parts of the body that may ample, when a hungry rat obtains food by inad-
last from 30 s to 5 min. It may begin with a sud- vertently pushing a lever, it learns to repeat that
den tingling in the fingers, toes, cheeks, or ears, response. Hull’s most important work was his
and in some women it is followed by a sensation widely cited Principles of Behavior: An Introduction
of cold. Fifty percent of women experience hot to Behavior Theory (1943). Together with B. F.
flashes around the time of menopause. skinner and Edward Chace tolman, he is con-
hotline n. a telephone line maintained by sidered one of the founders of neobehaviorism.
trained personnel for the purpose of providing a He spent the bulk of his career at Yale University,
crisis intervention service. See telephone where he was mentor to numerous graduate stu-
counseling. dents who became prominent psychologists.
hot-seat technique a technique of gestalt human channel capacity the limit on the
therapy in which a client sits in a chair next to amount of information that may be processed si-
the therapist, who encourages the client through multaneously by the human information-
direct prompting and questioning to relive processing system.
stressful experiences and openly express feelings Human Genome Project an international
of discomfort, guilt, or resentment. The tech- project to map each human gene and determine
nique aims to generate a new, more vivid aware- the complete sequence of base pairs in human
ness, which leads the client to find his or her dna. The project began in 1990 and was com-
own solutions to problems or emotional difficul- pleted in 2003. It has yielded vast amounts of
ties. In a group therapy variation of the hot- valuable information about the genes responsi-
seat technique, an individual member expresses ble for various diseases, which may lead to the
to the therapist his or her interest in dealing with development of effective genetic screening tests
a particular issue, and the focus moves away and, possibly, treatments. However, controversy
from the group into an extended interaction be- surrounds the attempts by some biotechnology
tween the group member and group leader for a companies to patent certain human DNA se-
limited period of time. During the one-on-one quences with the potential for commercial ex-
interaction, the other group members remain si- ploitation.
lent; afterward, they give feedback on how they human-growth movement see human-
were affected, what they observed, and how potential movement.
their own experiences are similar to those on
human immunodeficiency virus see hiv.
which the individual member worked. Compare
empty-chair technique. humanistic conscience the type of con-
science that is guided by individual standards
HRNB abbreviation for halstead–reitan and not by fear of external authority. Compare
neuropsychological battery. authoritarian conscience. [defined by Erich
HRSD abbreviation for hamilton rating scale fromm]
for depression. humanistic–existential therapy see exis-
HRT abbreviation for hormone replacement tential–humanistic therapy.
therapy. humanistic perspective the assumption in
278
HVA
psychology that people are essentially good and interrelated set of services aimed at providing
constructive, that the tendency toward self- physical and mental health programs.
actualization is inherent, and that, given the
human strength see character strength.
proper environment, human beings will develop
to their maximum potential. The humanistic humiliation n. a feeling of shame due to being
perspective arose from the contributions of disgraced or deprecated. The feeling sometimes
Gordon allport, Abraham maslow, and Carl leads to severe depression and deterioration of
rogers, who advocated a personality theory the individual’s sense of self-esteem. Humilia-
based on the study of healthy individuals as option of the partner is frequently found in sexual
posed to people with mental disorders. sadism and sexual masochism.
humanistic psychology an approach to psy- humility n. the quality of being humble, charac-
chology that flourished particularly in academia terized by a low focus on the self, an accurate
between the 1940s and the early 1970s and that (not over- or underestimated) sense of one’s ac-
is most visible today as a family of widely used complishments and worth, and an acknowledg-
approaches to psychotherapy and counseling. It ment of one’s limitations, imperfections,
derives largely from ideas associated with exis- mistakes, gaps in knowledge, and so on.
tentialism and phenomenology and focuses
hunger drive a drive or arousal state induced
on individuals’ capacity to make their own
choices, create their own style of life, and actual-
by food deprivation, precipitating food-seeking H
behavior.
ize themselves in their own way. Its approach is
holistic, and its emphasis is on the development Hunter’s syndrome an X-linked recessive dis-
of human potential through experiential means ease, the most common mucopolysaccharid-
rather than analysis of the unconscious or be- osis. As in hurler’s syndrome, there is an
havior modification. Leading figures associated excess of mucopolysaccharides in the tissues.
with this approach include Abraham maslow, The child shows normal development until the
Carl rogers, and Rollo may. Also called hu- 2nd year and may learn some words and sen-
manistic theory. See also human-potential tences and achieve toilet training. Hyperkinetic
movement. behavior and a clumsy gait develop after the
age of 2; physical activity slows down around the
humanistic therapy any of a variety of psycho-
age of 5. Mental retardation appears in the 2nd
therapeutic approaches that reject psychoana-
year. Also called mucopolysaccharidosis
lytic and behavioral approaches; seek to foster
Type II. [Charles Hunter (1872–1955), U.S. phy-
personal growth through direct experience; and
sician]
focus on the development of human potential,
the here and now, concrete personality change, Huntington’s disease (HD) a progressive he-
responsibility for oneself, and trust in natural reditary disease associated with degeneration of
processes and spontaneous feeling. Some exam- nerve cells in the basal ganglia and cerebral
ples of humanistic therapy are client-centered cortex. It is characterized by abnormalities of
therapy, gestalt therapy, existential psy- gait and posture, motor incoordination, and in-
chotherapy, and experiential psychother- voluntary jerking motions (chorea) as well as
apy. dementia, mood disturbances, and personality
and behavioral changes. The age of onset is usu-
humanity n. compassion in one’s personal rela-
ally between 30 and 50, but there is a juvenile
tions with specific others, shown by kindness,
form of the disease in which symptoms first ap-
nurturance, charity, and love.
pear before the age of 20. Huntington’s disease is
human-potential movement an approach inherited as an autosomal dominant trait (see
to psychotherapy and psychology based on the dominant allele); the single gene responsible
quest for personal growth, development, inter- is located on chromosome 4. Also called Hun-
personal sensitivity, and greater freedom and tington’s chorea. [George Huntington (1850–
spontaneity in living. The ideas of German-born 1916), U.S. physician]
U.S. psychiatrist Frederick (Fritz) S. Perls (1893–
Hurler’s syndrome an autosomal recessive
1970) were an influential force in the develop-
disease marked by mucopolysaccharide levels in
ment of the human-potential movement, which
tissues more than 10 times normal (see muco-
derives its general perspective from humanistic
polysaccharidosis), combined with elevated
psychology. gestalt therapy, sensitivity
levels of polysaccharides and gargoylism. Men-
training, and encounter groups are repre-
tal development begins normally but slows after
sentative of this approach. Also called human-
the early months and reaches a plateau around
growth movement.
2 years of age. The child may learn a few
human relations training techniques de- words, but not sentences, and toilet training is
signed to promote awareness in an individual of seldom achieved. Also called Pfaundler–
the feelings and needs of others and to promote Hurler syndrome; mucopolysaccharidosis
constructive interactions. See also sensitivity Type I. [Gertrud Hurler (1889–1965), Austrian
training; t-group. pediatrician]
human service delivery system a complex, HVA abbreviation for homovanillic acid.
279
HVLT
HVLT abbreviation for hopkins verbal learn- hydrocortisone n. see cortisol.

ing test. hydrophobia n. 1. a persistent and irrational
hwa-byung n. a culture-bound syndrome fear of water, resulting in avoidance of activities
specific to Korea and characterized by a range of involving water, such as swimming, drinking, or
symptoms that are attributed to the suppression washing one’s hands. 2. a former name for ra-
of anger (Korean, literally “anger disease”). bies. —hydrophobic adj.
Symptoms include a feeling of a mass in the hydrotherapy n. the therapeutic use of water to
throat, chest, or abdomen, a sensation of heat in promote recovery from disease or injury. Hydro-
the body, headaches, palpitations, indigestion, therapy includes such treatments as baths, streams
insomnia, fatigue, panic, dysphoria, fear of of water (douches), and aquatic sports or exer-
impending death, anorexia, generalized aches cise.
and pains, and poor concentration. Also called
suppressed anger syndrome; wool-hwa-
6-hydroxydopamine (6-OHDA) n. a dopa-
mine analog used in nonhuman animal studies
byung.
for its ability to destroy catecholamine-
hyalophagia n. the eating of glass, typically a containing nerve cell bodies. 6-OHDA does not
symptom of pica. cross the blood–brain barrier, but when adminis-
hybristophilia n. sexual interest in and attrac- tered into the central nervous system it causes
H tion to those who commit crimes. In some cases, permanent degeneration of catecholamine-
this may be directed toward people in prison for containing neurons. Destruction of dopamine-
various types of criminal activities. containing neurons in the nigrostriatal
tract with 6-OHDA results in symptoms that
hydantoin n. any of a group of drugs developed
clinically resemble Parkinson’s disease.
primarily to control epileptic seizures. They were
introduced in 1938 after careful studies of chem- 5-hydroxyindoleacetic acid (5-HIAA) the
icals capable of suppressing electroshock convul- main metabolic product of serotonin. Some in-
sions without also causing adverse effects on the dividuals with depression have low levels of 5-
central nervous system. Hydantoin molecules HIAA in the cerebrospinal fluid and exhibit a
are similar in structure to barbiturates but have preferential response to clomipramine.
the advantage of not altering the threshold for 5-hydroxytryptamine (5-HT) n. see seroto-
minimal seizures. The prototype of the hydantoins nin.
is phenytoin (previously called diphenylhydan-
5-hydroxytryptophan (5-HTP) n. a naturally
toin). Other hydantoins include mephenytoin
occurring precursor of the neurotransmitter se-
(U.S. trade name: Mesantoin) and ethotoin (U.S.
rotonin. It is produced from the essential amino
trade name: Peganone), but these are rarely
acid tryptophan (see tryptophan hydroxylase)
used.
and is converted in the brain to 5-hydroxy-
hydrocephalus n. a condition caused by exces- tryptamine, or serotonin. Administration of 5-
sive accumulation of cerebrospinal fluid in the HTP increases the production of serotonin in the
ventricles of the brain, resulting in raised intra- brain, and the agent is being investigated for po-
cranial pressure, with such symptoms as tential use in the treatment of certain forms of
headache, vomiting, nausea, poor coordination, myoclonus (severe muscle spasms). 5-HTP is
gait imbalance, urinary incontinence, slowing or currently available as a dietary supplement for
loss of development, lethargy, drowsiness, or ir- the relief of (among other conditions) headache,
ritability or other changes in personality or cog- depression, fibromyalgia, and cerebellar
nition, including memory loss. Hydrocephalus ataxia (causing difficulty in standing and walk-
commonly occurs due to obstruction of cerebro- ing) and for appetite suppression. However, re-
spinal fluid from head injury, brain tumor, or ports of a serious, potentially fatal reaction
hemorrhage. The pressure can sometimes be re- (eosinophilia-myalgia syndrome) have led to
lieved by surgery, in which the excess fluid is cautions regarding its use as a natural remedy.
shunted into the bloodstream. In infants, hydro-
hydroxyzine n. a sedating antihistamine of the
cephalus often produces enlargement of the
diphenylmethane class. It is used for the relief
skull. Also called hydrocephaly. —hydroce-
of pre- and postoperative pain, obstetric pain,
phalic adj.
anxiety, dermatitis, and emesis (vomiting). Al-
hydrocodone n. a mild to moderately potent, though also appropriate for the management of
orally administered opioid analgesic used in alcohol withdrawal, it is rarely used for this pur-
the treatment of moderate to moderately severe pose in modern clinical practice. Hydroxyzine
pain. It is more effective when combined with has significant anticholinergic effects. U.S.
acetaminophen or an nsaid (e.g., aspirin) and trade names: Atarax; Vistaril.
is generally marketed in combination with such hygiene n. 1. the science of health and how to
agents. It is also often marketed in combination maintain it. 2. a condition or practice that pro-
with a cough suppressant for the symptomatic motes cleanliness and good health. —hygienic
relief of cough due to colds or nasal congestion. adj. —hygienist n.
U.S. trade names (among others): Detussin (in
combination with pseudephedrine); Vicadin (in hyoscine n. see scopolamine.
combination with acetaminophen). hypalgesia n. see hypoalgesia.
280
hyperpnea
hyperactivity n. a condition characterized by when intake is greater than the maximum safe
spontaneous gross motor activity or restless- level.
ness that is excessive for the age of the individual. hyperkinesis n. 1. excessive involuntary move-
Although a prominent feature of attention-defi- ment. 2. restlessness or hyperactivity. Also
cit/hyperactivity disorder, it is not diagnos- called hyperkinesia. —hyperkinetic adj.
tic of any particular entity and must be
hyperlipidemia n. the presence in the blood of
correlated with other findings to identify the ap-
excessive amounts of lipids (e.g., cholesterol, tri-
propriate diagnosis. See also developmental
glycerides), which may predispose to atheroscle-
hyperactivity; purposeless hyperactivity.
rosis.
—hyperactive adj.
hyperlogia n. see logorrhea.
hyperaggressivity n. an increased tendency to
express anger and hostility in action, as in vio- hypermania n. an extreme manic state marked
lent and assaultive behavior. See also explosive by constant activity, erratic behavior, disorien-
personality. tation, and incoherent speech. See also lethal
catatonia. —hypermanic adj.
hyperbulimia n. inordinate appetite and exces-
sive intake of food. It is observed, for example, in hypermnesia n. 1. an extreme degree of reten-
certain psychological disorders and in patients tiveness and recall, with unusual clarity of mem-
with hypothalamic lesions. See also bulimia; ory images. In forensic contexts, eyewitnesses
have demonstrated increased recall after under- H
hyperphagia. —hyperbulimic adj.
going hypnotic induction to help retrieve mem-
hypercalcemia n. high concentrations of cal- ories, but such memories have been ruled
cium in the blood. inadmissible in some U.S. courts. See also cir-
hypercathexis n. in psychoanalytic theory, an cumstantiality. 2. remembering more over
excess of psychic energy invested in an object. time rather than less, in contrast to forgetting.
Compare hypocathexis. See cathexis. See reminiscence.
hypercritical adj. having an excessive ten- hypermotility n. abnormally increased or ex-
dency to scrutinize and find fault. cessive activity or movement, particularly in the
digestive tract. The cholinergic nervous system
hyperemia n. the presence of an increased
dominates the upper portion of the gastrointes-
amount of blood in a part of the body. In some
tinal tract, while the adrenergic system controls
parts, this condition causes a flushed appear-
the lower portion. Gastrin and serotonin stimu-
ance. See also blushing.
late digestive-tract motility, while secretin and
hyperesthesia n. extreme sensitivity in any of glucagon inhibit contractions. Hypermotility is
the senses, especially abnormal sensitivity to associated with gastric neuropathy, colitis, and
touch. —hyperesthetic adj. irritable bowel syndrome.
hyperexcitability n. a tendency to overreact hyperobesity n. a state of being extremely over-
to stimuli, often occurring during a manic epi- weight, sometimes defined as weighing in excess
sode. —hyperexcitable adj. of 45 kg (100 lb) above the accepted ideal
hyperfunction n. excessive activity of a body body weight for one’s height, age, and body
function, part, or organ. build. See also morbid obesity. —hyperobese
adj.
hyperglycemia n. an excess of glucose in the
blood. In diabetes mellitus, hyperglycemia re- hyperorexia n. a pathologically increased appe-
sults from a relative or absolute lack of insulin tite. See also bulimia. Compare hypophagia.
needed to remove the excess glucose from the hyperphagia n. pathological overeating, partic-
blood. Signs range from pain or sensory loss to ularly when due to a metabolic disorder or to a
failure of reflexes and coma. —hyperglycemic brain lesion. Compare aphagia; hypophagia.
adj. —hyperphagic adj.
hyperhedonia n. a pathological increase in the hyperphilia n. sexual arousal by and response
feeling of pleasure derived from any act or event. to a particular activity or type of stimulus that is
Compare anhedonia; hyphedonia. above the normal range.
hyperhidrosis n. excessive sweating, which hyperphrasia n. see logorrhea.
may occur under various circumstances and is hyperphrenia n. an obsolescent name for a
not necessarily related to environmental, physi- state of increased mental activity combined with
cal, or psychological factors. In severe cases, the concentration difficulty and distractibility, a
skin in the affected areas may become macerated common pattern in manic episodes.
and vulnerable to infections. Also called hyper- hyperplasia n. an abnormal increase in the size
idrosis. of an organ or tissue caused by the growth of an
hypericin n. a psychoactive compound that is excessive number of new, normal cells. —hyper-
thought to be the most pharmacologically active plastic adj.
agent in st. john’s wort. hyperpnea n. an abnormal increase in the rate
hyperingestion n. excessive intake of food, and depth of breathing, which may be deep, la-
fluid, or drugs through the mouth, particularly bored, and rapid.
281
hyperpraxia
hyperpraxia n. a less common name for is called secondary hypertension; it is usually

psychomotor agitation. cured if its cause is removed or is corrected. Com-
hyperprosexia n. an exaggerated fixation of at- pare hypotension. —hypertensive adj.
tention on an idea or stimulus (e.g., the creaking hyperthymia n. emotional response that is dis-
of a door) to the exclusion of other stimuli. proportionate to the stimulus, frequently occur-
Hyperprosexia is a feature of compulsive disor- ring in manic episodes and hypomanic
ders. Also called hyperprosessis. episodes.
hypersensitivity n. an excessive responsive- hyperthyroidism n. overactivity of the thy-
ness of the immune system to certain foreign roid gland, resulting in excessive production of
substances, including various drugs. Hypersensi- thyroid hormones and a consequent increase in
tivity reactions may be immediate, involving an metabolic rate. Manifestations include nervous-
acute allergic reaction leading to anaphylaxis, ness, excessive activity, and weight loss and
or more delayed, involving dangerous and some- other physical problems. Compare hypothy-
times fatal reductions in the number of certain roidism. See thyrotoxicosis.
white blood cells (see agranulocytosis) in hypertrophy n. overgrowth of an organ or part
response to treatment with some antipsy- due to an increase in the size of its constituent
chotic drugs (clozapine is a classic example). cells. —hypertrophic adj.
H Drug hypersensitivity can also result in serum-
sickness-type reactions or in an immune hyperventilation n. abnormally rapid and
vasculitis, such as stevens–johnson syn- deep breathing, usually due to anxiety or emo-
drome, as seen after administration of some tional stress. This lowers the carbon dioxide level
anticonvulsant drugs. of the blood and produces such symptoms as
light-headedness, palpitation, numbness and
hypersexuality n. extreme frequency of sexual
tingling in the extremities, perspiration, and in
activity, or an inordinate desire for sexual activ-
some cases fainting (these features are known as
ity. Hypersexuality may be associated with le-
hyperventilation syndrome). Also called over-
sions of the amygdala or hippocampus as
breathing.
demonstrated in nonhuman animal experiments,
but direct proof of this in humans is lacking. hypervigilance n. a state of abnormally height-
See nymphomania; satyriasis. —hypersexual ened alertness, particularly to threatening or po-
adj. tentially dangerous stimuli.
hypersomnia n. excessive sleepiness during hypesthesia (hypaesthesia) n. severely dimin-
daytime hours or abnormally prolonged epi- ished sensitivity in any of the senses, especially
sodes of nighttime sleep. This can be a feature of the touch sense. Also called hypoesthesia
certain dyssomnias (e.g., narcolepsy) or other (hypoaesthesia).
sleep or mental disorders, or it can be associated hyphedonia n. a pathological diminution in
with neurological dysfunction or damage, with a pleasure from experiences that normally would
general medical condition, or with substance produce pleasure. Compare hyperhedonia.
use. Hypersomnia may, however, occur in the
hyphenophilia n. sexual interest and arousal
absence of any known cause or of an association
derived from touching skin, fur, hair, leather, or
with another condition (see primary hyper-
fabrics.
somnia). See also disorders of excessive som-
nolence. Compare hyposomnia. hypnagogic adj. describing or relating to a state
of drowsiness or light sleep that occurs just be-
hypersthenia n. a condition of excessive
fore falling fully asleep.
strength and tension associated with hyperactiv-
ity of the lymphatic system. —hypersthenic hypnagogic reverie 1. dream activity or fanta-
adj. sies occuring during the period of drowsiness
hypertelorism n. an abnormally large distance and fading awareness that immediately precedes
between two body organs or areas. Ocular the onset of sleep. 2. the state of being hypno-
hypertelorism (Greig’s syndrome), in which the tized.
eyes are farther apart than normal, is often asso- hypnalgia n. literally, dream pain: pain experi-
ciated with mental retardation or other neuro- enced during sleep or in a dream.
logical conditions involving cranial anomalies. hypnoanalysis n. a modified and shortened
See also median-cleft-face syndrome. form of psychoanalytic treatment, or a tech-
hypertension n. high blood pressure: a circula- nique incorporated into full analysis, in which
tory disorder characterized by persistent arterial hypnosis is used (a) to help patients overcome
blood pressure that exceeds readings higher than resistances, (b) to enhance the transference
an arbitrary standard, which usually is 140/90. process, and (c) to recover memories and release
In the majority of cases there is no obvious cause repressed material. The material so brought forth
(see essential hypertension). In a few people is meant to be incorporated into the patient’s
high blood pressure can be traced to a known consciousness for exploration and, ultimately,
cause, such as tumors of the adrenal gland, for interpretation by the therapist. However, this
chronic kidney disease, hormone abnormalities, form of therapy is controversial because many
the use of oral contraceptives, or pregnancy. This psychologists and psychoanalysts question the
282
hypnotic susceptibility
veracity of repressed memories recovered during Hypnotherapy may use one or a combination of
a hypnotic state. techniques, typically involving the administra-
hypnodontics n. the use of hypnosuggestion tion by a properly trained professional of thera-
in dentistry as a means of relaxing tense patients, peutic suggestions to patients or clients who
relieving anxiety, reinforcing or replacing anes- have been previously exposed to a hypnotic in-
thesia, and correcting such habits as bruxism duction procedure. Although discussions of its
(grinding the teeth). clinical applications engender controversy,
there has been scientific evidence that
hypnodrama n. a technique of psychodrama hypnotherapy can be applied with some success
in which a hypnotic state is induced and the cli- to a wide range of clinical problems (e.g., hyper-
ent, or protagonist, is encouraged to act out tension, asthma, insomnia, bruxism); chronic
his or her relationships and traumatic experi- and acute pain management; habit modification
ences with the aid of auxiliary egos. Hypno- (e.g., overeating, smoking); mood and anxiety
drama might be used to overcome a client’s disorders (e.g., some phobias); and personality
resistance to dramatizing his or her problems in disorders. There is also some positive evidence
conscious psychodrama and to stimulate the re- demonstrating the effectiveness of hypnosis as
vival of past incidents and emotional scenes an adjunctive therapy. See also age regres-
in their full intensity. The technique is rarely sion; automatic writing; direct suggestion;
used now. [introduced in 1959 by Romanian- dream suggestion; ericksonian psychother- H
born U.S. psychiatrist Jacob Levi Moreno (1889– apy; hypnoanalysis; hypnotic regression.
1974)]
hypnotic 1. n. a drug that helps induce and sus-
hypnogenic adj. 1. sleep-producing. 2. hypno- tain sleep by increasing drowsiness and reducing
sis-inducing. motor activity. In general, hypnotics differ from
hypnogenic spot a putative point on the body sedatives only in terms of the dose adminis-
that, when touched, may induce hypnosis if the tered, with higher doses used to produce sleep or
individual is highly susceptible. Such an effect is anesthesia and lower doses to produce sedation
probably the result of autosuggestion. or relieve anxiety. benzodiazepines are among
hypnoid state 1. a state of light hypnosis. 2. a the most widely prescribed hypnotics; antihista-
state resembling hypnosis. Also called hyp- mines and other agents are used to lesser de-
noidal state. grees. Newer, nonbenzodiazepine hypnotics,
such as eszopiclone, zolpidem, and zaleplon,
hypnophrenosis n. any type of sleep distur-
are achieving clinical currency because of their
bance. See also sleep disorder.
relative infrequency of adverse side effects. 2.
hypnopompic adj. relating to the drowsy, semi- adj. pertaining to hypnosis or sleep.
conscious state between deep sleep and waking.
hypnotic amnesia suggested forgetfulness for
hypnosis n. (pl. hypnoses) the procedure, or designated events. In highly hypnotizable indi-
the state induced by that procedure, whereby a viduals (see hypnotic susceptibility), there
hypnotist suggests that a subject experience vari- can be spontaneous forgetfulness for the entire
ous changes in sensation, perception, cognition, hypnotic experience.
emotion, or control over motor behavior. Sub-
jects appear to be receptive, to varying degrees, hypnotic induction a process by which an in-
to suggestions to act, feel, and behave differently dividual comes under the influence of verbal
than in a normal waking state. The exact nature suggestions, or any other stimuli that are be-
of the psychological state and of the use and ef- lieved by the individual to induce suggestibility,
fectiveness of hypnotic procedures as therapy during hypnosis. The process depends on the
remain the subject of much debate and, conse- individual’s hypnotic susceptibility and
quently, of ongoing psychological research. As often involves fixation of attention and relax-
a specifically psychotherapeutic intervention, ation.
hypnosis is referred to as hypnotherapy. See hypnotic regression a therapeutic technique
also altered state of consciousness; hetero- in which an individual under hypnosis is in-
hypnosis; posthypnotic suggestion; self- duced to relive a previous experience that may
hypnosis; waking hypnosis. be contributing to current emotional difficulties.
hypnosuggestion n. the application of direct There are two types: age regression and past
hypnotic suggestion in therapy. It is used to re- life regression.
lieve such problems as insomnia, intractable hypnotic rigidity a condition of apparent
pain, cigarette smoking, anorexia nervosa, and muscular rigidity induced by suggestion during
various types of crises (e.g., combat situations, hypnosis.
panic, and dissociative amnesia). hypnotic susceptibility the degree to which
hypnotherapy n. the use of hypnosis in psy- an individual is able to enter into hypnosis. Al-
chological treatment, either in brief psycho- though many individuals can enter at least a
therapy directed toward alleviation of symp- light trance, people vary greatly in their ability
toms and modification of behavior patterns or to achieve a moderate or deep trance. Also
in long-term reconstructive psychotherapy called hypnotizability. See also stanford
aimed at personality adaptation or change. hypnotic susceptibility scale.
283
hypnotic trance
hypnotic trance see trance. sweating, nervousness, and dizziness. The adult
hypnotism n. 1. the act of inducing hypnosis. form may be a psychophysiological reaction
2. the state of hypnosis. (functional hyperinsulinism) or it may result
from inadequate intake of carbohydrates or insu-
hypnotizability n. see hypnotic susceptibil-
lin overdosage in those with diabetes mellitus.
ity. —hypnotizable adj.
—hypoglycemic adj.
hypoactive sexual desire disorder in DSM–
IV–TR, persistent and distressing deficiency or hypokinesis n. abnormal slowness in the initia-
absence of sexual interest and desire to engage in tion of voluntary movement. Also called
sexual activity. This may be global, involving all hypokinesia. Compare bradykinesia. —hy-
forms of sexual activity, or situational, limited to pokinetic adj.
one partner or one type of sexual activity. It also hypolipemia n. the presence in the blood of an
may be lifelong or result from some life event or abnormally low level of lipids.
relationship issue. hypomania n. see hypomanic episode. —hy-
hypoactivity n. abnormally slowed or deficient pomanic adj.
motor or other activity. hypomanic episode a period of elevated, ex-
hypoageusia n. see hypogeusia. pansive, or irritable mood lasting at least 4 days
hypoalgesia n. diminished sensitivity to pain. and accompanied by at least three of the follow-
H Also called hypalgesia. ing (four if the mood is irritable): inflated self-
hypocathexis n. in psychoanalytic theory, an esteem, a decreased need for sleep, increased
abnormally low investment of psychic energy speech, racing thoughts, distractibility, increase
in an object. Compare hypercathexis. See in activity or psychomotor agitation, and in-
cathexis. creased involvement in risky activities (e.g., fool-
ish investments, sexual indiscretions), all of
hypochondria n. morbid concern with the which affect functioning and are noticeable by
state of one’s health, including unfounded others but do not cause marked impairment.
beliefs of ill health. If severe and disabling, this One or more hypomanic episodes are character-
preoccupation is classified as a mental disorder istic of bipolar II disorder (see bipolar disor-
(see hypochondriasis). —hypochondriac or der), and hypomanic symptoms are a feature of
hypochondriacal adj. —hypochondriac n. cyclothymic disorder. Also called hypo-
hypochondriasis n. in DSM–IV–TR, a somato- mania.
form disorder characterized by a preoccupa-
hypomenorrhea n. a condition of diminished
tion with the fear or belief that one has a serious
menstrual flow or menstruation of abnormally
physical disease based on the incorrect and unre-
short duration.
alistic interpretation of bodily symptoms. This
fear or belief persists for at least 6 months and in- hypomotility n. abnormally decreased or defi-
terferes with social and occupational function- cient activity or movement.
ing in spite of medical reassurance that no hypophagia n. pathologically reduced food in-
physical disorder exists. take. Compare hyperphagia.
hypodermic injection see subcutaneous in- hypophilia n. sexual arousal by and response to
jection. a particular activity or type of stimulus that is
hypodontia n. see rieger’s syndrome. below the normal range.
hypoesthesia (hypoaesthesia) n. see hyp- hypophrasia n. impaired or slow speech, a fea-
esthesia. ture of severe psychomotor retardation that
hypofrontality n. a condition of reduced acti- sometimes occurs in a major depressive epi-
vation or inadequate functioning of the cortex sode.
of the frontal lobes of the brain. In theory, this is hypopituitarism n. see fröhlich’s syn-
a factor in schizophrenia but it is not well estab- drome.
lished, either as a characteristic phenomenon or
as a cause. hypoplasia n. underdevelopment of an organ or
tissue, usually due to an inadequate number of
hypofunction n. reduced function or activity, cells or diminished size of cells forming the
especially of an organ, such as a gland. structure. When applied to an entire body,
hypogeusia n. diminished sensitivity to taste. hypoplasia usually refers to a dwarf of the spe-
See also dysgeusia. —hypogeusic adj. cies. —hypoplastic adj.
hypoglycemia n. the condition of having a low hypoprosexia n. an abnormal lack of attentive
blood-sugar level, due to interference with the ability. Also called hypoprosessis.
formation of sugar in the blood or excessive utili-
zation of sugar. In infants the major symptoms hyposexuality n. an abnormally low level of
are tremors, cyanosis, seizures, apathy, weak- sexual behavior. Hyposexual individuals may
ness, respiratory problems, and failure to de- show no sex drive or interest in sexual activity.
velop intellectually; the infantile idiopathic —hyposexual adj.
form may be due to a single recessive gene. In hyposomnia n. a reduction in a person’s sleep
adults the major symptoms are debility, profuse time, often as a result of insomnia or some other
284
hysterical blindness
sleep disturbance. See also sleep disorder. stricted range of affect, occurring in severe cases
Compare hypersomnia. of major depressive episode.
hypospadias n. a congenital anomaly in which hypothyroidism n. underactivity of the thy-
the urethra opens below its normal anatomical roid gland, resulting in underproduction of thy-
position. In males, hypospadias is usually mani- roid hormones and a consequent decrease in
fested by a urethral opening on the underside of metabolic rate. Manifestations include fatigue,
the penis. In females, the urethra may open into weakness, and weight gain and other physical
the vagina. problems. Compare hyperthyroidism. See also
congenital hypothyroidism.
hypotaxia n. poor motor coordination. —hy-
potaxic adj. hypoxanthine–guanine phosphoribosyl-
transferase (HGPRT) an enzyme whose defi-
hypotension n. abnormally low blood pressure,
ciency in the human body leads to symptoms of
causing dizziness and fainting. Compare hyper-
lesch–nyhan syndrome. It was the first en-
tension. See also orthostatic hypotension.
zyme found to be associated with an inherited
—hypotensive adj.
disorder involving maladaptive behavior and
hypothalamic–pituitary–adrenocortical mental retardation. Also called hypoxanthine
system (HPA system) a neuroendocrine sys- phosphoribosyltransferase.
tem that is involved in the physiological re- H
hypoxemia n. a deficiency of oxygen in the
sponse to stress. Outputs from the amygdala to
blood. The most reliable method for measuring
the hypothalamus stimulate the release of
the degree of hypoxemia is blood gas analysis to
corticotropin-releasing factor (CRF). CRF
determine the partial pressure of oxygen in the
elicits the release from the anterior pituitary of
arterial blood. Insufficient oxygenation of the
corticotropin, which in turn regulates the
blood may lead to hypoxia. Compare anox-
production and release of stress hormones (e.g.,
emia.
cortisol) from the adrenal cortex into the blood-
stream. hypoxia n. reduced oxygen in the body tissues,
including the brain. This can result in wide-
hypothalamic syndrome any of various dis-
spread brain injury depending on the degree
orders arising from injuries to the hypothala-
of oxygen deficiency and its duration. Signs and
mus. These may involve disturbances of eating,
symptoms of hypoxia vary according to its
drinking, sleep, water balance, and temperature
cause, but generally include shortness of breath,
or development of secondary sexual characteris-
rapid pulse, fainting, and mental disturbances
tics.
(e.g., delirium, euphoria). See also anoxia. —hy-
hypothalamus n. (pl. hypothalami) part of poxic adj.
the diencephalon of the brain, lying ventral to
hypoxyphilia n. erotic self-strangulation. See
the thalamus, that contains nuclei with pri-
asphyxophilia; autoerotic asphyxiation.
mary control of the autonomic (involuntary)
functions of the body. It also helps integrate au- hysteria n. the historical name for the condition
tonomic activity into appropriate responses to classified in DSM–IV–TR as somatization dis-
internal and external stimuli. —hypothalamic order. Although technically outdated, it is often
adj. used as a lay term for any psychogenic disorder
characterized by such symptoms as paralysis,
hypothermia n. the state of having an abnor- blindness, loss of sensation, and hallucinations
mally low body temperature. It can be caused by
and often accompanied by suggestibility, emo-
absence of normal reflexes such as shivering,
tional outbursts, and histrionic behavior. Sig-
sometimes associated with disease or a disorder
mund freud interpreted hysterical symptoms as
of the brain, or by exposure to extreme cold. Ac-
defenses against guilty sexual impulses (e.g., a
cidental hypothermia is most likely to affect
paralyzed hand cannot masturbate), but other
older people, who are less able to cope with the
conflicts are now recognized. Freud also included
cooling effect of environmental temperatures in
dissociative conditions in his concept of hyste-
the winter months. Symptoms include listless-
ria, but these are now regarded as separate disor-
ness, drowsiness, apathy, and indifference to
ders. The name derives ultimately from the Greek
progressive frostbite, progressing (if untreated)
husteros, “uterus,” based on the early and erro-
to coma and death. —hypothermic adj.
neous belief that such disorders were unique
hypothesis n. (pl. hypotheses) an empirically to women and originated in uterine disorders.
testable proposition about some fact, behavior, —hysterical adj.
relationship, or the like, usually based on theory, hysterical amnesia an older name, now rarely
that states an expected outcome resulting from encountered, for a disorder characterized by
specific conditions or assumptions. inability to recall traumatic or anxiety-pro-
hypothesis testing the process of using any of voking events, such as experiences associated
a collection of statistical tests to assess the like- with guilt, failure, or rejection. See dissociative
lihood that an experimental result might have amnesia.
been the result of a chance or random process. hysterical blindness see functional blind-
hypothymia n. an obsolescent name for a re- ness.
285
hysterical disorder
hysterical disorder an outdated name for any (formerly referred to as hysterical personality
disorder characterized by involuntary psycho- disorder), usually in response to a stressful pre-
genic dysfunction of the sensory, motor, or vis- cipitating life event. Symptoms are of short dura-
ceral activities of the body. See conversion tion, lasting 2 weeks or less, and there is a full
disorder; somatization disorder. return to the previous level of functioning. In
DSM–III, hysterical psychosis was subsumed
hysterical paralysis a former name for con-
under the diagnostic category of brief reactive
version paralysis.
psychosis (see brief psychotic disorder). Cur-
hysterical personality disorder see histri- rently, however, hysterical psychosis is not
onic personality disorder. widely considered a distinct clinical entity; it is
hysterical psychosis an old name for a con- not listed in the DSM–IV–TR. Also called
dition in which psychotic symptoms (e.g., hal- dissociative psychosis.
lucinations, delusions, and bizarre and some- hysteriform adj. characterized by symptoms
times violent behavior) appear suddenly in a per- that resemble those associated with hysteria.
son with histrionic personality disorder The term is not in current usage.
286
Ii
IAAP abbreviation for international associa- ICF abbreviation for intermediate care facil-
tion of applied psychology. ity.
IADLs abbreviation for instrumental activi- iconomania n. a pathological impulse to collect
ties of daily living. and worship images.
iatrogenesis n. the process of producing an iat- ICU abbreviation for intensive care unit.
rogenic illness. Also called iatrogeny. id n. in psychoanalytic theory, the component of
iatrogenic adj. denoting or relating to a patho- the personality that contains the instinctual, bi-
logical condition that is caused inadvertently by ological drives that supply the psyche with its
treatment, particularly the actions of a health basic energy or libido. Sigmund freud con-
care professional. For example, an iatrogenic ad- ceived of the id as the most primitive compo-
diction is a dependence on a substance, most nent of the personality, located in the deepest
often a painkiller, originally prescribed by a phy- level of the unconscious; it has no inner orga-
sician to treat a physical or psychological disor- nization and operates in obedience to the plea-
der. sure principle. Thus the infant’s life is domi-
iatrogenic illness a disorder that is induced or nated by the desire for immediate gratification
aggravated by the attending clinician, therapist, of instincts, such as hunger and sex, until the
or physician. It may be due to the behavior of ego begins to develop and operate in accor-
the clinician (e.g., his or her comments or ex- dance with reality. See also primary process;
pressions, the manner in which the patient is ex- structural model.
amined) or a result of the treatment given (e.g., id anxiety in psychoanalytic theory, anxiety de-
an infection acquired during the course of the riving from instinctual drives. This is the main
treatment). cause of primary anxiety (automatic anxiety).
iatrogenic schizophrenia see tardive dys- Compare ego anxiety.
mentia. idealism n. 1. in philosophy, the position that
iatrogeny n. see iatrogenesis. reality, including the natural world, is not inde-
pendent of mind. Positions range from strong
ibogaine n. a hallucinogenic agent found in the
forms, holding that mind constitutes the things
root of the African forest plant Tabernanthe
of reality, to weaker forms holding that reality is
iboga. It is used mainly by adherents of the Bwiti
correlated with the workings of the mind. There
(or Bouiti) religion in rituals or as a stimulant, al-
is also a range of positions as to the nature of
though data suggest that ibogaine may have po-
mind, from those holding that mind must be
tential clinical use in the treatment of substance
conceived of as absolute, universal, and apart
dependence and management of withdrawal
from nature itself to those holding that mind
symptoms. Although its mechanism of action is
may be conceived of as individual minds. See ab-
unknown, ibogaine may function as a low-
solute idealism; idealistic monism; subjec-
affinity blocker of the ion channels associated
tive idealism. See also mind–body problem. 2.
with nmda receptors.
commitment to moral, political, or religious ide-
ibotenic acid an agent that enhances the action als. Compare materialism. —idealist n. —ide-
of the excitatory neurotransmitter glutamate: alistic adj.
It is an agonist at nmda receptors. Ibotenic
idealization n. 1. the exaggeration of the posi-
acid and its metabolic product, muscimol (a
tive attributes and minimization of the imperfec-
gaba agonist), are found in some mushrooms
tions or failings associated with a person, place,
of the genus Amanita (see fly agaric).
thing, or situation, so that it is viewed as perfect
IBS abbreviation for irritable bowel syn- or nearly perfect. 2. in psychoanalytic theory, a
drome. defense mechanism that protects the individ-
ICD abbreviation for international classifica- ual from conscious feelings of ambivalence to-
tion of diseases. ward the idealized object. Idealization of the
ice n. slang for illicitly manufactured metham- parents and other important figures plays a role
phetamine, a common drug of abuse, especially in the development of the ego-ideal. —ideal-
the free-base, concentrated, smokable form of ize vb.
methamphetamine. It has an intense, persistent ideal observer a hypothetical person whose
action; chronic use may lead to serious psychiat- sensory and perceptual systems operate without
ric, metabolic, cardiovascular, and neuromusc- error or bias. The concept of the ideal observer is
ular changes. used most commonly within the context of
287
ideal self
psychophysical testing, particularly signal de- emulating other characteristics, of the aggressor.
tection theory. Performance of the ideal ob- This has been observed in cases of hostage taking
server can be simulated and compared with and in other extreme situations, such as concen-
actual human performance. tration camps. In psychoanalytic theory, it oc-
ideal self in models of self-concept, a mental curs on a developmental level when the male
representation of an exemplary set of psycholog- child identifies with his rival, the father, toward
ical attributes that one strives or wishes to pos- the end of the oedipal phase. It was first de-
sess. scribed by Anna freud in 1936. See also stock-
holm syndrome.
idea of influence see delusion of influence.
identified patient a member of a structured
idea of reference the sense that events or the group (especially a family) who exhibits the
actions of others (e.g., talking, whispering, or symptoms of a mental disorder and for whom
smiling) relate particularly to oneself. In an ex- treatment may be sought by the other group
treme degree, it is a delusion of reference. members. Clinical investigation may reveal that
ideation n. the process of forming ideas and im- there is a complex and seriously maladaptive be-
ages. —ideate vb. —ideational adj. havioral pattern among members of the group as
idée fixe 1. a firmly held, irrational idea or belief a whole but that the psychological stigma has
that is maintained despite evidence to the con- fallen primarily on one person, the identified pa-
trary. It may take the form of a delusion and be- tient. Also called symptom bearer; symptom
come an obsession. Also called fixed belief; wearer. See also dysfunctional family.
I fixed idea. 2. a subconscious unit of mental identity n. 1. an individual’s sense of self de-
processing (see automatism) that has become fined by (a) a set of physical and psychological
split off or dissociated from consciousness and, characteristics that is not wholly shared with
as a result, interferes with the normal processing any other person and (b) a range of social and in-
of information. In some theories, this is consid- terpersonal affiliations (e.g., ethnicity) and so-
ered a primary mechanism for the symptoms cial roles. Identity involves a sense of continuity:
of hysteria. [proposed by French psychologist the feeling that one is the same person today
Pierre Janet (1859–1947)] that one was yesterday or last year (despite phys-
id-ego n. in psychoanalytic theory, the undiffer- ical or other changes). Such a sense is derived
entiated structure of the infant’s personality be- from one’s body sensations; one’s body image,
fore the ego develops enough maturity to and the feeling that one’s memories, purposes,
separate from the id. The concept is based on values, and experiences belong to the self. Also
Sigmund freud’s view that the newborn infant called personal identity. 2. in cognitive devel-
is all id and the ego develops out of it in response opment, awareness that an object remains the
to the demands of reality. See ego develop- same even though it may undergo many trans-
ment. formations. For example, a piece of clay may be
made to assume various forms but is still the
identical twins see monozygotic twins.
same piece of clay.
identification n. 1. the process of associating
the self closely with other individuals and their identity confusion uncertainty regarding
characteristics or views. This process takes many one’s identity, which often occurs during adoles-
forms: The infant feels part of his or her mother; cence but may also occur at a later stage of life.
the child gradually adopts the attitudes, stan- See identity versus identity confusion.
dards, and personality traits of the parents; the identity crisis a phase of life marked by role ex-
adolescent takes on the characteristics of the perimentation, changing, conflicting, or newly
peer group; the adult identifies with a particular emerging values, and a lack of commitment to
profession or political party. Identification oper- one’s usual roles in society (especially in work
ates largely on an unconscious or semiconscious and family relationships). Erik erikson claimed
level. 2. in psychoanalytic theory, a defense that it is natural and desirable for adolescents to
mechanism in which the individual incorpo- go through a period of identity crisis and that
rates aspects of his or her objects inside the ego greater maturity results from the experience. The
in order to alleviate the anxiety associated with concept has been expanded to refer to adult
object loss or to reduce hostility between him- midlife crisis and other periods marked by
self or herself and the object. change or experimentation with the self. See
identification transference in group ther- ego identity.
apy, the client’s identification with other mem- identity diffusion 1. lack of stability or focus
bers of the group and desire to emulate them. in the view of the self or in any of the elements of
[first described by Russian-born U.S. psychother- an individual’s identity. 2. in the ego psy-
apist Samuel Richard Slavson (1890–1981)] chology of Erik erikson, a possible outcome of
identification with the aggressor an un- the identity versus identity confusion stage
conscious mechanism in which an individual in which the individual emerges with an uncer-
identifies with someone who poses a threat or an tain sense of identity and confusion about his or
opponent who cannot be mastered. The identifi- her wishes, attitudes, and goals.
cation may involve adopting the aggression, or identity disorder 1. in DSM–III, a chronic dis-
288
idiographic trait
turbance, usually of late adolescence, in which vidual may experience a psychosocial morato-
feelings of uncertainty and distress are generated rium, a period of time that permits experimenta-
by such identity issues as long-term goals, career tion with social roles. The individual may “try
choice, sexual orientation and behavior, group on” different roles and identify with different
loyalty, moral values, and religious identifica- groups before forming a cohesive, positive iden-
tion. In DSM–IV–TR, this is categorized as an tity that allows him or her to contribute to soci-
identity problem within the section Other Con- ety; alternatively, the individual may identify
ditions That May Be a Focus of Clinical Atten- with outgroups to form a negative identity, or
tion. 2. see dissociative identity disorder; may remain confused about his or her sense of
gender identity disorder. identity, a state Erikson calls identity diffu-
identity foreclosure premature commitment sion.
to an identity: the unquestioning acceptance by idiocentric 1. adj. denoting internality to the
individuals (usually adolescents) of the role, val- self, particularly an orientation toward or focus
ues, and goals that others (e.g., parents, close on personal needs and interests. 2. n. an individ-
friends, teachers, athletic coaches) have chosen ual who is dispositionally predisposed to put his
for them. The individual’s commitment to the or her personal interests and motivations before
foreclosed identity—for example, that of an ath- the interests and goals of other people and other
lete—occurs without exploring its value or con- groups. Just as societies based on individualism
templating alternative roles that might be more stress the rights of the individual over the group,
appropriate for him or her. See also separation– so idiocentrics emphasize their personal needs
individuation. and are emotionally detached from groups and I
communities. They are more likely to describe
identity need in the theory of Erich fromm,
themselves in terms of personal qualities and
the need to achieve a sense of uniqueness, indi-
traits rather than memberships and roles. See
viduality, and selfhood. Psychological auton-
also egocentrism; individualism. Compare
omy and the severing of incestuous ties are
allocentric. —idiocentrism n.
considered essential for healthy individuality.
Unhealthy, spurious individuality is expressed idiogamist n. a person who is capable of full sex-
in conformity, a manifestation of the escape ual response only with his or her spouse and is
from freedom. Compare rootedness. sexually incapable or inadequate with other
partners. An idiogamist is usually a man who
identity style an adolescent’s characteristic cannot obtain or maintain penile erection with
mode of approaching problems and decisions
any partner other than his wife (or, sometimes,
that are relevant to his or her personal identity
women who resemble his wife).
or sense of self. Differences in style reflect differ-
ences in the social-cognitive processes that indi- idiogenesis n. origin without evident cause, par-
viduals use to construct a sense of identity. Three ticularly the origin of an idiopathic disease.
basic identity styles are recognized: informational, idioglossia n. the omission, substitution, and
normative, and diffuse-avoidant. Information- distortion of so many sounds that speech is ren-
oriented individuals actively seek out, evaluate, dered unintelligible. It is often associated with
and use self-relevant information. They are skep- mental retardation. Also called idiolalia.
tical about their self-constructions and willing to
idiographic adj. relating to the description and
test and revise aspects of their self-identity when
understanding of an individual case, as opposed
confronted with discrepant feedback. Normative
to the formulation of nomothetic general laws
individuals deal with identity questions and de-
describing the average case. U.S. psychologists
cisional situations by conforming to the pre-
Kenneth MacCorquadale (1919–1986) and Paul
scriptions and expectations of significant others.
meehl identified these as two contrasting tradi-
Diffuse-avoidant-oriented individuals are reluc-
tions in explaining psychological phenomena.
tant to face up to and confront personal prob-
An idiographic approach involves the thorough,
lems and decisions.
intensive study of a single person or case in order
identity theory the theory that mental states to obtain an in-depth understanding of that per-
are identical with brain states. In token identity son or case, as contrasted with a study of the uni-
theory, identical mental and brain states occur versal aspects of groups of people or cases. In
within the individual. Type identity theory ex- those areas of psychology in which the individ-
tends this to theorize that when two or more ual person is the unit of analysis (e.g., in person-
people share a mental state (e.g., the belief that ality, developmental, or clinical psychology),
ice is cold) they also have the same brain state. the idiographic approach has appeal because it
Also called central state theory; identity seeks to characterize a particular individual, em-
theory of the mind. See also epiphenomen- phasizing that individual’s characteristic traits
alism; materialism; mind–body problem; (see idiographic trait) and the uniqueness of
physicalism; reductionism. the individual’s behavior and adjustment, rather
identity versus identity confusion the than to produce a universal set of psychological
fifth of erikson’s eight stages of develop- constructs that might be applicable to a popula-
ment, marked by an identity crisis that occurs tion.
during adolescence. During this stage the indi- idiographic trait a personality trait that is ob-
289
idiolalia
served in only one individual or one member of iich’aa n. a culture-bound syndrome found
a population or that is seldom found in the same in Navaho communities, with symptoms similar
form among individuals or members. Also called to those of amok.
unique trait. I–It adj. describing a relationship in which a sub-
idiolalia n. see idioglossia. ject (“I”) treats something or someone else exclu-
idiopathic adj. without known cause or of spon- sively as an impersonal object (“It”) to be used or
taneous origin: usually denoting diseases, such controlled. German Jewish philosopher Martin
as some forms of epilepsy, whose etiology is Buber (1878–1965), who originated the term,
obscure. maintained that this type of relationship be-
idiosyncratic intoxication a condition char- tween people stands in the way of human
acterized by sudden and extreme changes in per- warmth, mutuality, trust, and group cohesive-
sonality, mood, and behavior following the ness. Compare i–thou.
ingestion of an amount of alcohol usually con- ikota n. see myriachit.
sidered to be too little to account for the degree Illinois Test of Psycholinguistic Abilities
of the changes. It may include extreme excite- (ITPA) a norm-referenced test for children aged
ment, impulsive and aggressive behavior (at times 5–13 years and designed to measure spoken and
to the point of extreme violence), persecutory written linguistic abilities considered important
ideas, disorientation, and hallucinations. The in communication and learning disorders. It cur-
episode ends when the individual falls into a rently consists of 12 subtests: spoken analo-
deep sleep, after which there is often complete gies, spoken vocabulary, morphological closure,
I loss of memory for it. Some researchers believe syntactic sentences, sound deletion, rhyming
that the condition may be related to stress or sequences, sentence sequencing, written vocab-
may be due in part to a psychomotor seizure trig- ulary, sight decoding, sound decoding, sight
gered by alcohol. Also called mania a potu; spelling, and sound spelling. First published in
pathological intoxication. See also furor. 1961 as an experimental edition, the ITPA is now
idiosyncratic reaction an unexpected reac- in its third edition (published in 2001). [origi-
tion to a drug resulting in effects that may be nally developed by U.S. psychologists Samuel Al-
contrary to the anticipated results. Idiosyncratic exander Kirk (1904–1996) and James Jerome
reactions can result in various symptoms, but McCarthy (1927– ) at the University of Illinois]
generally refer to an extreme sensitivity or an ex- illness behavior behaviors, attitudes, and emo-
treme insensitivity to a particular agent. Such re- tions exhibited by individuals during the course
actions may be genetically mediated. of a physical or mental illness. It includes the
idiot savant (pl. idiots savants or, less often, perception of feeling ill, the expression of ill-
idiot savants) see savant. [French, “learned ness-related concerns to others, changes in func-
idiot”] tioning, and utilization of health care services.
id psychology in psychoanalysis, an approach illogicality n. a tendency to make unwarranted
that focuses on the unorganized, instinctual im- or faulty inferences, often characteristic of delu-
pulses contained in the id that seek immediate sional thinking and speech. —illogical adj.
pleasurable gratification of primitive needs. The illumination n. a moment of insight, for exam-
id is believed to dominate the lives of infants and ple into the nature and processes of an interper-
is frequently described as blind and irrational sonal relationship, the solution to a problem, or
until it is disciplined by the other two major understanding of an event. See also aha experi-
components of the personality: the ego and the ence; epiphany.
superego. Compare ego psychology.
illuminism n. an exalted hallucinatory state in
id resistance in psychoanalysis, a form of resis- which the person carries on conversations with
tance to therapy that is motivated by uncon- imaginary, often supernatural, beings.
scious id impulses, whose underlying motive is
the repetition compulsion. Compare repres- illusion n. 1. a false perception. Illusions of the
sion-resistance; superego resistance. senses, such as visual (or optical) illusions, result
from the misinterpretation of sensory stimuli.
IDS abbreviation for integrated delivery sys- For example, parallel railroad tracks appear to
tem. meet in the distance. Many illusions are quite
IEP abbreviation for individualized education normal occurrences, although they may also
program. occur in delirium, schizophrenia, and in those
IFSP abbreviation for individual family ser- taking mind-altering drugs. Visual illusions may
vice plan. also occur as a result of a pathological condition.
if…then profiles a methodology for describing 2. a distortion in memory, such as déjà vu. —il-
personal dispositions in which within-person lusory adj.
variations across social contexts are charted in illusion of agency the illusion of controlling
terms of the behaviors evoked by particular situ- an action that is not actually under one’s con-
ations. [developed by U.S. personality psycholo- trol. Also called illusion of will. [defined by
gists Walter Mischel (1930– ) and Yuichi Shoda] U.S. psychologist Daniel M. Wegner (1948– )]
IHS abbreviation for indian health service. illusion of control a false belief that external
290
imaging
events result from or are governed by one’s own stressful situations, for example, by a nervous
actions or choices. See positive illusion. passenger in an aircraft. See also guided affec-
illusion of doubles see capgras syndrome. tive imagery.
illusion of orientation misidentification of imaginal exposure a type of exposure ther-
environmental or other stimuli, such as confu- apy used for treating individuals with anxiety
sion about one’s location or the identity of peo- disorders (e.g., phobias, obsessive-compulsive
ple, due to impaired consciousness, for example, disorder) or posttraumatic stress disorder.
during delirium. Vivid imagery evoked through speech is used by
the therapist to expose the client mentally to an
illusory correlation 1. the appearance of a re- anxiety-evoking stimulus. Compare in vivo ex-
lationship that in reality does not exist. 2. an
posure.
overestimation of the degree of relationship (i.e.,
correlation) between two variables. For example, Imaginary n. the realm of images: one of three
if an unusual action occurred at the same time aspects of the psychoanalytic field defined by
that an adolescent was present, the assumption French psychoanalyst Jacques Lacan (1901–
that the action was carried out by the adolescent 1981). The Imaginary is that state of being in
would be an illusory correlation. which the infant has no sense of being a subject
distinct from other people or the external world
illusory memory see false memory.
and no sense of his or her place in human cul-
iloperidone n. an atypical antipsychotic ture. After the infant’s entry into the symbolic
agent of the benzisoxazole class that is active at a (the world of language, culture, and morality),
range of receptors. It acts as an antagonist at he or she can return to the wholeness of the I
postsynaptic serotonin 5-HT2A receptors as well Imaginary only in fantasy. See also real.
as at dopamine D2 receptors. It is thought also to
imaginary audience the belief of an adoles-
act as a partial agonist at postsynaptic dopa-
cent that others are constantly focusing atten-
mine D2 receptors. This blend of agonist and an-
tion on him or her, scrutinizing behaviors,
tagonist properties, plus its wide-ranging recep-
appearance, and the like. The adolescent feels as
tor activity, is thought to confer antipsychotic
though he or she is continually the central topic
activity without the negative side effects com-
of interest to a group of spectators (i.e., an audi-
monly associated with antipsychotics. U.S. trade
ence) when in fact this is not the case (i.e., an
name: Fanapt.
imaginary audience). It is an early adolescent
im abbreviation for intramuscular. construct reflective of acute self-consciousness.
image n. 1. a likeness or cognitive representation imaginary companion a fictitious person,
of an earlier sensory experience recalled without animal, or object created by a child or adoles-
external stimulation. For example, remembering cent. The individual gives the imaginary com-
the shape of a horse or the sound of a jet airplane panion a name, talks, shares feelings, and
brings to mind an image derived from earlier ex- pretends to play with it, and may use it as a
periences with these stimuli. 2. a representation scapegoat for his or her misdeeds. The phenome-
of an object produced by an optical system. non is considered an elaborate but common
imageless thought thinking that occurs with- form of symbolic play. Also called invisible
out the aid of images or sensory content. The playmate.
so-called Würzburg school (late 19th century) imagination n. the faculty that produces ideas
upheld the existence of imageless thought on and images in the absence of direct sensory data,
the basis of introspective reports, for example, often by combining fragments of previous sen-
experimental participants’ stated ability to sory experiences into new syntheses. See also cre-
name a piece of fruit without picturing it. Ed- ative imagination. —imaginary adj. —imag-
ward Bradford titchener and others in the ine vb.
structural school opposed this view (see imagination inflation the increased likeli-
structuralism). hood of a person judging that an event has actu-
imagery n. 1. cognitive generation of sensory ally occurred (e.g., during that person’s childhood)
input from the five senses, individually or collec- when the person imagines the event before mak-
tively, which is recalled from experience or self- ing such a judgment.
generated in a nonexperienced form. 2. mental imaging n. 1. the process of scanning the brain
images considered collectively, or the particular or other organs or tissues to obtain an optical
type of imagery characteristic of an individual, image. Techniques used include computed to-
such as visual imagery. mography, positron emission tomography
imagery technique the use of imagined scenes (PET), anatomical magnetic resonance imag-
as a therapeutic technique, often in hypnother- ing (aMRI), and functional magnetic reso-
apy but also in therapies that use breathing and nance imaging (fMRI). The imaging may be
relaxation techniques to reduce anxiety. For ex- either static or dynamic. See also brain imag-
ample, an anxious client may be directed to ing; nuclear imaging. 2. in therapy, the use of
imagine a placid scene recalled from memory, suggested mental images to control body func-
such as sitting, relaxed and calm, on a beach. tion, including the easing of pain. See also imag-
The technique may be used by an individual in ery technique; visualization.
291
imago
imago n. an unconscious mental image of an- analysis (see mediate experience). See also
other person, especially the mother or father, contemporaneity.
that influences the way in which an individual immediate gratification the experience of
relates to others. The imago is typically formed satisfaction or receipt of reward as soon as a re-
in infancy and childhood and is generally an sponse is made. See also pleasure principle.
idealized or otherwise not completely accurate Compare delay of gratification.
representation. The term was originally used by
Sigmund freud and the early psychoanalysts,
immediate memory a type or stage of mem-
ory in which an individual recalls information
and its meaning has carried over into other
recently presented, such as a street address or
schools of psychology and psychotherapy.
telephone number, although this information
imago therapy a type of therapy for relation- may be forgotten after its immediate use. Imme-
ship problems based on the theory that people diate memory is frequently tested in assessing in-
carry unconscious composite images (see telligence or cerebral impairment. See also
imago) of the character traits and behaviors of short-term memory.
their primary childhood caretakers that impel immobilizing activity see libido-binding
them to select certain partners and to behave in activity.
ways that are meant to heal earlier emotional
wounds but that actually create relationship immune system a complex system in verte-
problems. Structured exercises, either in groups brates that helps protect the body against patho-
(for individuals or couples) or in couples ther- logical effects of foreign substances (antigens),
I apy, reveal the imago and help individuals learn such as viruses and bacteria. The organs involved
to become less defensive and more compassion- include the bone marrow and thymus, in which
ate toward partners as well as themselves. lymphocytes—the principal agents responsible
for specific immune responses—are produced,
imbecility n. formerly, a low to moderate level together with the spleen, lymph nodes, and
of intellectual disability characterized by an IQ other lymphoid tissues and various chemicals
between 25 and 50–55 and social and practical that mediate the immune response. The im-
skills similar to those of 2- to 7-year-olds. This mune system interacts with both the nervous
level of intellectual disability is now described as system and the endocrine system. See also
severe mental retardation or moderate psychoneuroimmunology.
mental retardation (depending on the de-
gree). Imodium n. a trade name for loperamide.
impact analysis a quantitative analytic proce-
imipramine n. a tricyclic antidepressant dure used to assess the net success or failure of a
(TCA) with a tertiary amine molecular structure.
program, usually through controlled experimen-
It was originally synthesized in the hopes of cre-
tation. It is appropriate only if the program’s ob-
ating an effective antipsychotic, but was ob-
jectives are specifiable and measurable, the
served to be ineffective in reducing psychotic
program is well implemented for its intended
symptoms. It did, however, seem to help indi-
participants, and the outcome measures are reli-
viduals with severe depression and was subse-
able and valid. Also called impact assessment.
quently marketed as an antidepressant. It is
See also outcome evaluation; summative
considered the prototype TCA and, like all
evaluation.
tricyclic agents, its use as an antidepressant has
been largely supplanted by less toxic drugs. It impaired judgment difficulty in forming
continues, however, to have a therapeutic role as evaluative opinions or reaching conclusions
a sedative and adjunct in the management of concerning available evidence, often about peo-
neuromuscular or musculoskeletal pain. U.S. ple and courses of action. Impaired judgment
trade name: Tofranil. may lead to seemingly irrational actions and
risk-taking behaviors. It has been thought of as
imitation n. the process of copying the behavior both a diagnostic and a predictive criterion for
of another person, group, or object, intention- delirium, dementia, and substance-related disor-
ally or unintentionally. It is a basic form of learn- ders, but its diagnosis and measurement are hin-
ing that accounts for many human skills, dered by the lack of an agreed operational
gestures, interests, attitudes, role behaviors, so- definition. Various fields have contributed re-
cial customs, and verbal expressions, but can search to this, including developmental and in-
also take pathological form, as in echolalia and dustrial psychology, experimental psychology
echopraxia. —imitate vb. (perception), medicine, and legal decision mak-
immaturity n. a state of incomplete growth or ing.
development (e.g., neural immaturity). The impairment n. any departure from the body’s
term, however, is often used to describe childish, typical physiological or psychological function-
maladaptive, or otherwise inappropriate behaving.
iors, particularly when indicative of a lack of age-
impairment index a measure of impairment
relevant skills.
on a series of cognitive tests. The best known
immediate experience current experience such index is the Halstead–Reitan Impairment
and impressions of that experience without any Index, which reflects the percentage of tests in
292
impotence
the impaired range; the higher the percentage, on their psychological characteristics but instead
the greater the likelihood of brain damage. employs subtle indices capable of tapping men-
impenetrability n. the state of certain cogni- tal content that individuals may not wish to ex-
tive capacities, such as syntax, that are claimed press or perhaps are not even aware they possess
to be inherently walled off from conscious access because the mental content is not explicitly rep-
and not available to introspective analysis. resented in consciousness. Measures of the time
it takes individuals to answer questions, irrespec-
imperative n. in psychoanalytic theory, a de- tive of the content of their answers, are one com-
mand of the superego that represents the com-
monly employed implicit measure.
manding voice of parental or social rule, and
operates on an unconscious level to direct the implicit memory memory for a previous event
behavior of the individual. or experience that is produced indirectly, with-
out an explicit request to recall the event and
impersonation n. 1. the deliberate assumption
without awareness that memory is involved. For
of another person’s identity, usually as a means
instance, after seeing the word store in one con-
of gaining status or other advantage. See also im-
text, a person would complete the word frag-
postor syndrome. 2. the imitation of another
ment st_r_ as store rather than stare, even
person’s behavior or mannerisms, which is
without remembering that store had been re-
sometimes done for its corrective or therapeutic
cently encountered. Implicit memory can exist
effect on one’s own behavior (e.g., to gain in-
when conscious or explicit memory fails, as oc-
sight).
curs in amnesia and brain disease. This term,
impingement n. 1. in the object relations proposed in 1985 by Canadian psychologist I
theory of British psychoanalyst Donald Winni- Peter Graf and U.S. psychologist Daniel Schacter,
cott (1896–1971), an experience in the infant’s is used interchangeably with nondeclarative
maternal environment that is felt to be disturb- memory. Compare explicit memory.
ing. Such experiences are posited to lead to the
development of a false self because the infant implicit personality theory any set of tacit
may develop through a series of reactions to im- assumptions about the interrelations of person-
pingements rather than becoming aware of his ality traits, used in everyday life when people
or her true tendencies and capacities by discover- infer the presence of one trait on the basis of ob-
ing the environment on his or her own terms. 2. serving another.
in perception, impact or contact with a sensory implicit process 1. a cognitive event that can-
receptor. —impinge vb. not be described accurately, even under optimal
implanted memory the apparent recollection conditions. 2. an occasional synonym for un-
of an event that never occurred because some- conscious process. Compare explicit pro-
one has convinced the person that it did occur. cess.
There have been allegations that some psycho- implosive therapy a technique in behavior
therapists have implanted memories in their cli- therapy that is similar to flooding but distinct
ents by leading questioning. See false memory in generally involving imagined stimuli and in
syndrome. attempting to enhance anxiety arousal by add-
implicit attitude an attitude of which a pering imaginary exposure cues believed by the
son has little or no conscious awareness. Com- therapist to be relevant to the client’s fear. Also
pare explicit attitude. called implosion therapy. [developed by U.S.
psychologists Thomas G. Stampfl (1923–2005)
implicit behavior 1. behavior that cannot be and Donald J. Levis (1936– )]
observed directly, such as a cognitive process or
emotional reaction. 2. behavior that cannot be impostor syndrome 1. the tendency to attrib-
observed without the aid of instruments, such as ute achievements and success to external factors
subtle physiological responses. 3. behavior of rather than internal factors, associated with a
which the individual is not consciously aware. persistent belief in one’s lack of ability despite
consistent objective evidence to the contrary. As
implicit cognition an idea, perception, or
a result, the individual may feel like a fraud and
concept that may be influential in the cognitive
have low self-esteem and identity problems. Also
processes or the behavior of an individual, even
called impostor phenomenon. 2. a personal-
though the person is not explicitly aware of it.
ity pattern characterized by pathological
See cognition.
lying, which takes the form of fabricating an
implicit knowledge see tacit knowledge. identity or a series of identities in an effort to
implicit learning learning of a cognitive or be- gain recognition and status. See imperson-
havioral task that occurs without intention to ation.
learn or awareness of what has been learned. Im- impotence n. the inability of a man to complete
plicit learning is evidenced by improved task the sex act due to partial or complete failure to
performance rather than as a response to an ex- achieve or maintain erection. This condition is
plicit request to remember. See also implicit called male erectile disorder in DSM–IV–TR
memory. Compare explicit memory. and erectile dysfunction in clinical contexts.
implicit measure of personality any mea- The most common causes of drug-induced im-
sure that does not ask people to report explicitly potence are antidepressants and antihyperten-
293
impoverished
sives. It is not clearly understood how the use of process of establishing a stimulus as a
antidepressants results in impotence and other reinforcer by presenting it in the appropriate
forms of sexual dysfunction: Possible mecha- context. The stimulus thus established is called
nisms include inhibition of nitric oxide or ef- an imprinted stimulus.
fects on serotonin (particularly the 5-HT2 improvement rate see discharge rate.
serotonin receptor), dopamine, acetylcho-
line, and norepinephrine. Impotence may also
improvisation n. in psychodrama, the spon-
taneous acting out of problems and situations
denote premature ejaculation, limited interest in
without prior preparation.
sex, orgasm without pleasure, or coitus without
ejaculation. See also orgastic impotence; pri- IMPS abbreviation for inpatient multidimen-
mary erectile dysfunction; secondary sional psychiatric scale.
erectile dysfunction. —impotent adj. impulse n. 1. a sudden and compelling urge to
impoverished adj. 1. describing a stimulus that act immediately, often resulting in action with-
is lacking in complexity or information value. 2. out deliberation for a purpose that cannot be re-
deficient in or deprived of qualities or lacking in called. Also called impulsion. See also impulse-
richness because something essential is missing. control disorder; impulsive. 2. see nerve
An impoverished environment offers few oppor- impulse. 3. in psychoanalytic theory, the move-
tunities to engage in activity and does not provide ment of psychic energy associated with in-
adequate sensory and intellectual stimulation. stinctual drives, such as sex and hunger.
See also intellectual impoverishment. —im- impulse control the ability to resist an im-
I poverishment n. pulse, desire, or temptation and to regulate its
translation into action. See also impulse-
impression n. 1. the presumed effect on the
control disorder.
brain of stimulation. 2. a vague or unanalyzed
judgment or reaction. impulse-control disorder a disorder charac-
terized by a failure to resist impulses, drives, or
impression formation the process in which temptations to commit acts that are harmful to
an individual develops a perceptual schema of
oneself or to others. Impulse-control disorders
some object, person, or group. Early research on
include those in the DSM–IV–TR category im-
impression formation demonstrated that the ac-
pulse-control disorders not elsewhere
curacy of impressions was frequently poor; more
classified. Other disorders that may involve
recent studies have focused on the roles played
problems of impulse control include substance-
in the process by such factors as the perceiver’s
use disorders, paraphilias, conduct disorders,
cognitive processes (e.g., how readily some types
and mood disorders.
of ideas come to mind) and feelings (e.g., anger
can predispose the perceiver to stereotype an in- impulse-control disorders not elsewhere
dividual). classified in DSM–IV–TR, a class of impulse-
control disorders not classified in other ca-
impression management behaviors that are tegories (such as substance-use disorders). This
designed to control how others perceive one’s class includes pathological gambling, klep-
self, especially by guiding them to attribute de- tomania, pyromania, intermittent explo-
sirable traits to the self. Typically, it is assumed sive disorder, and trichotillomania, all of
that people attempt to present favorable images which have their own specific sets of diagnostic
of themselves as a means of obtaining social re- criteria, together with impulse-control disorders
wards and enhancing self-esteem. Impression not otherwise specified, which do not meet the
management has been offered as an alternative criteria for any of the specific disorders. All these
explanation for some phenomena that have tra- disorders have the following common features:
ditionally been interpreted in terms of cogni- (a) failure to resist an impulse or a drive or a
tive dissonance theory. Some psychologists temptation to perform an act that is harmful to
distinguish impression management from self- the individual or others; (b) mounting tension
presentation by proposing that impression before committing the act; and (c) pleasure or re-
management involves only deliberate, conscious lief during the act, with or without regret and
strategies. self-reproach afterward.
imprinting n. 1. a simple yet profound and impulsion n. see impulse.
highly effective learning process that occurs dur-
impulsive adj. describing or displaying behavior
ing a critical period in the life of some ani-
characterized by little or no forethought, reflec-
mals. It was first described in 1873 by British
tion, or consideration of the consequences,
naturalist Douglas A. Spalding (1840–1877)
which may involve taking risks. See also reflec-
when he observed that newly hatched chicks
tivity–impulsivity; self-control. —impul-
tended to follow the first moving object, human
siveness or impulsivity n.
or animal, that caught their attention. The term
itself was introduced by Austrian ethologist impulsive character a personality pattern
Konrad Lorenz (1903–1989) in 1937. Some in- marked by a tendency to act hastily and without
vestigators believe that such processes are in- due reflection.
stinctual; others regard them as a form of imu n. a culture-bound syndrome resembling
prepared learning. 2. in conditioning, the latah, observed among the Ainu and Sakhalin
294
incompetence
women of Japan. It is characterized by an ex- are found in practically every society. —inces-
treme startle response involving automatic tuous adj.
movements, imitative behavior, infantile reac- incest barrier in psychoanalytic theory, an
tions, and obedience to command. See also ego defense against incestuous impulses and
jumping frenchmen of maine syndrome; fantasies. The barrier is the result of the intro-
myriachit. jection of social laws and customs. These inter-
Imuran n. a trade name for azathioprine. nal and external prohibitions free the libido to
inaccessibility n. unresponsiveness to external make an external object choice.
stimuli, most commonly associated with the incest taboo social prohibition against sexual
state of withdrawal sometimes seen in autism intercourse between people of close blood rela-
and schizophrenia. —inaccessible adj. tionship. See incest.
inappetence n. impaired appetite or desire, a incestuous ties in psychoanalytic theory, the
frequent symptom of depression. condition in which an individual remains psy-
inappropriate affect emotional responses chologically dependent on the mother, family,
that are not in keeping with the situation or are or symbolic substitute to the extent that healthy
incompatible with expressed thoughts or wishes, involvement with others and with society is in-
for example, smiling when told about the death hibited or precluded. According to Erich fromm,
of a friend. Extreme inappropriate affect is a de- who introduced the term, incestuous ties repre-
fining characteristic of disorganized schizo- sent the negative resolution of the search for
phrenia. rootedness. See also identity need.
I
Inapsine n. a trade name for droperidol. incidence n. the rate of occurrence of new cases
inattention n. a state in which there is a lack of of a given event or condition, such as a disorder,
concentrated or focused attention or in which disease, symptom, or injury, in a particular pop-
attention drifts back and forth. See also selec- ulation in a given period. An incidence rate is
tive inattention. normally expressed as the number of cases per
some standard proportion (1,000 or 100,000 are
inattentional blindness failure to notice and commonly used) of the entire population at risk
remember otherwise perceptible stimuli in the per year. See also prevalence.
visual background while the focus of attention is
elsewhere. Research into inattentional blindness incidental stimulus an unintentional or co-
has led some to conclude that there is no con- incidental stimulus that may occur during an
scious perception of the world without atten- experiment or in another situation, which may
tion. [defined by U.S. psychologists Arien Mack elicit an unplanned response from the partici-
(1931– ) and Irvin Rock (1922–1995)] pants or result in the distortion of research find-
ings.
inborn error of metabolism any biochemi-
cal disorder caused by a genetic defect. It is often inclusion n. the practice of teaching students
expressed as a defect or deficiency in the struc- with disabilities in the same classroom as other
ture or enzymatic function of a protein molecule students to the fullest extent possible, via the
or in the transport of a vital substance across a provision of appropriate supportive services. See
cell membrane. Examples of such errors include also full inclusion.
diabetes mellitus, gout, phenylketonuria, and inclusion–exclusion criteria in clinical re-
Tay–Sachs disease. Also called metabolic anom- search, criteria used for determining which indi-
aly. viduals are eligible to participate in a particular
incendiarism n. compulsive or intentional fire study. Inclusion criteria might specify, for exam-
setting. See fire-setting behavior; pyromania. ple, age range, whereas exclusion criteria might
specify, for example, the existence of more than
incentive motivation 1. an inducement, one illness or psychological disorder.
such as the expectation of a reward or punish-
ment, that serves as an intervening variable incoherence n. inability to express oneself in a
to influence response strength. 2. more gener- clear and orderly manner, most commonly man-
ally, any motivation induced by a positive rein- ifested as disjointed and unintelligible speech.
forcer. This may be an expression of disorganized and
impaired thinking. —incoherent adj.
incentive theory the theory that motivation
arousal depends on the interaction between en- incompatible response a response or action
vironmental incentives (i.e., stimulus objects)— that conflicts with another or occurs simulta-
both positive and negative—and an organism’s neously with another. For example, a state of
psychological and physiological states (e.g., anxiety is incompatible with a state of relax-
drive states). ation.
incest n. sexual activity between people of close incompatible response method a technique
blood relationship (e.g., brother and sister) that used to break bad habits in which an undesirable
is prohibited by law or custom. In some societies response is replaced by a more acceptable one
sexual intercourse between cousins, uncles and that cannot coexist with the undesirable re-
nieces, or aunts and nephews is prohibited; in sponse.
others it is permitted. Incest taboos of some kind incompetence n 1. in law, the inability of a de-
295
incompetency plea
fendant to participate meaningfully in criminal peated unreinforced presentation of a condi-

proceedings, which include all elements of the tioned stimulus. For example, a person with a
criminal justice system, from initial interroga- spider phobia might become more afraid of spi-
tion to sentencing. Defendants who do not have ders each time he or she encounters one, even if
the ability to communicate with attorneys or un- no encounter is paired with a traumatic event,
derstand the proceedings may be ruled incompe- such as the spider biting. [first proposed by Hans
tent to stand trial (see competency to stand eysenck as the basis of his conditioning theory
trial). See also dusky standard. 2. in law, the of neurosis]
inability to make sound judgments regarding indemnity plan a system of health insur-
one’s transactions or personal affairs. See legal ance in which the insurer pays for the costs of
capacity. Also called incompetency. —in- covered services after care has been given. Such
competent adj. plans typically offer participants considerable
incompetency plea the plea, in a court of law, freedom to choose their own health care provid-
that the defendant, because of mental illness, ers and are contrasted with group health plans,
mental defect, or other reasons, does not under- which provide service benefits through group
stand the nature and object of the proceedings, medical practices.
cannot appreciate or comprehend his or her own
independence n. 1. complete lack of relation-
condition in relation to the proceedings, or is
ship between two or more events, sampling
unable, for some other reason, to assist the attor-
units, or variables such that none is influenced
ney in his or her own defense. See also compe-
by any other and that changes in any one have
I tency to stand trial.
no implication for changes in any other. 2. in
incomplete-sentence test see sentence- probability theory, the condition in which the
completion test. probability of an event does not depend on the
incongruence n. lack of consistency or appro- probability of some other event. If A and B are in-
priateness, as in inappropriate affect or as dependent events, then Pr(A/B) = Pr(A). —inde-
when one’s subjective evaluation of a situation is pendent adj., n.
at odds with reality. —incongruent adj. independent events either of two events
incontinence n. 1. an inability to control basic whose occurrence does not influence the occur-
body functions, particularly urination and deference of the other.
cation (see fecal incontinence; urinary in- independent living 1. the ability of an indi-
continence). Incontinence is often caused by vidual to perform—without assistance from oth-
bodily and neurological injury or damage or or- ers—all or most of the daily functions typically
ganic abnormalities and changes. 2. an inability required to be self-sufficient, including those
to restrain sexual impulses. —incontinent adj. tasks essential to personal care (see activities of
incorporation n. in psychoanalytic theory, the daily living) and to maintaining a home and
fantasy that one has ingested an external ob- job. 2. a philosophy and civil reform movement
ject, which is felt to be physically present inside promoting the rights of people with disabilities
the body. According to the theory, it first occurs to determine the course of their lives and be full,
in the oral stage, when the infant fantasizes productive members of society with access to the
that he or she has ingested the mother’s breast. same social and political freedoms and opportu-
Incorporation is often confused with identifi- nities as individuals without disabilities. Central
cation and introjection. —incorporate vb. to the philosophy are the concepts of self-
incorporation dream a dream whose content determination and self-worth, peer support,
is wholly or partially taken in from concurrent consumer-controlled assistance and support ser-
sensory stimulation. See accidental stimulus. vices, and political and social reform. Centers for
Independent Living (CILs), nonresidential, non-
incremental validity an increase in the accu- profit organizations that are staffed and operated
racy level of decisions made on the basis of a test by individuals with disabilities, encourage self-
over the level of accuracy obtained had the test sufficiency and self-determination in all aspects
not been employed. of life for individuals with disabilities by provid-
incubation n. 1. the provision of warmth and ing information and referral services, peer coun-
protection for eggs that develop outside the fe- seling, and independent living training (e.g.,
male’s body. In birds, incubation can be under- assistance with such things as assistive tech-
taken by either or both parents and is essential nology, budgeting, meal preparation, transpor-
for hatching of the eggs. 2. the gradual genera- tation arrangements, employment searches, and
tion of a solution to a problem at an unconscious access to housing and health care). CILs also ad-
or semiconscious level, often after an attempt at vocate on behalf of individuals with disabilities
a conscious, deliberate solution has failed. 3. the to achieve legislative and social change.
maintenance of an artificial environment for independent-living program 1. a system of
a premature or hypoxic infant. —incubate vb. community-based services and support designed
—incubator n. to help individuals with disabilities achieve their
incubation of anxiety the increase in a con- highest level of personal functioning without the
ditioned anxiety response that occurs with re- need to depend on others. Independent-living
296
individualized education program
programs are administered by state vocational by client-centered therapy, in which the

rehabilitation agencies. See also independent therapist does not attempt to direct the client’s
living. 2. a federally funded, state-administered communication or evaluate the client’s remarks,
program to prepare foster care youth who are although he or she may refer back to the client’s
16–21 years old for the transition to independ- remarks or restate them (see restatement).
ence. individual accountability the extent to
independent measures measures that are un- which a particular person can be held responsi-
related to each other. ble for his or her actions and the consequences
independent practice association (IPA) of those actions. In groups, accountability is
an organized form of prepaid medical practice in influenced by anonymity and the extent to
which a group of private physicians join to- which the contributions of each member of the
gether in an association and are reimbursed on a group are clearly identifiable.
fee-for-service basis or a capitation basis. individual differences traits or other charac-
independent self-construal a view of the teristics by which individuals may be distin-
self (self-construal) that emphasizes one’s guished from one another. This is the focus of
unique traits and accomplishments and down- differential psychology, for which the term
plays one’s embeddedness in a network of social individual differences psychology increasingly is
relationships. Compare interdependent self- used.
construal. Individual Family Service Plan (IFSP) a
independent variable (IV) the variable in an plan of services and supports for children up to 3
experiment that is specifically manipulated or is years of age and their families. Under the U.S. re-
I
observed to occur before the occurrence of the quirements for early intervention programs, the
dependent, or outcome, variable. Independent IFSP content must address the child’s develop-
variables may or may not be causally related to mental status and the concerns of parents, de-
the dependent variable. In statistical analysis, fine services to be provided and their desired
an independent variable is likely to be referred to outcomes, and (if appropriate) contain transi-
as a predictor variable. See also treatment. tion steps to preschool services. Also called Indi-
Inderal n. a trade name for propranolol. vidualized Family Service Plan.
index of discrimination an index of the sen- individualism n. 1. a social or cultural tradi-
sitivity of a test or test item to differences be- tion, ideology, or personal outlook that empha-
tween individuals. Also called discrimination sizes the individual and his or her rights,
index. independence, and relationships with other in-
index variable a variable that is not a determi- dividuals. Compare collectivism. 2. in ethical
nant or true causal factor but represents or sym- and political theory, the view that individuals
bolizes the complex process or processes under have intrinsic value. Once granted, this implies
study. that the unique values, desires, and perspectives
of individuals should also be valued in their own
Indian Health Service (IHS) the principal right. Thus, individualism often manifests itself
federal health care provider and health advocate as an approach to life that emphasizes the essen-
for Native Americans, providing services to ap- tial right to be oneself and to seek fulfillment of
proximately 1.5 million American Indians and one’s own needs and desires. —individualist n.
Alaska Natives belonging to more than 557 fed- —individualistic adj.
erally recognized peoples in 35 states. It is an
agency within the U.S. Department of Health individuality n. the uniqueness of each indi-
and Human Services. vidual’s personality.
indicator variable a variable used with the individualized education program (IEP)
general linear model for quantitatively indi- a plan for providing specialized educational ser-
cating the class of a qualitative attribute. vices and procedures that meet the unique needs
of a child with a disability. Each IEP must be doc-
indirect agonist a substance that acts to in-
umented in writing, tailored to a particular
crease the activity of an agonist at a receptor in
child, and implemented in accordance with the
ways other than direct action at the receptor site.
requirements of U.S. federal law. The IEP must be
Indirect agonists may exert their effect by in-
created by a team of individuals that includes,
creasing the metabolism or release of agonist
but is not restricted to, parents, teachers, a repre-
compounds or by displacing other substances
sentative of the school system, and an individual
that impair full binding of an agonist to its re-
who will evaluate the child’s needs and moni-
ceptor site.
tor progress. Additionally, the IEP must contain
indirect associations a symptom of schizo- certain information, such as the child’s current
phrenia in which the association between ideas academic performance, annual achievement ob-
is not apparent and not expressed, such that the jectives for the child, a discussion of the particu-
person’s statements seem bizarre and incoherent lar special education and related services that
to others. See also loosening of associations. will be provided for the child and their duration
indirect method of therapy a method and location, and a means of measuring and in-
of conducting therapy, particularly exemplified forming the parents of the child’s progress.
297
individual psychology
individual psychology 1. the psychological by hypnotic suggestion in highly susceptible in-

theory of Alfred adler, which is based on the dividuals.
idea that throughout life individuals strive for a induced psychotic disorder see shared psy-
sense of mastery, completeness, and belonging chotic disorder.
and are governed by a conscious drive to over-
inductive reasoning the form of reasoning in
come their sense of inferiority by developing to
which inferences and general principles are
their fullest potential, obtaining their life goals,
drawn from specific observations and cases. In-
and creating their own styles of life, as opposed
ductive reasoning is a cornerstone of the scien-
to the view that human beings are dominated
tific method (Baconian method) in that it
by “blind,” irrational instincts operating on an
underlies the process of developing hypotheses
unconscious level. Also called Adlerian psy-
from particular facts and observations. See also
chology. 2. historically, a synonym for differ-
bottom-up analysis; generalization. Com-
ential psychology.
pare deductive reasoning.
individual psychotherapy see individual industrial and organizational psychol-
therapy. ogy (I/O psychology) the branch of psychol-
Individual Service Plan (ISP) the core plan ogy that studies human behavior in the work
of services and supports for a person with a de- environment and applies general psychological
velopmental disability, constructed by profes- principles to work-related issues and problems,
sionals, paraprofessionals, the focal person notably in such areas as personnel selection, per-
(depending on his or her abilities), and others sonnel training, employee evaluation, working
I concerned (e.g., parents and advocates). The ISP conditions, accident prevention, job analysis,
incorporates relevant comprehensive functional job satisfaction, leadership, team effectiveness,
assessment findings, stipulates desired and pre- and work motivation. I/O psychologists conduct
ferred outcomes, and identifies the full range of empirical research aimed at understanding indi-
services and supports to be provided in order to vidual and group behavior within organizations
achieve each outcome. In certain instances ISPs and use their findings to improve organizational
may be drawn up for individuals with psychiat- effectiveness and the welfare of employees. Also
ric conditions, emotional disturbances, or be- called business psychology; employment
havior disorders. psychology; industrial psychology; man-
agement psychology; occupational psy-
individual therapy treatment of psychologi-
chology; organizational psychology; work
cal problems that is conducted on a one-to-one
psychology. See also occupational health
basis. One therapist sees one client at a time, tai-
psychology.
loring the process to his or her unique needs in
the exploration of contributory factors and alle- industrial psychopath an individual in a
viation of symptoms. Also called dyadic ther- work setting who displays a pattern of behavior
apy; individual psychotherapy. Compare regarded as typical of antisocial personality
group therapy. disorder. Such individuals act without regard
for others and use manipulation to effectively
individuation n. 1. in psychology, the physio- manage both supporters and detractors, often
logical, psychological, and sociocultural processes
resulting in career advancement. This type of in-
by which a person attains status as an individual
dividual is most likely to find success in organi-
human being and exerts him- or herself as such
zations undergoing rapid changes.
in the world. 2. in the psychoanalytic theory of
Carl jung, the gradual development of a unified, industriousness n. see persistence.
integrated personality that incorporates greater industry versus inferiority the fourth of
and greater amounts of the unconscious, both erikson’s eight stages of development, oc-
personal and collective, and resolves any con- curring from ages 6 to 11 years, during which the
flicts that exist, such as those between intro- child learns to be productive and to accept evalu-
verted and extraverted tendencies. Also called ation of his or her efforts or becomes discour-
self-realization. 3. a phase of development, aged and feels inferior or incompetent.
occurring between the 18th and 36th months, in ineffability n. 1. the quality of certain kinds of
which infants become less dependent on their feelings or experiences that are difficult to de-
mothers and begin to satisfy their own wishes scribe explicitly. The sense of something being
and fend for themselves. [postulated by Hungar- ineffable is often attributed to spiritual, aes-
ian-born U.S. psychiatrist Margaret Schonberger thetic, or affective states. 2. an irrepressible sense
Mahler (1897–1985)] of well-being that is difficult to convey to others,
indoctrination n. the social inculcation of be- often described by patients experiencing a
liefs, especially by those in positions of power or manic episode. —ineffable adj.
authority. Such beliefs are characterized by their inertia principle see principle of inertia.
inflexibility. —indoctrinate vb.
infancy n. the earliest period of postnatal life, in
indolealkylamines pl. n. see hallucinogen. humans generally denoting the time from birth
induced hallucination a hallucination that is through the first year. —infant n.
evoked in one individual by another, typically infant and preschool tests individually ad-
298
infibulation
ministered tests designed to assess the develop- infantilism n. behavior, physical characteris-
ment of infants (from birth to 18 months) and tics, or mental functioning in older children or
preschool children (from 18 to 60 months). Im- adults that is characteristic of that of infants or
portant tests include the bayley scales of in- young children. See regression.
fant and toddler development and the infantilization n. the encouragement of infan-
wechsler preschool and primary scale of tile or childish behavior in a more mature indi-
intelligence. vidual.
infant at risk an infant whose development infant massage therapy the systematic gen-
may be threatened by complications at the time tle touching, stroking, and kneading of the body
of birth, such as conditions that reduce the sup- of a baby. Therapeutic benefits include helping
ply of oxygen to brain tissue, or by conditions the baby relax and inducing sounder, longer
after birth, such as malnutrition during the first sleep.
months of life.
infarction n. 1. an area of dead tissue resulting
infant consciousness sensory and higher from obstruction of a supplying artery. Infarc-
order awareness as developed early in life, in- tion of brain tissue can have effects ranging from
cluding prenatally. See ontogeny of con- mild to severe, depending on the extent of
scious experience. the dead tissue and its location in the brain (see
infant development program a coordi- cerebral infarction). A myocardial infarction
nated program of stimulatory, social, therapeu- (heart attack) involves death of a segment of the
tic, and treatment services provided to children heart muscle, usually due to obstruction of a cor-
from birth to 3 years of age with identified con- onary artery, and is a common cause of death. 2. I
ditions placing them at risk of developmental a sudden shortfall in the blood supply to a partic-
disability or with evident developmental delays. ular tissue, organ, or part resulting from obstruc-
Younger children are more likely to have syn- tion of a supplying artery, due, for example, to
dromes posing risk of mental retardation or thrombosis or embolism. Also called infarct.
physical and sensory disability, whereas older See stroke.
children are likely to have developmental delays
infecundity n. inability to produce offspring.
identified by the age of 1½ to 2 years. Services
can include assessment, stimulation, parent or inferential statistics a broad class of statisti-
family training, and assistance to families in cal techniques that allows inferences about char-
identifying and accessing appropriate commu- acteristics of a population to be drawn from a
nity services. Also called early intervention sample of data from that population while con-
program. trolling (at least partially) the extent to which er-
rors of inference may be made. These techniques
infantile amnesia see childhood amnesia.
include approaches for testing hypotheses and
infantile autism see autistic disorder. estimating the value of parameters.
infantile osteopetrosis a rare hereditary dis- inferior function in the analytic psychol-
order in which the bones, including the skull ogy of Carl jung, one of the three nondom-
bones, are abnormally dense and brittle. It is inant, unconscious functions of the personality
sometimes accompanied by retinal degeneration that are dominated by the superior function
and cranial-nerve palsy. Mental retardation has in a particular functional type.
been reported in more than 20% of affected chil-
dren, with sensory deprivation a possible con- inferiority n. in erikson’s eight stages of de-
tributing factor. velopment, see industry versus inferiority.
infantile sexuality in psychoanalytic theory, inferiority complex a basic feeling of inade-
the concept that psychic energy or libido con- quacy and insecurity, deriving from actual or
centrated in various organs of the body through- imagined physical or psychological deficiency,
out infancy gives rise to erotic pleasure. This that may result in behavioral expression ranging
is manifested in sucking the mother’s breast from the “withdrawal” of immobilizing timidity
during the oral stage of development, in de- to the overcompensation of excessive competi-
fecating during the anal stage, and in self- tion and aggression. See also superiority com-
stimulating activities during the early genital plex.
stage. The term and concept, first enunciated infertility n. inability to produce offspring due
by Sigmund freud, proved highly controversial to a low fertility level in the male partner (about
from the start, and it is more in line with subse- 40% of cases), the female partner (about 60% of
quent thought to emphasize the sensual nature cases), or both. Infertility is caused by physical
of breast-feeding, defecation, and discovery of problems: No evidence clearly shows a psycho-
the body in childhood and the role of the plea- logical cause, although maternal stress has been
surable feelings so obtained in the origin and de- suggested as a factor. Many patients can be
velopment of sexual feelings. treated successfully. See also artificial insemi-
infantile speech speech or verbalizations using nation; in vitro fertilization. —infertile
the sounds and forms characteristic of infants or adj.
very young children beyond the stage when infibulation n. the removal of the entire clitoris
such speech is normal. and most of the labia and sewing together of the
299
influencing machine
remaining tissue, leaving a small opening for being associated with damage to the kidneys,
menstruation and urination. It is practiced in liver, and both central and peripheral nervous
some cultures as the most severe form of female systems. Organic nitrites are less toxic but may
genital mutilation, usually being done in cause arrhythmias in individuals with heart
early childhood or in the prepubertal years. conditions. See also inhalation of drugs.
influencing machine the subject of a delu- inhalant abuse in DSM–IV–TR, a pattern of in-
sion of persecution in which the individual halant use manifested by recurrent significant
feels controlled by a machine that serves as the adverse consequences related to the repeated
instrument of persecution. ingestion of these substances. This diagnosis is
information feedback responses that inform preempted by the diagnosis of inhalant de-
an individual about the correctness, physical ef- pendence: If the criteria for inhalant abuse and
fect, or social or emotional impact of his or her inhalant dependence are both met, only the lat-
behavior or thinking. The concept is similar to ter diagnosis is given. See also substance abuse;
the principle behind “knowledge of results,” substance dependence.
namely, that immediate feedback is beneficial to inhalant dependence in DSM–IV–TR, a clus-
learning. In interpersonal relations and psycho- ter of cognitive, behavioral, and physiological
therapy, information feedback gives an individ- symptoms indicating continued use of inhalants
ual insight into other people’s experience of him despite significant inhalant-related problems.
or her. In behavior therapy, information feed- There is a pattern of repeated inhalant ingestion
back is intended to help change and shape be- resulting in tolerance, withdrawal symptoms if
I havior directly. use is suspended, and an uncontrollable drive to
information overload the state that occurs continue use. See inhalant abuse. See also sub-
when the amount or intensity of environmental stance abuse; substance dependence.
stimuli exceeds the individual’s processing ca- inhalant intoxication a reversible syndrome
pacity, thus leading to an unconscious or sub- resulting from the recent ingestion of inhalants.
liminal disregard for some environmental It includes clinically significant behavioral or
information. psychological changes (e.g., confusion, belliger-
information processing (IP) 1. the manipu- ence, assaultiveness, apathy, impaired judg-
lation of data by computers to accomplish some ment, and impaired social or occupational
goal, such as problem solving or communica- functioning), as well as one or more signs of
tion. 2. in cognitive psychology, the flow of in- physiological involvement (e.g., dizziness, visual
formation through the human nervous system, disturbances, involuntary eye movements, in-
involving the operation of perceptual systems, coordination, slurred speech, unsteady gait,
memory stores, decision processes, and response tremor). At higher doses, lethargy, psycho-
mechanisms. Information processing psychol- motor retardation, generalized muscle weak-
ogy is the approach that concentrates on under- ness, depressed reflexes, stupor, or coma may
standing these operations. develop. See also substance intoxication.
informed consent voluntary agreement to inhalation of drugs a means of administering
participate in a research or therapeutic proce- a drug—in the form of a gas or aerosol—via the
dure on the basis of the participant’s or patient’s mouth or the nose (insufflation), enabling it to
understanding of its nature, its potential benefits reach the body tissues rapidly. Anesthetics for
and possible risks, and available alternatives. major surgery are administered by inhalation,
Supported by court decisions, the principle of in- which permits almost instant contact with the
formed consent has provided a foundation for blood supplying the alveoli (air sacs) of the
do not resuscitate (DNR) orders, advance di- lungs. Inhalation (oral or nasal) is also a means
rectives, and the natural-death acts that have of self-administration of abused substances, in-
been passed into law throughout the United cluding cannabis, nicotine, cocaine, and volatile
States. hydrocarbons (see inhalant). Oral inhalation is
used for nicotine (smoking) and amyl or butyl
ingenuity n. cleverness at solving routine prob-
nitrite, and the nasal route (“snorting”) for co-
lems of daily life (at work, home, etc.): everyday
caine, heroin, amphetamines, and other street
creativity. —ingenious adj.
drugs.
INH abbreviation for isonicotinic acid hydrazide.
inhibited female orgasm in DSM–III, the
See isoniazid.
dysfunction now called female orgasmic dis-
inhalant n. any of a variety of volatile substances order.
that can be inhaled to produce intoxicating ef-
inhibited male orgasm in DSM–III, the dys-
fects. Anesthetic gases (e.g., ether, chloroform,
function now called male orgasmic disorder.
nitrous oxide), industrial solvents (e.g., tolu-
ene, gasoline, trichloroethylene, various aerosol inhibitedness n. the tendency to constrain
propellants), and organic nitrites (e.g., amyl ni- one’s actions and emotional experiences, partic-
trite) are common inhalants. Anesthetic gases ularly in social settings, or to withdraw entirely
may cause asphyxiation, and chloroform has from social interactions in such settings. —in-
been associated with damage to the liver and hibited adj.
kidneys. Industrial solvents are generally toxic, inhibited sexual desire in DSM–III, the dys-
300
inositol
function now called hypoactive sexual desire distinguished from those that develop later in
disorder. infancy and childhood under maturational con-
inhibited sexual excitement in DSM–III, a trol. Also called inborn; native; natural.
psychosexual disorder characterized by recur- innate behavior behavior that appears to be
rent and persistent inhibition of sexual excite- developed and expressed with no specific train-
ment during sexual activity that is judged to be ing or experience and thus has a strong genetic
adequate in focus, intensity, and duration. In basis. It is generally accepted that most behav-
DSM–IV–TR this general diagnosis was replaced ior is neither purely innate nor purely due to
by female sexual arousal disorder and male learning or experience. See epigenesis; nature–
erectile disorder. nurture.
inhibition n. 1. the process of restraining one’s inner audience the imaginary hearer of silent,
impulses or behavior, either consciously or un- spontaneous inner speech, often associated in
consciously, due to such factors as lack of confi- psychoanalytic and psychodynamic theory with
dence, fear of consequences, or moral qualms. 2. parental figures.
in psychoanalysis, an unconscious mechanism inner boundary see internal boundary.
in which the superego controls instinctive im-
inner conflict see intrapsychic conflict.
pulses that would threaten the ego if allowed
conscious expression. For example, inhibited inner dialogue a mental debate that an indi-
sexual desire may result from unconscious feel- vidual may engage in about any issue. In some
ings of guilt implanted by parents. See also re- systems of psychotherapy, clients are encour-
ciprocal inhibition. 3. in conditioning, the aged to express the inner dialogue aloud in I
active blocking or delay of a response to a stimu- words during sessions.
lus. —inhibit vb. —inhibited adj. inner-directed adj. describing or relating to an
inhibitor n. a mechanism or stimulus that slows individual who is self-motivated and not easily
or suppresses an activity, process, or behavior. influenced by the opinions, values, or pressures
of other people. Compare other-directed;
inhibitory process any phenomenon in tradition-directed. [introduced by U.S. soci-
human or animal behavior that prevents or
ologist David Riesman (1909–2002)]
blocks actions that are problematic for the indi-
vidual. See excitatory–inhibitory processes. inner estrangement the feeling that external
objects are unfamiliar and unreal. [defined by
initial insomnia difficulty in falling asleep, Austrian psychoanalyst Paul Federn (1871–
usually due to tension, anxiety, or depression. 1950)]
Some people with insomnia due to anxiety be-
come so worried about being unable to fall inner language 1. the visual, auditory, and
asleep or about the effects of loss of sleep that kinesthetic mental imagery of words and con-
they cannot relax sufficiently to induce sleep. cepts. 2. speech spoken to oneself without vocal-
Initial insomnia may be a symptom of a major ization. According to Lev vygotsky, inner lang-
depressive episode. Compare middle insom- uage follows egocentric speech and represents
nia; terminal insomnia. the child’s recruitment of language in his or her
reasoning efforts. Also called inner speech. See
initial interview in psychotherapy, the first also internalized speech; verbal thought.
interview with a client, which has some or all of
the following goals: to establish a positive rela- innovative therapies loosely, psychological
tionship; to listen to the client’s problem de- treatments that are new and different from tra-
scribed in his or her own words; to make a ditional therapies. Relatively current examples
tentative diagnosis; and to formulate a plan for include the empty-chair technique and para-
diagnostic tests, possible treatment, or referral. doxical techniques.
initiative versus guilt the third of erikson’s Inocybe n. a genus of mushrooms, some species
eight stages of development, which occurs of which are poisonous because they contain the
during the child’s 3rd through 5th years. In plan- toxic alkaloid muscarine. Symptoms of poison-
ning, launching, and initiating all forms of fan- ing include salivation, perspiration, and lacrima-
tasy, play, and other activity, the child learns to tion (tears); at higher doses these symptoms may
believe in his or her ability to successfully pursue be followed by abdominal pains, severe nausea
goals. However, should these pursuits often fail and vomiting, diarrhea, visual disturbances, la-
or be criticized, the child may develop instead a bored breathing, and bradycardia (slowed heart
feeling of self-doubt and guilt. rate), which may potentially result in death from
cardiac or respiratory failure. Treatment is with
injection n. see administration; intramuscu- atropine.
lar injection; intravenous injection; sub-
cutaneous injection. inositol n. a compound (similar to glucose) that
occurs in many foods and is sometimes classed
inkblot test see rorschach inkblot test. as a vitamin. It is a component of cell-membrane
innate adj. denoting a capability or characteristic phospholipids and plasma lipoproteins, and
existing in an organism from birth, that is, be- phosphorylated derivatives (see inositol phos-
longing to the original or essential constitution phates) function as second messengers in
of the body or mind. Innate processes should be cells.
301
inositol phosphates
inositol phosphates derivatives of inositol defense, have been used at various times in
that contain one or more phosphate groups, many jurisdictions. These include the durham
some of which are second messengers in cells, rule, the american law institute model penal
serving to relay signals from receptors at the cell code insanity test, and the mcnaughten rule.
surface to other parts of the cell. The most stud- See also partial insanity. —insane adj.
ied of these second messengers is inositol 1,4,5- insanity defense in criminal law, the defense
trisphosphate (IP3 ). The action of lithium salts, plea that an individual lacks criminal respon-
used to treat bipolar disorders, may be linked to sibility for his or her conduct. See also amer-
their inhibition of the enzyme inositol mono- ican law institute model penal code
phosphatase, which is involved in the recycling insanity test; diminished responsibility;
of inositol from the inositol phosphates. It has durham rule; mcnaughten rule.
been hypothesized that this inhibition thus
Insanity Defense Reform Act (IDRA) legis-
leads to a deficiency of inositol and a corre-
lation passed by the U.S. Congress in 1984 that
sponding excess of inositol phosphates.
modified existing laws relating to insanity de-
inpatient n. a person who has been formally ad- fense cases. One modification involved remov-
mitted to a hospital for a period of at least 24 ing the volitional component of the american
hours for observation, care, diagnosis, or treat- law institute model penal code insanity
ment, as distinguished from an outpatient or test, so that “conforming one’s conduct to the
an emergency-room patient. requirements of the law” was no longer a factor
Inpatient Multidimensional Psychiatric in judging insanity. Another modification in-
I Scale (IMPS) an interview-based rating instru- volved shifting the burden of proof (responsibil-
ment used to assess attitudes and behaviors of ity for convincing the court beyond a reasonable
individuals with psychoses, typically adminis- doubt of the truth of an allegation) in insanity
tered on admission to mental institutions. It defense cases from the prosecution to the de-
yields information on symptom severity and is fense.
used to classify patients into psychotic types, insect phobia see acarophobia; animal pho-
such as hostile–paranoid, excited–hostile, ex- bia; specific phobia.
cited–grandiose, and so forth. The scale was orig- insecure attachment in the strange situa-
inally published in 1962 as a revision of the 1953 tion, one of several patterns of generally nega-
Multidimensional Scale for Rating Psychiatric tive parent–child relationship in which the child
Patients. [developed by U.S. psychometrician fails to display confidence when the parent is
Maurice Lorr (1910–1998) and U.S. psychologists present, sometimes shows distress when the par-
C. James Klett (1926– ), Douglas M. McNair ent leaves, and reacts to the returning parent by
(1927–2008), and Julian J. Lasky (1918–2012)] avoidance (see avoidant attachment) or with
inpatient services diagnostic and treatment ambivalence (see ambivalent attachment).
services available to hospitalized patients and See also anxious–avoidant attachment;
usually unavailable or only partially available in anxious–resistant attachment; disorga-
outpatient facilities. Examples are continuous nized attachment.
supervision; medical treatment and nursing insecurity n. a feeling of inadequacy, lack of
care; and specialized treatment techniques, such self-confidence, and inability to cope, accompa-
as rehabilitational, occupational, movement, or nied by general uncertainty and anxiety about
recreation therapy, as well as social work ser- one’s goals, abilities, or relationships with oth-
vices. ers. —insecure adj.
input–output mechanism a simple model of insensible adj. 1. denoting or relating to a state
information processing in which a given input of nonresponsiveness and unconsciousness. 2.
automatically produces a given output. An input– lacking emotional response. —insensibility n.
output mechanism is a closed system in which insight n. 1. the clear and often sudden discern-
information is subjected to a fixed sequence of ment of a solution to a problem by means that
preset operations and there is no interaction are not obvious and may never become so, even
with the environment during throughput. Some after one has tried hard to work out how one
behaviorist theories have been criticized as re- has arrived at the solution. There are many dif-
ducing the human organism to an input–output ferent theories of how insights are formed and of
mechanism. the kinds of insights that exist. For example, in
insanity n. in law, a condition of the mind that the 1990s, U.S. psychologists Robert Sternberg
renders a person incapable of being responsible (1949– ) and Janet Davidson proposed a theory
for his or her criminal acts. Defendants who are in which there are three main kinds of insights:
found to be not guilty by reason of insanity (a) selective encoding insights, which are used to
therefore lack criminal responsibility for distinguish relevant from irrelevant informa-
their conduct. Whether a person is insane, in tion; (b) selective comparison insights, which
this legal sense, is determined by judges and ju- are used to distinguish what information already
ries, not psychologists or psychiatrists. Numer- stored in long-term memory is relevant for one’s
ous legal standards for determining criminal purposes; and (c) selective combination insights,
responsibility, the central issue in an insanity which are used to put together the information
302
institution
available so as to formulate a solution to a given instinct n. 1. an innate, species-specific biologi-

problem. 2. in psychotherapy, an awareness of cal force that impels an organism to do some-
underlying sources of emotional, cognitive, or thing, particularly to perform a certain act or
behavioral difficulty in oneself or another per- respond in a certain manner to specific stimuli.
son. See also aha experience; epiphany. See also hormic psychology. 2. in psychoana-
insight learning a cognitive form of learning lytic theory, a basic biological drive (e.g., hun-
involving the mental rearrangement or restruc- ger, thirst, sex, aggression) that must be fulfilled
turing of the elements in a problem to achieve a in order to maintain physical and psychological
sudden understanding of the problem and arrive equilibrium. Sigmund freud classified instincts
at a solution. Insightful learning was described into two types: those derived from the life
by Wolfgang köhler in the 1920s, based on his instinct and those derived from the death in-
observations of apes stacking boxes or using stinct. See also component instinct; destru-
sticks to retrieve food, and was offered as an al- do; erotic instinct; libido; satisfaction of
ternative to trial-and-error learning. instincts; sexual instinct. 3. in popular
usage, any inherent or unlearned predisposition
insight therapy any form of psychotherapy (behavioral or otherwise) or motivational force.
based on the theory that a client’s problems can- —instinctive or instinctual adj.
not be resolved without his or her gaining self-
understanding and thus becoming aware of their instinctive behavior stereotyped, unlearned,
origins. This approach (characteristic, for exam- largely stimulus-bound adaptive behavior lim-
ple, of psychoanalysis and psychodynamic ited in its expression by the inherent properties
psychotherapy) contrasts with therapies di- of the nervous system and genetic factors. It is I
rected toward removal of symptoms or behavior species-specific and involves complex activity
modification. patterns rather than simple reflexes.
insomnia n. difficulty in initiating or maintain- instinctive drift the tendency of learned, rein-
ing a restorative sleep that results in fatigue, forced behavior to gradually return to a more in-
the severity or persistence of which causes clini- nate behavior. For example, racoons trained to
cally significant distress or impairment in func- drop coins into a container will eventually begin
tioning. Such sleeplessness may be caused by to dip the coins into the container, pull them
a transient or chronic physical condition or back out, rub them together, and dip them in
psychological disturbance. Also called agryp- again. The learned behavior of dropping coins
nia; ahypnia; ahypnosia; anhypnia. See becomes more representative of the innate be-
disorders of initiating and maintaining havior of food washing. Also called instinctual
sleep; initial insomnia; intermittent insom- drift. [proposed in 1961 by U.S. psychologists
nia; middle insomnia; primary insomnia; Keller Breland (1915–1965) and Marian Breland
pseudoinsomnia; terminal insomnia. —in- (1920–2001)]
somniac n. instinctive knowledge unlearned and gener-
ally unalterable behavior, observable when a
inspectionalism n. see voyeurism.
new stimulus (i.e., one not previously encoun-
inspiration n. 1. in cognitive psychology, a sud- tered) elicits an affective response indicative of
den insight or leap in understanding that pro- genetic influences. An example is fear of and
duces new, creative ideas or approaches to a flight from certain predators in the absence of
problem. See aha experience; discontinuity previous exposure to these animals.
hypothesis. See also creative imagination;
instinctual aim see aim of the instinct.
creative thinking; divergent production.
2. the process of being aroused or stimulated to instinctual drive see instinct.
do something, or the quality of being so aroused, instinctual fusion see fusion.
as in Her speech gave us the inspiration we needed.
instinctual impulse see instinct. See also im-
—inspirational adj. —inspire vb. —inspired
pulse.
adj.
instinctualization of smell 1. the capacity
instability n. in psychology, a tendency toward of smell to play a part in coprophilia or anal
lack of self-control, erratic behavior, and rapidly fixations. 2. the role of body odors as arousal fac-
changing or excessive emotions. Also called tors in sexual foreplay. See also component in-
lability. —unstable adj. stinct.
instant gratification the meeting or satisfy- institution n. 1. an established practice, tradi-
ing of one’s needs or wishes without delay. Ther- tion, behavior, or system of roles and relation-
apy may be important to help reduce the desire ships, such as marriage, that is considered
for instant gratification when postponing needs normative within a society. Sociologists usually
and tolerating delays would be realistic or in the distinguish between four main types of insti-
best interests of the client. tution: political institutions (e.g., monarchy),
instigation therapy behavior therapy in economic institutions (e.g., capitalism), cultural
which the therapist provides a positive model institutions (e.g., religion and accepted forms of
and reinforces the client’s progress toward self- artistic expression), and kinship institutions (e.g.,
regulation and self-evaluation. the extended family). 2. a building or building
303
institutional care
complex in which individuals are cared for or that have brought the client into therapy or
confined for extended periods of time, especially counseling and preliminary information regard-
a psychiatric hospital or a prison. —institu- ing personal and family history. 2. the initial in-
tional adj. terview with a patient who is being admitted
institutional care medical or mental health into a psychiatric hospital, day treatment, or in-
care services received by an inpatient in a hospi- patient substance abuse facility. Intake inter-
tal, nursing home, or other residential institu- views are also common in government-funded
tion. mental health services, such as those provided at
community mental health centers, in determin-
institutionalism n. see social breakdown
ing eligibility and appropriateness of the client
syndrome.
for services offered. An intake interview may be
institutionalization n. 1. placement of an in- carried out by a specialist who may not necessar-
dividual in an institution for therapeutic or cor- ily treat the patient, but the information ob-
rectional purposes. 2. an individual’s gradual tained is used to determine the best course of
adaptation to institutional life over a long pe- treatment and the appropriate therapist to pro-
riod, especially when this is seen as rendering vide it.
him or her passive, dependent, and generally un-
suited to life outside the institution. —institu- integrated care a consistent, systematic, and
tionalize vb. coordinated set of health care services that are
developed, managed, and delivered to individ-
institutional neurosis see social break- ual patients over a range of organizations and by
down syndrome.
I a variety of associated professionals and other
institutional review board (IRB) a commit- care providers. The approach seeks to reduce
tee named by an agency or institution to review fragmented care (i.e., diagnosis and treatment by
research proposals originating within that multiple unconnected and minimally commu-
agency for ethical acceptability. nicating doctors and caregivers); to improve
instructional treatments educational inter- clinical outcomes, quality of life, patient satisfac-
ventions that have been designed, imple- tion, effectiveness and efficiency (ideally using
mented, and evaluated by an instructor to evidence-based practice guidelines); and to
increase learning or various kinds of perfor- reduce costs. The complexities underlying devel-
mance. opment of such approaches include establishing
instrumental activities of daily living a common philosophy of assessment and treat-
(IADLs) activities essential to an individual’s ment, developing partnership relationships,
ability to function autonomously, including linking and planning information systems, co-
cooking, doing laundry, using the telephone, ordinating patient flow among providers, and so
managing money, shopping, getting to places forth. The efficacy of integrated care is often
beyond walking distance, and the like. See also viewed and measured from two perspectives:
activities of daily living. that of the patient and that of the organizations
and individual service providers. Although pri-
instrumental behavior behavior that is
marily associated with medicine proper, services
learned and elicited via positive or negative rein-
may include mental health components (e.g.,
forcement of target (rather than instinctive) re-
psychosocial assessment and treatment). Also
sponses. The term is used synonymously with
called integrated medicine. See also inte-
operant behavior, usually for describing be-
grated delivery system.
havior during conditioning procedures that
involves long sequences of activity, such as solv- integrated delivery system (IDS) a health
ing a puzzle box. care provider organization that is completely in-
instrumental conditioning any form of tegrated operationally and clinically and that of-
conditioning in which the correct response is fers a full range of health care services, including
essential for reinforcement. Instrumental con- physician, hospital, and adjunct services. IDSs
ditioning is similar to operant conditioning began to develop in the early 1980s and multi-
and usually involves complex activities in order plied rapidly in the 1990s. They come in varying
to reach a goal, such as when a rat is trained to formats, one of the more typical being an alli-
navigate a maze to obtain food. It contrasts with ance between hospitals and individual physi-
pavlovian conditioning, in which reinforce- cians or group medical practices. An IDS is a
ment is given regardless of the response. Also managed care organization.
called instrumental learning; Type II con- integrated model in evaluation research, an
ditioning; Type R conditioning. administrative relationship, used in formative
instrumental dependence the tendency to evaluation, between the program director and
rely on others for accomplishing tasks. multiple production units, each made up of writ-
ers, designers, and evaluators who are all in-
insulin-coma therapy see coma therapy.
volved in program development as well as
insulin-shock therapy see coma therapy. program evaluation. Members of these units do
intake interview 1. the initial interview with a not necessarily share equal importance or equal
client by a therapist or counselor to obtain both access to the program director. Also called de-
information regarding the issues or problems pendent model. Compare segregated model.
304
intensive care syndrome
integrated personality a personality in lived and may develop either integrity—a sense
which the constituent traits, behavioral pat- of satisfaction in having lived a good life and the
terns, motives, and so forth are used effectively ability to approach death with equanimity—or
and with minimal effort or without conflict. despair—a feeling of bitterness about opportuni-
Those with integrated personalities are thought ties missed and time wasted, and a dread of ap-
essentially to know themselves and to be able to proaching death. Also called ego integrity
enjoy and live life fully. Also called well- versus despair.
integrated personality. intellect n. 1. the intellectual functions of
integrated therapy see integrative psycho- the mind considered collectively. 2. an individ-
therapy. ual’s capacity for abstract, objective reasoning,
integration n. the coordination or unification especially as contrasted with his or her capacity
of parts into a totality. This general meaning has for feeling, imagining, or acting. —intellectual
been incorporated into a wide variety of psycho- adj.
logical contexts and topics. For example, the in- intellectual detachment see detachment.
tegration of personality denotes the gradual intellectual disability increasingly the pre-
bringing together of constituent traits, behav- ferred term for mental retardation.
ioral patterns, motives, and so forth to form an
organized whole that functions effectively and intellectual function any of the mental func-
with minimal effort or without conflict. tions involved in acquiring, developing, and re-
lating ideas, concepts, and hypotheses. Memory,
integrative behavioral couples therapy imagination, and judgment can also be consid-
couples therapy that uses techniques of behav- I
ered intellectual functions. Also called intellec-
ioral couples therapy but also focuses on
tual operation. See higher mental process.
each person’s emotional acceptance of his or her
partner’s genuine incompatibilities, which may intellectual impoverishment diminished
or may not be amenable to change. It is based on intellectual capacity, such as problem-solving
the conviction that focusing on changing inability and concentration. This condition is ob-
compatibilities leads to a resistance to change served in many people with chronic schizophre-
when change is possible or that this focus results nia, senility, or depression and in individuals
in unnecessary frustration for both partners living in a deprived, unstimulating environ-
when change is not possible. ment. See also poverty of ideas.
integrative medicine the combination of intellectual insight in psychotherapy, an ob-
conventional medical treatments and comple- jective, rational awareness of experiences or rela-
mentary therapies that have demonstrated sci- tionships. Some theorists posit that intellectual
entific merit with regard to safety and efficacy. insight by itself does not advance the therapeu-
See also complementary and alternative tic process and may even impede it because little
medicine. or no feeling (i.e., emotional content) is in-
volved.
integrative psychotherapy psychotherapy
that selects models or techniques from various intellectual subaverage functioning an
therapeutic schools to suit the client’s particular IQ more than two standard deviations below the
problems. For example, psychodynamic psy- mean obtained on an intelligence test. Also
chotherapy and gestalt therapy may be called significantly subaverage intellec-
combined through the practice of interpreta- tual functioning.
tion of material in the here and now. The So- intelligence quotient see iq.
ciety for the Exploration of Psychotherapy
intelligence test an individually administered,
Integration (SEPI), founded in 1983, reflects the
standardized test used to determine a person’s
growing interest in, and the rapid development
level of intelligence by measuring his or her abil-
and use of, such combined therapeutic tech-
ity to solve problems, form concepts, reason, ac-
niques. Also called integrated therapy; psy-
quire detail, and perform other intellectual tasks.
chotherapy integration. See also eclectic
It comprises mental, verbal, and performance
psychotherapy.
tasks of graded difficulty that have been stan-
integrity n. the quality of moral consistency, dardized by use on a representative sample of the
honesty, and truthfulness with oneself and oth- population. Examples of intelligence tests in-
ers. clude the stanford–binet intelligence scale
integrity group psychotherapy a type of and the wechsler adult intelligence scale.
group therapy in which openness and honesty Also called intelligence scale. See iq.
are expected from all participants, and experi- intensive care syndrome a type of psychotic
enced members of the group serve as models of condition observed in some individuals in inten-
sincerity and involvement. [developed by U.S. sive care who are immobilized in an isolated, un-
psychologist O. Hobart Mowrer (1907–1982)] familiar environment that may have the effect of
integrity versus despair the eighth and final sensory deprivation. Variable factors may in-
stage of erikson’s eight stages of develop- clude the mental and physical condition of the
ment, which occurs during old age. In this stage individual prior to the need for intensive care,
the individual reflects on the life he or she has the age of the individual, medical or surgical
305
intensive care unit
complications, and behavioral effects of drugs ables changes as their values change. Interaction
administered. effects contrast with—and may obscure—main
intensive care unit (ICU) a hospital unit in effects. Compare additive effect.
which critically ill patients receive intensive and interactionism n. 1. the position that mind
continuous nursing, medical care, and supervi- and body are distinct, incompatible substances
sion that includes the use of sophisticated moni- that nevertheless interact, so that each has a
toring and resuscitative equipment. ICUs are causal influence on the other. This position is
often organized for the care of specific groups of particularly associated with French philosopher
patients, such as neonatal ICUs or pulmonary René Descartes (1596–1650). See cartesian du-
ICUs. Also called critical care unit (CCU). alism; mind–body problem. 2. a set of ap-
Compare continuing care unit. proaches, particularly in personality psychology,
intensive psychotherapy broad, thorough, in which behavior is explained not in terms of
and prolonged psychological treatment of an in- personality attributes or situational influences
dividual’s concerns and problems. The qualifier but by references to interactions that typify the
“intensive” indicates both the nature of the dis- behavior of a certain type of person in a certain
cussions, which typically involve extensive ex- type of setting. —interactionist adj.
amination of the individual’s life history and interaction-process analysis (IPA) a tech-
conflicts, and the duration of the therapy. Com- nique used to study the emotional, intellectual,
pare brief psychotherapy; counseling. and behavioral interactions among members of
intent analysis analysis of social interaction in a group, for example, during group therapy. It
I which verbal content is classified according to requires observers to classify every behavior dis-
intent (providing support, seeking approval, etc.). played by a member of a group into one of 12
mutually exclusive categories, such as “asks for
intentional accident see purposive acci- information” or “shows tension.” [developed by
dent. U.S. social psychologist Robert Freed Bales
intentional forgetting inaccessibility of a (1916–2004)]
memory that is due to repression or to an un-
interactive group psychotherapy see in-
conscious wish to forget. See also forgetting.
terpersonal group psychotherapy.
intentionality n. a characteristic of an individ-
intercourse n. see coitus.
ual’s acts that requires the individual (a) to have
goals, desires, and standards; (b) to select behav- interdependence n. 1. dependence of two or
iors that are in the service of attaining the goal more people, things, situations, or other entities
(e.g., means to an end); and (c) to call into con- on each other. 2. a state in which factors rely on
scious awareness a desired future state. Investiga- or react with one another such that one cannot
tors differ as to whether (a) alone, (a) and (b) but change without affecting the other. Also called
not (c), or (a), (b), and (c) are required for in- interdependency. —interdependent adj., n.
tentionality to be attributable to an individual. interdependent self-construal a view of the
The concept of intentionality, as developed by self (self-construal) that emphasizes one’s
German philosopher and psychologist Franz embeddedness in a network of social rela-
Brentano (1838–1917), has been very influential tionships and downplays one’s unique traits or
in act psychology, phenomenology, and re- accomplishments. Compare independent self-
lated approaches in hermeneutics. construal.
intention movement a physical behavior that interdisciplinary approach a manner of
precipitates another physical response, such that dealing with psychological, medical, or other
the first behavior may signal the second. For ex- scientific questions in which individuals from
ample, when two people are talking, one may ex- different disciplines or professions collaborate to
hibit certain postural behaviors (e.g., changing obtain a more thorough, detailed understanding
stance, shifting weight) predictive of terminat- of the nature of the questions and consequently
ing the interaction, before actually ending the develop more comprehensive answers. For ex-
conversation and walking away. ample, an interdisciplinary approach to the
interactional model of anxiety a model of treatment or rehabilitation of an individual who
anxiety proposing that state anxiety is deter- is ill, disabled, or experiencing distress or pain
mined by the interaction of factors relating to uses the talents and experiences of therapists
the situation (situational factors) and factors re- from a number of appropriate medical and psy-
lating to the individual (person factors). chological specialties. Also called multidisci-
interaction effect the joint effect of two or plinary approach.
more independent variables on a dependent interdisciplinary team a health care team
variable above and beyond the sum of their indi- that consists of professionals from different ther-
vidual effects: The independent variables com- apeutic disciplines, paraprofessionals, a focal
bine to have a different (and multiplicative) person, and concerned family members. Teams
effect, such that the value of one is contingent establish treatment priorities and goals and plan
upon the value of another. This indicates that and provide treatment. Effective teams increase
the relationship between the independent vari- treatment benefits by conducting comprehen-
306
internal working model of attachment
sive assessment, sharing information, and that one can take action to deal with any
adopting complementary treatment approaches. problems, threats, or challenges. Higher internal
interfemoral sex see coitus. control is thought to be associated with better
mental health. See internalizers; locus of
intergluteal sex coitus in which the penis is
control. Compare external control.
placed between the cheeks of the buttocks, with-
out entry into the vagina or anus. internal frustration in psychoanalytic the-
ory, denial of gratification of instinctual im-
interjudge reliability see interrater reli-
pulses due to internal factors (e.g., the
ability.
superego), as opposed to external factors.
interlocking pathologies unconscious and
dysfunctional ways of acting that are present in a internalization n. 1. the unconscious mental
couple or other intimate dyad or in a family or process by which the characteristics, beliefs, feel-
other close social unit. ings, or attitudes of other individuals or groups
are assimilated into the self and adopted as one’s
intermarriage n. 1. marriage between two in- own. 2. in psychoanalytic theory, the process of
dividuals belonging to different racial, ethnic, or incorporating an object relationship inside the
religious groups. 2. marriage between two closely psyche, which reproduces the external relation-
related individuals, as in a consanguineous mar- ship as an intrapsychic phenomenon. For exam-
riage. —intermarry vb. ple, through internalization the relationship
intermediate care facility (ICF) a facility between father and child is reproduced in the re-
providing an appropriate level of nursing and lationship between superego and ego. Inter-
other medical care to individuals who do not re- nalization is often mistakenly used as a synonym I
quire the degree of care and treatment provided for introjection. —internalize vb.
by a hospital or skilled nursing facility but internalized speech silent speech in which
need more than room and board. one argues with oneself over a course of action,
intermediate need in maslow’s motiva- rehearses what one is going to do, or reassures
tional hierarchy, a deficiency need that is oneself when feeling threatened. See also inner
psychologically based, such as the need for self- language; self-talk.
esteem, love, or security.
internalizers pl. n. people who assume that the
intermetamorphosis syndrome a misiden- locus of control over their lives is within
tification syndrome characterized by delu- themselves (i.e., under their own control) and
sions that particular people have been who characteristically try harder to change
transformed both physically and psychologi- themselves and their environment. This in-
cally into other people. volves being more perceptive, gathering more
intermission n. an asymptomatic period, for information and remembering it better, and
example, between manic episodes, major de- using more facts and care in making decisions
pressive episodes, or both. about how to cope. Internalizers may be less
intermittent explosive disorder an im- likely to follow orders blindly; they are more
pulse-control disorder consisting of multiple epi- likely to realize there are choices to be made
sodes in which the individual fails to resist and to rely on their own judgment. Compare ex-
aggressive impulses and commits assaultive acts ternalizers.
or destroys property. These aggressive acts are internalizing behavior see externalizing–
significantly out of proportion to any precipitat- internalizing.
ing factors, are not caused by any other mental internal locus of control see locus of con-
disorder or a general medical condition, and trol.
are not substance-induced. In DSM–IV–TR this
disorder is included in the category impulse- internal object an image or representation of a
conrol disorders not elsewhere classified. person (particularly someone significant to the
Compare isolated explosive disorder. individual, such as a parent) that is experienced
as an internalized “presence” within the mind.
intermittent insomnia periods of insomnia In her development of object relations the-
occurring several times a night. ory, Melanie Klein saw the psyche as being
internal attribution see dispositional at- made up of internal objects whose relations to
tribution. each other and to the individual determine his
internal boundary in psychoanalytic theory, or her personality and symptoms. See also part-
the boundary between ego and id. Also called object.
inner boundary. Compare external bound- internal saboteur see antilibidinal ego.
ary.
internal validity the degree to which a study
internal conflict see intrapsychic conflict. or experiment is free from flaws in its internal
internal consistency the degree to which all structure and its results can therefore be taken to
the items on a test measure the same thing. See represent the true nature of the phenomenon.
interrater reliability. internal working model of attachment a
internal control the belief that one is responsi- cognitive construction or set of assumptions
ble for the consequences of one’s behavior and about the workings of relationships, such as ex-
307
International Association of Applied Psychology
pectations of support or affection. The earliest interneuron n. any neuron that is neither sen-
relationships may form the template for this in- sory nor motor but connects other neurons
ternal model, which may be positive or negative. within the central nervous system. Also called
See also attachment theory. [originally pro- connector; connector neuron; inter-
posed by John bowlby] nuncial neuron.
International Association of Applied interpersonal adj. pertaining to actions,
Psychology (IAAP) the oldest international events, and feelings between two or more indi-
association of professional psychologists, viduals. For example, interpersonal skill is an ap-
founded in 1920 to promote the science and titude enabling a person to carry on effective
practice of applied psychology and to facilitate relationships with others, such as an ability to
interaction and communication among those communicate thought and feeling or to assume
who work in applied psychology around the appropriate social responsibilities.
world. interpersonal conflict disagreement or dis-
International Classification of Diseases cord between people with respect to goals,
(ICD) a system of categories of disease condi- values, or attitudes. See also extrapsychic con-
tions compiled by the World Health Organiza- flict.
tion (WHO) in conjunction with 10 WHO interpersonal distance the distance that in-
collaborating centers worldwide. Based on a for- dividuals choose to maintain between them-
mal classification system developed in 1893 that selves and others. Studies show that most
was known as the Bertillon Classification or Inter- individuals maintain a smaller interpersonal dis-
I national List of Causes of Death, the ICD is now in tance for friends than for strangers.
its 10th revision. The ICD-10, published in 1992 interpersonal group psychotherapy a
as the International Statistical Classification of group approach to the treatment of psychologi-
Diseases and Related Health Problems, uses a four- cal, behavioral, and emotional problems that
character alphanumeric coding system to clas- emphasizes the curative influence of interper-
sify diseases and disorders and their subtypes. sonal learning, including the analysis of group
Such standardization permits international sta- events, experiences, and relationships, rather
tistical analyses and comparisons of mortality than the review of issues that are external to the
data, although the ICD is often used in epidemi- group. Also called interactive group psycho-
ological studies and by systems of payment for therapy.
health care. See also dsm–iv–tr.
interpersonal process recall (IPR) a
International Council of Psychologists a method used for understanding the processes of
professional organization founded in 1941 to ad- psychotherapy and for the training of counselors
vance psychology and its applications by facili- and therapists. It involves videotaping or audio-
tating communication and strengthening bonds taping counseling or psychotherapy sessions,
between psychologists worldwide. In 1981, ICP which are later reexperienced and analyzed by
was recognized as a nongovernmental organiza- the counselor or therapist in the presence of a su-
tion in consultative status with the United Na- pervisor, who questions and discusses the
tions Economic and Social Council. thoughts and feelings of the counselor or thera-
International Pilot Study of Schizophre- pist and client. [developed by U.S. counseling
nia (IPSS) a 1973 diagnostic study sponsored psychologist Norman I. Kagan (1931–1994)]
by the World Health Organization, involving interpersonal psychotherapy (IPT) a time-
psychiatrists in 9 countries and a total of 1,119 limited form of psychotherapy, originally based
patients assigned to a schizophrenic or non- on the interpersonal theory of U.S. psychia-
schizophrenic category. The most discriminating trist Harry Stack Sullivan (1892–1949), positing
of 13 symptoms were lack of insight, auditory that relations with others constitute the primary
hallucinations, verbal hallucinations, ideas of force motivating human behavior. A central fea-
reference, and delusions of reference. The pro- ture of IPT is the clarification of the client’s inter-
ject used the present state examination. See personal interactions with significant others,
also first-rank symptoms. including the therapist. The therapist helps the
Internet addiction a behavioral pattern char- client explore current and past experiences in
acterized by excessive or obsessive online and detail, relating not only to interpersonal reac-
offline computer use that leads to distress and tion but also to environmental influences gener-
impairment. The condition, though controver- ally on personal adaptive and maladaptive
sial, has attracted increasing attention in the thinking and behavior.
popular media and among healthcare profes- interpersonal reconstructive psycho-
sionals; it has been proposed for inclusion in therapy an integrative psychotherapy and
the next edition of the Diagnostic and Statistical method of symptom analysis that blends
Manual of Mental Disorders (see dsm–iv–tr). Ex- psychodynamic and cognitive behavior tech-
panding research has identified various sub- niques and focuses on presenting problems and
types, including those involving excessive symptoms as they relate to long-term interper-
gaming, sexual preoccupations, and e-mail and sonal difficulties. Interventions are active and
text messaging. focused on attachment-based factors that main-
308
intervening variable
tain current problems. [approach developed by rater reliability, interrater agreement refers
U.S. clinical psychologist Lorna Smith Ben- only to the degree to which raters agree on (typi-
jamin] cally) categorical assignments.
interpersonal relations 1. the connections interrater reliability the consistency with
and interactions, especially ones that are socially which different examiners produce similar rat-
and emotionally significant, between two or ings in judging the same abilities or characteris-
more people. 2. the pattern or patterns observ- tics in the same target person or object.
able in an individual’s dealings with other peo- Although often used synonymously with
ple. interrater agreement, this is a more specific
interpersonal theory in psychoanalysis, the term linked conceptually with classical test
theory of personality developed by U.S. psycho- theory and possessing an underlying true
analyst Harry Stack Sullivan (1892–1949), which score sense. It usually refers to continuous mea-
is based on the belief that people’s interactions surement assignments. Also called interjudge
with other people, especially significant oth- reliability.
ers, determine their sense of security, sense of interrole conflict the form of role conflict
self, and the dynamisms that motivate their be- that occurs when individuals have more than
havior. For Sullivan, personality is the product of one role within a group and the expectations
a long series of stages in which the individual and behaviors associated with one role are not
gradually develops “good feeling” toward others consistent with the expectations and behaviors
and a sense of a good me toward himself or her- associated with another. Compare intrarole
self. The individual also learns how to ward off conflict. I
anxiety and correct distorted perceptions of intersexuality n. a modern term for herma-
other people; learns to verify his or her ideas phroditism and pseudohermaphroditism: the
through consensual validation; and above condition of possessing the sexual characteris-
all seeks to achieve effective interpersonal rela- tics of both sexes. An individual who exhibits
tionships on a mature level. such characteristics is called an intersex. Also
interpersonal trust the confidence a person called intersexualism. See also hermaphro-
or group of people has in the reliability of an- ditism; pseudohermaphroditism. —inter-
other person or group, specifically the degree to sexual adj.
which people feel they can depend on others to intersubjectivity n. the property of being ac-
do what they say they will do. The key factor is cessible in some way to more than one mind, im-
not the intrinsic honesty of the other people but plying a communication and understanding
their predictability. among different minds and the possibility of
interpretation n. in psychotherapy, explana- converting subjective, private experiences into
tion by the therapist in terms that are meaning- objective, public ones. —intersubjective adj.
ful to the client of the client’s issues, behaviors, interval n. in statistics, a range of scores or val-
or feelings. Interpretation typically is made ues. See confidence interval.
along the lines of the particular conceptual interval data numerical values that indicate
framework or dynamic model of the form of magnitude but lack a “natural,” meaningful zero
therapy. In psychoanalysis, for example, the an- point. Interval data represent exact quantities of
alyst uses the constructs of psychoanalytic the- the variables under consideration, and when ar-
ory to interpret the patient’s early experiences, ranged consecutively have equal differences
dreams, character defenses, and resistance. Al- among adjacent values (regardless of the specific
though interpretation exists to some extent in values selected) that correspond to genuine dif-
almost any form of therapy, it is a critical proce- ferences between the physical quantities being
dural step in psychoanalysis and in other forms measured. Temperature is an example of interval
of psychodynamic psychotherapy. data: the difference between 50°F and 49°F is the
interpretive response a reply by a therapist same as the difference between 40°F and 39°F,
intended to summarize or illuminate the essen- but a temperature of 0°F does not indicate that
tial meaning of or motive underlying a state- there is no temperature. See also ratio data.
ment made by a client during therapy. See also interval scale a scale marked in equal intervals
interpretation. so that the difference between any two consecu-
interpretive therapy any form of active, di- tive values on the scale is equivalent regardless of
rective psychotherapy in which the therapist the two values selected. Interval scales lack a
elicits the client’s conflicts, repressions, dreams, true, meaningful zero point, which is what dis-
and resistances, which are then interpreted or tinguishes them from ratio scales.
explained to the client in the light of his or her intervening variable 1. a hypothetical entity
experiences. See also interpretation. that is influenced by an independent variable
interrater agreement the degree to which a and that in turn influences a dependent vari-
group of raters (people, instruments, tests) rate able. 2. more specifically, an unseen process or
an attribute in the same way (e.g., assign the event, inferred to occur within the organism be-
same score or category to the same case). Al- tween a stimulus event and the time of response,
though often used synonymously with inter- that affects the relationship between the stimu-
309
intervention
lus and response. Also called mediating vari- ers, whether physically or psychologically,
able; mediator variable. which might involve difficulties with sexual
intervention n. 1. action on the part of a thera- contact, self-disclosure, trust, or commitment to
pist to deal with the issues and problems of a cli- a lasting relationship. See also fear of commit-
ent. The selection of the intervention is guided ment.
by the nature of the problem, the orientation of intimacy versus isolation the sixth of
the therapist, the setting, and the willingness erikson’s eight stages of development,
and ability of the client to proceed with the which extends from late adolescence through
treatment. Also called psychological inter- courtship and early family life to early middle
vention. 2. a technique in addictions counsel- age. During this period, individuals must learn
ing in which significant individuals in a client’s to share and care without losing themselves; if
life meet with him or her, in the presence of a they fail, they will feel alone and isolated. The
trained counselor, to express their observations development of a cohesive identity in the previ-
and feelings about the client’s addiction and re- ous stage provides the opportunity to achieve
lated problems. The session, typically a surprise true intimacy.
to the client, may last several hours, after which intoxicant n. a substance capable of producing
the client has a choice of seeking a recom- transient alterations in mental function. The na-
mended treatment immediately (e.g., as an inpa- ture of the intoxication depends on the psycho-
tient) or ignoring the intervention. If the client active properties of the intoxicant. In general,
chooses not to seek treatment, participants state mild intoxication is marked by minor perceptual
I the interpersonal consequences; for example, a changes or a sense of euphoria or well-being;
drug-abusing adult living at home may be re- more pronounced intoxication involves such
quested to move out, or the client’s employment changes as behavioral disinhibition, perceptual
may be terminated. 3. a similar confrontation distortions, hallucinations, or delirium; and se-
between an individual and family and friends, vere intoxication is marked by loss of motor con-
but outside of the formal structure of counseling trol and cognitive and autonomic function,
or therapy, usually over similar issues and with possibly progressing to coma or death.
the goal of urging the confronted individual to
seek help with an attitudinal or behavioral prob- intoxication n. see intoxicant; substance in-
lem. toxication.
interventionist n. a physician, behavioral sci- intraconscious personality a phenomenon
entist, therapist, or other professional who mod- of dissociative identity disorder in which
ifies the conditions or symptoms of a patient. one personality functioning on a subconscious
level is aware of the thoughts and outer world of
interview n. a directed conversation in which a another personality functioning on a conscious
researcher, therapist, clinician, employer, or the level.
like (the interviewer) intends to elicit specific in-
formation from an individual (the interviewee) intracranial pressure (ICP) the pressure
for purposes of research, diagnosis, treatment, or within the skull. Excessive intracranial pressure
employment. Interviews may be either highly can cause brain damage and impede blood flow
structured, including set questions, or unstruc- within the brain, with a range of effects that may
tured, varying with material introduced by the include memory loss, balance problems, demen-
interviewee. See also clinical interview. tia, coma, and death. Causes of raised ICP in-
clude hydrocephalus, hemorrhage, hematomas,
interview group psychotherapy a type of brain tumors, and head injuries.
group therapy for adolescents and adults. A
balanced therapeutic group is selected on the intrafamily dynamics the changes in the re-
basis of common problems and personal charac- lationships among the members of a family
teristics, and participants are encouraged to re- within a period of time, together with the influ-
veal their attitudes, symptoms, and feelings. See ences operating in their interactions with each
also analytic group psychotherapy. [devel- other that bring about these changes.
oped by Russian-born U.S. psychotherapist Sam- intramuscular injection (im injection) the
uel Richard Slavson (1890–1981)] injection of a substance into a muscle by means
in the closet see closet homosexual. of a hypodermic syringe, usually into the muscle
of the upper arm, thigh, or buttock. The choice
intimacy n. an interpersonal state of extreme of muscle area is important in order to avoid
emotional closeness such that each party’s per- damage to a nerve or blood vessel. See adminis-
sonal space can be entered by any of the other tration.
parties without causing discomfort to that per-
son. Intimacy characterizes close, familiar, and intrapersonal adj. describing factors operating
usually affectionate or loving personal relation- or constructs occurring within the person, such
ships and requires the parties to have a detailed as attitudes, decisions, self-concept, self-esteem,
knowledge or deep understanding of each other. or self-regulation.
—intimate adj. intrapersonal conflict see intrapsychic
intimacy problem difficulty in forming close conflict.
relationships and becoming intimate with oth- intrapsychic adj. pertaining to impulses, ideas,
310
introjective personality
conflicts, or other psychological phenomena their environment. According to Jean piaget’s

that arise or occur within the psyche or mind. theory of cognitive development, cognitive
intrapsychic ataxia lack of coordination of structures, by their very nature, seek to be active,
feelings, thoughts, and volition (e.g., laughing predisposing the child to learn from experience
when depressed). The concept was introduced in with the environment.
1904 by Austrian psychiatrist Erwin Stransky intrinsic behavior 1. a type of behavior ex-
(1878–1962) in association with schizophrenia, pressed through a specific organ (e.g., smiling,
but it has subsequently been seen in other disor- the knee-jerk reflex). 2. behavior that is inher-
ders as well. Also called mental ataxia. See also ently rewarding. For example, reading a book is
inappropriate affect. pleasurable for some individuals and so is intrin-
intrapsychic conflict in psychoanalytic the- sically rewarding.
ory, the clash of opposing forces within the psy- intrinsic motivation an incentive to engage
che, such as conflicting drives, wishes, or in a specific activity that derives from the activ-
agencies. Also called inner conflict; internal ity itself (e.g., a genuine interest in a subject
conflict; intrapersonal conflict; psychic studied), rather than because of any external
conflict. benefits that might be obtained (e.g., course
intrarole conflict the form of role conflict credits). Compare extrinsic motivation.
caused by incompatibility among the behaviors intrinsic reward a positively valued outcome
and expectations associated with a single role. that is implicit in an activity, such as the plea-
These inconsistencies may result from the inher- sure or satisfaction gained from developing a
ent complexity of the role itself, the ambiguity special skill. Intrinsic rewards originate directly I
of the role, or a superordinate group’s lack of from the task performance and do not originate
consensus in defining the role and its demands. from other people. Compare extrinsic reward.
Compare interrole conflict. introception n. a personality trait reflecting the
intrasubject replication design see single- extent to which a person is attentive to under-
case experimental design. standing the needs, motives, and experiences of
intrauterine device (IUD) a device made of him- or herself and others. —introceptive adj.
plastic or other material (e.g., copper or rubber) introjection n. 1. a process in which an individ-
that is inserted into the cervix as a contraceptive ual unconsciously incorporates aspects of reality
device. Usually having a coil design or the shape external to himself or herself into the self, par-
of a T, Y, or other configuration, it interferes ticularly the attitudes, values, and qualities of
with implantation of an embryo in the wall of another person or a part of another person’s per-
the uterus. sonality. Introjection may occur, for example, in
intravenous drug usage a form of drug use in the mourning process for a loved one. 2. in psy-
which the drug is injected directly into a vein choanalytic theory, the process of internalizing
with a needle and syringe. The opioids, espe- the qualities of an external object into the psy-
cially heroin, are often injected intravenously che in the form of an internal object or mental
to enhance their effects. Poor hygiene results in representation, which then has an influence
dirty needles or syringes, use of which increases on behavior. This process is posited to be a nor-
the risk of acquiring serious blood-borne disor- mal part of development, as when introjection
ders, including hepatitis and hiv infection. of parental values and attitudes forms the super-
intravenous injection (iv injection) the in- ego, but may also be used as a defense mecha-
jection of a substance into a vein by means of a nism in situations that arouse anxiety. Compare
hypodermic syringe. This technique is used identification; incorporation. —introject
when rapid absorption of a drug is needed, when vb. —introjective adj.
the substance would be irritating to the skin or introjective depression self-critical depres-
to muscle tissue, or when it cannot be adminis- sion: intense sadness and dysphoria stemming
tered through the digestive tract. It is a danger- from punitive, relentless feelings of self-doubt,
ous route of administration because of its rapid self-criticism, and self-loathing that often are re-
onset of pharmacological action, which may lated to the internalization of the attitudes and
cause a potentially fatal reaction. Slow intrave- values of harsh and critical parental figures. The
nous injection, called intravenous (iv) infusion, individual with introjective depression becomes
is used for blood transfusions, parenteral admin- involved in numerous activities in an attempt to
istration of nutrients (i.e., directly into the compensate for his or her excessively high stan-
bloodstream, bypassing the digestive tract), or dards, constant drive to perform and achieve,
continuous administration of drugs. See also ad- and feelings of guilt and shame over not having
ministration. lived up to expectations. Compare anaclitic
intrinsic activity 1. the magnitude of a re- depression.
sponse to a drug regardless of dosage. 2. a mea- introjective personality according to some
sure of the efficacy of a drug-receptor complex in psychoanalytic theories, a line of personality
producing a pharmacological effect. Also called development that is focused on achievement
intrinsic efficacy. 3. the inborn readiness of and evaluation and—if the personality fails to
babies to be inquisitive and to make contact with develop properly—may result in feelings of
311
intromission
worthlessness, failure, and psychopathological procedural memory, both of which are forms
self-criticism. Compare anaclitic personality. of knowing that are not necessarily accompa-
intromission n. the act of sending or putting in nied by verbal awareness of knowing.
something, especially the insertion of the penis intuitive sociogram see sociogram.
into the vagina. See also penetration. —intro- intuitive type in Carl jung’s analytic psy-
missive adj. chology, a functional type characterized by
intropunitive adj. referring to the punishment an ability to adapt “by means of unconscious in-
of oneself: tending to turn anger, blame, or hos- dications” and “a fine and sharpened perception
tility internally, against the self, in response to and interpretation of faintly conscious stimuli.”
frustration. Compare extrapunitive. —intro- The intuitive type is one of Jung’s two irratio-
punitiveness n. nal types; the other is the sensation type. See
also feeling type; thinking type.
introspection n. the process of attempting to
access directly one’s own internal psychologi- invalidate vb. to show the lack of validity of a
cal processes, judgments, perceptions, or states. proposition, hypothesis, or theory.
—introspective adj. inventory n. a list of items, often in question
introversion n. orientation toward the internal form, used in describing and studying behavior,
private world of one’s self and one’s inner interests, and attitudes.
thoughts and feelings, rather than toward the inventory test 1. in educational assessment, a
outer world of people and things. Introversion type of achievement test that contains questions
I is a broad personality trait and, like extra- in the major areas of instruction so that an over-
version, exists on a continuum of attitudes and view or profile of the individual’s achievement
behaviors. Introverts are relatively more with- may be obtained. 2. in personality research, a
drawn, retiring, reserved, quiet, and deliberate; test designed to provide a broad overview of per-
they may tend to mute or guard expression of sonality patterns in a variety of areas.
positive affect, adopt more skeptical views or inverse agonist see agonist.
positions, and prefer to work independently. Inversine n. a trade name for mecamylamine.
See also introversion–extraversion. [concept
inversion n. in sexual psychology, an old name
originated by Carl jung for the study of person-
for same-sex sexual behavior or orientation or
ality types] —introversive adj. —introvert n.
the assumption of the role of the opposite sex.
—introverted adj.
inversion of affect see reversal of affect.
introversion–extraversion the range, or
continuum, of self-orientation from introver- inverted Oedipus complex see negative
sion, characterized by inward and self-directed oedipus complex.
concerns and behaviors, to extraversion, inverted-U hypothesis a proposed correlation
characterized by outward and social-directed between motivation (or arousal) and perfor-
concerns and behaviors. See also eysenck’s typ- mance such that performance is poorest when
ology; five-factor personality model. [con- motivation or arousal is at very low or very high
cept originated by Carl jung for the study of states. This function is typically referred to as the
personality types] Yerkes–Dodson law. Emotional intensity (moti-
vation) increases from a zero point to an optimal
intrusive thoughts mental events that inter-
point, increasing the quality of performance; in-
rupt the flow of ongoing and task-related
crease in intensity after this optimal point leads
thoughts in spite of persistent efforts to avoid
to performance deterioration and disorganiza-
them. They are a common aspect of such dis-
tion, forming an inverted U-shaped curve. The
orders as posttraumatic stress and obsessive-
optimal point is reached sooner (i.e., at lower in-
compulsive disorder. Also called TUITs (task-
tensities) the less well learned or more complex
unrelated images and thoughts).
the performance; increases in emotional inten-
intuition n. immediate insight or perception as sity supposedly affect finer skills, finer discrimi-
contrasted with conscious reasoning or reflec- nations, complex reasoning tasks, and recently
tion. Intuitions have been characterized alterna- acquired skills more readily than routine activi-
tively as quasi-mystical experiences or as the ties. However, the correlation is considered
products of instinct, feeling, minimal sense weak; at best, the inverted U-function represents
impressions, or unconscious forces. —intuit vb. an entire family of curves in which the peak of
—intuitive adj. performance takes place at different levels of
intuitive judgment a decision reached on the arousal.
basis of subjective feelings that cannot easily be investment n. see cathexis. —invest vb.
articulated and may not be fully conscious. See investment model a theory explaining com-
intuition. mitment to a relationship in terms of one’s satis-
intuitive knowledge knowledge that appears faction with, alternatives to, and investments in
to be based on subjective judgment or gut feeling the relationship. According to the model, com-
rather than on specific learning. Intuitive knowl- mitment is a function not only of a comparison
edge is probably based on nonconsciously re- of the relationship to the individual’s expecta-
called information, such as implicit memory or tions, but also the quality of the best available al-
312
iproniazid
ternative and the magnitude of the individual’s or illness to a mental hospital by medical autho-
investment in the relationship; the investment rization and legal direction (as in involuntary
of resources serves to increase commitment by civil commitment). Individuals so hospitalized
increasing the costs of leaving the relationship. may be considered dangerous to themselves or
Although originally developed in the context of others, may fail to recognize the severity of their
romantic associations and friendships, the in- illness and the need for treatment, or may be un-
vestment model has since been extended to a va- able to have their daily living and treatment
riety of other areas, including employment and needs otherwise met in the community or sur-
education. vive without medical attention. Compare vol-
in vitro referring to biological conditions or pro- untary admission.
cesses that occur or are made to occur outside the involuntary treatment the treatment of peo-
living body, usually in a laboratory dish (Latin, ple diagnosed with a mental illness against their
literally: “in glass”). Compare in vivo. will. See forced treatment.
in vitro fertilization (IVF) a procedure in involutional depression a largely obsolete
which an ovum (egg) is removed from a name for a major depressive episode occurring
woman’s body, fertilized externally with sperm, during late middle age or menopause.
and then returned to the uterus. It is used to treat
the most difficult cases of infertility, but suc- ion n. an atom or molecule that has acquired an
cess rates for the procedure are not high. electrical charge by gaining or losing one or
more electrons. —ionic adj.
in vivo 1. referring to biological conditions or
processes that occur or are observed within the Ionamin n. a trade name for phentermine. I
living organism. Compare in vitro. 2. denoting ion channel a group of proteins forming a chan-
a condition or process that approximates a real- nel that spans a cell membrane, allowing the
life environment, often created for an experi- passage of ions between the extracellular envi-
ment or research study. [Latin, literally: “in life”] ronment and the cytoplasm of the cell. Ion
in vivo desensitization a technique used in channels are selective; allow passage of ions of a
behavior therapy, usually to reduce or elimi- particular chemical nature, size, or electrostatic
nate phobias, in which the client is exposed to charge; and may be ungated (i.e., always open)
the stimuli that induce anxiety. The therapist, in or gated, opening and closing in response to
discussion with the client, produces a hierarchy chemical, electrical, or mechanical signals. Ion
of anxiety-invoking events or items relating to channels are important in the transmission of
the anxiety-producing stimulus or phobia. The neural signals between neurons at a synapse.
client is then exposed to the actual stimuli in the The opening of sodium channels in the mem-
hierarchy, rather than being asked to imagine brane of a postsynaptic neuron permits an influx
them. Success depends on the client overcoming of sodium ions (Na+) into the neuron, which
anxiety as the events or items are encountered. produces an excitatory postsynaptic potential,
Compare covert desensitization. See also that is, an increased probability that the
systematic desensitization. [first developed postsynaptic neuron will initiate an action po-
by U.S. psychologist Mary Cover Jones (1896– tential and hence fire a nerve impulse. The
1987)] opening of potassium channels or chloride chan-
in vivo exposure a type of exposure therapy, nels allows potassium ions (K+) to leave the
generally used for treating individuals with postsynaptic neuron or chloride ions (Cl–) to
phobias, obsessive-compulsive disorder, and enter it, either of which produces an inhibitory
other anxiety disorders, in which the client di- postsynaptic potential, that is, a decreased prob-
rectly experiences anxiety-provoking situations ability that the postsynaptic neuron will initiate
or stimuli in real-world conditions. For example, an action potential and hence fire a nerve im-
a client who fears flying could be accompanied pulse.
by a therapist to the airport to simulate boarding I/O psychology abbreviation for industrial
a plane while practicing anxiety-decreasing and organizational psychology.
techniques, such as deep breathing. Compare
imaginal exposure.
ip abbreviation for intraperitoneal.
involuntary civil commitment commit- IPA 1. abbreviation for independent practice
ment of an individual to a mental facility association. 2. abbreviation for interaction-
against his or her wishes. For individuals to be process analysis.
committed in this way, it must be established in IPR abbreviation for interpersonal process re-
court that the individuals pose a threat to them- call.
selves or others.
iproniazid n. a monoamine oxidase inhibi-
involuntary errors errors that are made in tor developed in the 1950s for the treatment of
spite of one knowing that they are mistakes, for tuberculosis and later found to have therapeutic
example, slips of the tongue and place-losing er- value in the treatment of mood disorders.
rors. Iproniazid was found to elevate the mood of tu-
involuntary hospitalization the confine- berculosis patients, and clinical trials led to its
ment of a person with a serious mental disorder widespread use as an antidepressant. However, it
313
ipsative
has now been replaced by other less toxic antide- irrational adj. 1. lacking in reason or sound
pressant drugs. judgment: illogical or unreasonable. 2. lacking
ipsative adj. referring back to the self. For examin usual mental clarity.
ple, ipsative analyses of personal characteristics irrational belief an illogical, erroneous, or
involve assessing multiple psychological attrib- distorted idea, firmly held despite objective con-
utes and conducting within-person analyses of tradictory evidence. See also cognitive distor-
the degree to which an individual possesses one tion. [attributed to U.S. psychologist Albert Ellis
attribute versus another. (1913–2007)]
IPSS abbreviation for international pilot irrationality n. the state, condition, or quality
study of schizophrenia. of lacking rational thought. The term is typically
IPT abbreviation for interpersonal psycho- used in relation to cognitive behavior (e.g.,
therapy. thinking, decision making) that is illogical.
IQ intelligence quotient: a standard measure of an irrational type in Carl jung’s analytic psy-
individual’s intelligence level based on psycho- chology, one of the two major categories of
logical tests. In the early years of intelligence functional type: It comprises the intuitive
testing, IQ was calculated by dividing the men- type and the sensation type. Compare ratio-
tal age by the chronological age and multi- nal type.
plying by 100 to produce a ratio IQ. This concept irreflexive affect see affect.
has now mostly been replaced by the deviation irrelevant language a language composed of
iq, computed as a function of the discrepancy of
I an individual score from the mean (or average)
sounds, phrases, or words that are usually under-
stood only by the speaker, as observed in some
score. The mean IQ is customarily 100, with individuals with schizophrenia or autistic disor-
slightly more than two thirds of all scores falling der.
within plus or minus 15 points of the mean (usu-
irresistible impulse rule formerly, a rule
ally one standard deviation). More than 95% of
commonly used in U.S. courts of law for deter-
all scores fall between 70 (two standard devia-
mining insanity, according to which defen-
tions below the mean) and 130 (two standard de-
dants were judged to be insane and therefore
viations above the mean). Some tests yield more
absolved of criminal responsibility if they
specific IQ scores, such as a verbal iq, which
were unable to control their conduct, even if
measures verbal intelligence, and perfor-
they were aware that it was wrong. This rule is no
mance IQ, which measures nonverbal intelli-
longer used.
gence. Discrepancies between the two can be
used diagnostically to detect learning disabilities irreversible decrement model the view that
or specific cognitive deficiencies. Additional physical and psychological changes associated
data are often derived from IQ tests, such as with aging are caused by biological deterioration
performance speed, freedom from distractibility, and thus are not amenable to training or inter-
verbal comprehension, and perceptual orga- vention.
nization indices. There are critics who consider irritability n. 1. a state of excessive, easily pro-
the concept of IQ (and other intelligence scales) voked anger, annoyance, or impatience. 2. in
to be flawed. They point out that the IQ test is physiology, the ability of a cell or tissue to re-
more a measure of previously learned skills and spond to stimuli (e.g., neural irritability). —irri-
knowledge than of underlying native ability and table adj.
that many participants are simply not accus- irritable bowel syndrome (IBS) a common
tomed to sitting still and following orders (con- functional disorder of the intestines character-
ditions that such tests require), although they ized by abdominal pain or discomfort (e.g.,
function well in the real world. Critics also refer bloating) and changes in bowel habits, with
to cases of misrepresentation of facts in the his- some people experiencing increased constipa-
tory of IQ research. Nevertheless, these problems tion, others increased diarrhea, and others alter-
seem to apply to the interpretation of IQ scores nating between the two. As yet there is no
rather than the validity of the scores themselves. known cause (psychogenic or organic), though
IRB abbreviation for institutional review stress and emotional factors are currently
board. thought to play a role. Also called mucous coli-
irkunii n. see myriachit. tis.
ironic mental control the phenomenon IRT abbreviation for item response theory.
whereby the attempt to suppress some mental ischemia n. deficiency of blood in an organ or
content from consciousness results in an unex- tissue, due to functional constriction or actual
pectedly high level of awareness of that very obstruction of a blood vessel. See cerebral
content. [defined by U.S. psychologist Daniel M. ischemia. —ischemic adj.
Wegner (1948– )] islets of Langerhans clusters of endocrine
ironic monitoring process a component of cells within the pancreas. The A (or alpha) cells
mental processing that keeps suppressed mental secrete glucagon, the B (or beta) cells secrete in-
content active and available outside of aware- sulin, and the D (or delta) cells secrete
ness. somatostatin. Together these hormones play a
314
item difficulty
key role in regulating blood sugar and carbohy- isomorphism n. 1. a one-to-one structural cor-
drate metabolism. [Paul Langerhans (1847– respondence between two or more different enti-
1888), German anatomist] ties or their constituent parts. 2. the concept,
isocarboxazid n. an irreversible monoamine especially in gestalt psychology, that there is
oxidase inhibitor (MAOI) whose use is limited a structural correspondence between perceptual
by its unpleasant side effects (sedation, experience and psychoneural activity in the
orthostatic hypotension, weight gain, etc.) brain. —isomorph n. —isomorphic adj.
and potentially dangerous interactions with isoniazid n. a drug of choice for the treatment of
tyramine-containing foodstuffs (e.g., cheese). tuberculosis. Use of the drug can cause a form
U.S. trade name: Marplan. of neuritis by blocking the function of py-
isolate 1. n. an individual who remains apart ridoxine (vitamin B6) in metabolizing glu-
from others, either as a result of choosing to tamic acid to form the neurotransmitter gamma-
minimize his or her contact with others or aminobutyric acid. Isoniazid is a precursor of
through rejection and ostracism by other indi- the monoamine oxidase inhibitor iproniazid
viduals or groups. 2. n. in the psychology of and was reputed to have some antidepressant ac-
groups, a group member with no, very few, or tivity, though it is not clinically used in this role.
very superficial social and personal relations Also called isonicotinic acid hydrazide
with other group members. 3. n. in sociom- (INH).
etry, any individual who is infrequently or isophilia n. feelings of affection or affectionate
never mentioned when group members report behavior toward members of one’s own sex, but
on whom they like in their group. In measures of without the genital component characteristic of I
peer acceptance among children, an isolate (or same-sex sexual behavior. [first described by U.S.
neglected child) is a child who has low social im- psychiatrist Harry Stack Sullivan (1892–1949)]
pact and is usually referred to negatively but is
not actively disliked by other children. Compare isopropyl alcohol an isomer of propyl alcohol
rejected child. 4. vb. see isolation. used as an ingredient in cosmetics (e.g., hand lo-
tion) as well as in medications for external use. It
isolated explosive disorder an impulse- also may be used as an antiseptic. If ingested, it
control disorder characterized by a single, has initial effects similar to those of ethanol,
discrete episode in which the individual com- but it is extremely toxic.
mits a violent, catastrophic act, such as shooting
strangers during a sudden fit of rage. The episode Isopto Carpine a trade name for pilocarpine.
is out of all proportion to any precipitating Isopto Eserine a trade name for physo-
stress, is not due to any other mental disorder or stigmine.
to a general medical condition, and is not sub-
isotretinoin n. an analog of vitamin A used in
stance-induced. Also called catathymic crisis.
the treatment of severe acne that is resistant to
Compare intermittent explosive disorder.
other therapies. It is highly teratogenic (see
isolation n. 1. the condition of being separated teratogen) and therefore should not be used in
from other individuals. See loneliness; social pregnancy. More controversially, the use of
isolation. 2. in psychoanalytic theory, a de- isotretinoin has been linked with psychological
fense mechanism that relies on keeping unwel- disturbances, such as depression, psychosis, and
come thoughts and feelings from forming suicide. The mechanism responsible for these
associative links with other thoughts and feel- side effects is unknown. U.S. trade name (among
ings, with the result that the unwelcome others): Accutane.
thought is rarely activated. See also compart-
ISP abbreviation for individual service plan.
mentalization. 3. in erikson’s eight stages
of development, see intimacy versus isola- I statement a communication tool in which the
tion. —isolate vb. first person pronoun is used in talking about re-
lationship issues. Therapists may coach clients
isolation of affect in psychoanalytic theory, a
to use “I” instead of “you” in statements, for ex-
defense mechanism in which the individual
ample, “I am bothered by your habit” rather
screens out painful feelings by recalling a trau-
than “You have a bad habit” (which is a you
matic event without experiencing the emotion
statement). I statements tend to reduce the
associated with it.
negativity and blame directed toward the other
isomers pl. n. forms of molecules that are identi- person and put the ownership of the issue with
cal in chemical composition but differ in the the speaker, not the listener.
spatial orientation of their atoms (i.e., they are
stereoisomers). Enantiomers are stereoisomers item analysis a set of procedures used to evalu-
that exist in pairs as mirror images. The two en- ate the statistical merits of individual items com-
antiomers of a pair rotate the plane of polarized prising a psychological measure or test. These
light in opposite directions: L forms produce left- procedures may be used to select items for a test
ward or counterclockwise rotation (levorota- from a larger pool of initial items or to evaluate
tion), while D forms produce rightward or clock- items on an established test.
wise rotation (dextrorotation). In general, L item difficulty the difficulty of a test item for a
forms tend to have biological activity. particular group as determined by the propor-
315
item response theory
tion of individuals who correctly respond to the subject (“I”) treats someone or something else as
item. another unique subject (“Thou”) and in which
there is complete personal involvement. Ger-
item response theory (IRT) a psychometric
man Jewish philosopher Martin Buber (1878–
theory of measurement based on the concept
1965), who introduced the term, held that this
that the probability that an item will be correctly
type of relationship between individuals is char-
answered is a function of an underlying trait or
acterized by mutual openness to, and recogni-
ability that is not directly observable, that is, a la-
tion of, the unique personhood of the other. The
tent trait (see latent trait theory). Item re-
I–Thou relationship is transformative for both
sponse theory models differ in terms of the
people. Buber held that a person’s relationship
number of parameters contained in the model.
with God is the ultimate I–Thou relationship, be-
item scaling the assignment of a test item to a cause God is quintessentially Thou. In forms of
scale position on some dimension, often the di- existential–humanistic therapy especially,
mension of difficulty level. I–Thou moments are prized and denote a signifi-
item validity the extent to which an individual cant contact and understanding between client
item in a test or experiment measures what it and therapist. Compare i–it.
purports to measure. itinerancy n. see peregrination.
item weighting a numerical value assigned to ITPA abbreviation for illinois test of
a test item that expresses its percentage of the psycholinguistic abilities.
total score of the test. For example, an essay IUD abbreviation for intrauterine device.
I question may be assigned a value of 40, repre- iv abbreviation for intravenous. See intravenous
senting 40 out of 100 possible points. injection.
I–Thou adj. denoting a relationship in which a IVF abbreviation for in vitro fertilization.
316
Jj
Jacobson relaxation method see progres- Jenkins Activity Survey (JAS) a self-admini-
sive relaxation. stered, multiple-choice survey that attempts to
James, William (1842–1910) U.S. psychologist duplicate the clinical assessment of the type a
and philosopher. After earning his medical de- behavior pattern by means of an ob-jective
gree in 1868 from Harvard Medical School, psychometric procedure. It measures character-
James served as professor of physiology, philoso- istics of this behavior pattern, such as extreme
phy, and psychology at Harvard University. Ar- competitiveness, striving for achievement and
guably the most influential psychologist of his personal recognition, aggressiveness, haste, im-
time, he taught many students who contributed patience, and explosiveness. [Carlyle David
to the development of American psychology, in- Jenkins (1928– ), U.S. psychologist]
cluding Mary Whiton Calkins, G. Stanley Hall, jimsonweed n. a poisonous annual weed,
Robert S. Woodworth, and Edward L. Thorndike. Datura stramonium, of the nightshade family
He also wrote a best-selling textbook, Principles of that grows wild in temperate and subtropical
Psychology (1890), that helped shape the field areas of North America and the rest of the world
of psychology in its early decades. Embracing and contains several potent anticholinergic
Darwinian evolutionary theory, he promoted a agents, including the alkaloids scopolamine
functionalist approach to psychology, empha- and atropine. It has been taken in small doses
sizing the usefulness of psychological phenom- to treat asthma, whooping cough, muscle
ena, such as habits, emotions, and conscious- spasms, and other conditions and has also been
ness, in helping organisms survive. James also applied externally for pain relief. Poisoning re-
made lasting contributions to the psychology of sults in such symptoms as hyperthermia, flush-
religion in his Varieties of Religious Experience ing, dry mucous membranes, nausea and
(1902) and to psychical research as a means of vomiting, rapid heartbeat, visual disturbances,
uncovering unconscious factors in mental life. hallucinations, delirium, coma, and potentially
In addition, James is one of the founders, with death; there is often amnesia for the period of in-
John dewey and Charles S. Peirce (1839–1914), toxication. The name is a corruption of “James-
of pragmatism, America’s most important con- town weed,” the name given to the plant by
tribution to philosophy. See james–lange the- early settlers of Virginia. Also called devil’s
ory; functionalism; self; stream of action; trumpet.
stream of consciousness. jinjinia bemar see koro.
JAS abbreviation for jenkins activity survey. jiryan n. a culture-bound syndrome found in
JCAHO abbreviation for joint commission on India, with symptoms similar to those of shen-
accreditation of healthcare organiza- k’uei.
tions. Jocasta complex in psychoanalytic theory, an
jealousy n. a negative emotion in which an in- abnormally close or incestuous attachment of a
dividual resents a third party for appearing to mother to her son. It is named for Jocasta, the
take away (or be likely to take away) the affec- mother and wife of Oedipus in Greek mythol-
tions of a loved one. Jealousy requires a triangle ogy. Compare oedipus complex.
of social relationships between three individu- joie de vivre a sense of enjoyment or pleasure in
als: the one who is jealous, the partner with life that is absent in anhedonia. [French, “joy of
whom the jealous individual has or desires a reliving”]
lationship, and the rival who represents a pre- Joint Commission on Accreditation of
emptive threat to that relationship. Romantic Healthcare Organizations (JCAHO) a na-
relationships are the prototypical source of jeal- tional, private, nonprofit organization, founded
ousy, but any significant relationship (with par- in 1951, whose purpose is to encourage the at-
ents, friends, and so on) is capable of producing tainment of uniformly high standards of institu-
it. It differs from envy in that three people are al- tional medical care. The Joint Commission
ways involved. See also delusional jealousy. evaluates and accredits hospitals and health care
—jealous adj. organizations that provide managed care (in-
Jehovah complex a form of megalomania in cluding hmos, ppos, and integrated delivery
which the individual suffers from delusions of systems), home care, long-term care, behav-
grandeur and identifies with qualities associated ioral health care, laboratory services, and ambu-
with God. latory care services.
317
Jonah complex
Jonah complex in the humanistic psychology healthy personality development consisted in

of Abraham maslow, inhibition of becoming constructively resolving these conflicts and
fully self-actualized—that is, of fulfilling one’s achieving a new integration. For conflicts that
potential—for fear of facing new challenges and persist and generate emotional disturbances,
situations. It is named for the biblical prophet Jung advocated a form of therapy aimed at elicit-
Jonah, who attempted to evade the mission im- ing unconscious forces to help individuals solve
posed on him by God. See also fear of success. their problems and realize their potential. This
process usually involves the study of dreams and
jouissance n. in the theory of French psychoan-
drawings and the exploration of new activities
alyst Jacques Lacan (1901–1981), enjoyment or
that will express the individual’s personality, but
pleasure that goes beyond mere satisfaction of
does not utilize the Freudian couch or the
an instinct. Such pleasure is seen as a subver-
method of free association. The popular
sive and destabilizing force. [French, literally:
myers–briggs type indicator is based on
“enjoyment,” “pleasure”]
Jungian principles. See also anamnestic analy-
joy n. a feeling of extreme gladness, delight, or ex- sis; anima; animus; complex; functional
ultation of the spirit arising from a sense of well- types; individuation; introversion–extra-
being or satisfaction. Joy promotes confidence version; self; shadow; teleology. —Jung-
and an increase in energy, which in turn tend to ian adj.
promote positive feelings about the self. Jungian psychology the psychoanalytical the-
judgment n. the capacity to recognize relation- ory and approach to psychotherapy of Carl
ships, draw conclusions from evidence, and jung. See analytic psychology.
make critical evaluations of events and people. Jungian typology a theory of personality that
jumping Frenchmen of Maine syndrome classifies individuals into types according to (a)
J attitudes of introversion and extraversion
a culture-bound syndrome resembling latah,
observed in lumberjacks of French Canadian de- (see attitudinal types) and (b) the dominant
scent living in Quebec and Maine. It is character- functions of the psyche (see functional types).
ized by an extreme startle response involving [Carl jung]
yelling, imitative speech and behavior, involun- junkie n. slang for a drug addict, especially a her-
tary jumping, flinging of the arms, and com- oin addict. See heroin dependence.
mand obedience. Also called jumper disease junk science invalid research findings admitted
of Maine; jumping disease. See also imu; into court. Junk science is a cause of concern be-
myriachit. cause judges, attorneys, and juries often lack the
Jung, Carl Gustav (1875–1961) Swiss psychia- scientific training to identify unsound research.
trist and psychoanalyst. Jung studied natural sci- justification n. 1. in clinical psychology, the
ence and medicine at the University of Basel in defensive intellectualization of behavior, as in
Switzerland, earning a medical degree (c. 1899). making an excuse for an action, cognition, or af-
He then moved to Zürich to work at the fect that one knows to be or is considered to be
Bürghölzi Mental Hospital with the prominent wrong or indefensible. 2. in epistemology, a con-
Swiss physician Eugen Bleuler (1857–1939), who cept of intellectual responsibility regarding the
specialized in the schizophrenic disorders. A norms of belief about ideas, actions, emotions,
wide-ranging student of medicine, archeology, claims, theories, and so forth.
mysticism, and philosophy, Jung associated
juvenile justice system the courts and other
himself with the psychoanalytic school of
government entities involved in the adjudica-
Sigmund freud because it recognized the influ-
tion of cases involving minors (usually identi-
ence of the unconscious. However, after 5
fied as individuals aged under 18). Fundament-
years he broke with Freud over Freud’s theories
ally, it differs from the criminal justice system
of infantile sexuality, his emphasis on instinc-
for adults in its belief that young people are
tual impulses, and his limitation of mental con-
more amenable to treatment than adults. Conse-
tents to personal experiences. In contrast, Jung
quently, there is greater emphasis on rehabilita-
held that we are molded by our ancestral as well
tion, and greater efforts are made than in the
as personal history, and motivated by moral and
adult system to reduce the stigmatization associ-
spiritual values more than by psychosexual
ated with being labeled a criminal.
drives. On this basis he constructed a theory of
analytic psychology. An important aspect of juvenile transfer hearing a formal presenta-
this theory was its emphasis on personality dy- tion and assessment of facts during which the
namics, viewed in terms of opposing forces, such court decides whether a minor should be trans-
as conscious versus unconscious values, ferred to an adult court for adjudication.
introversive versus extraversive tendencies, and juvenilism n. a sexual attraction to children or
rational versus irrational processes. For Jung, adolescents. See ephebophilia; pedophilia.
318
Kk
kainate receptor see glutamate receptor. The primary active ingredients of the plant are
kairos n. in existential psychology, the mo- kavain, dihydrokavain, methysticin, and di-
ment of heightened awareness at which a person hydromethysticin—alkaloids that have anti-
gains insight into the meaning of an important convulsant and muscle relaxant properties and
event. See also aha experience; epiphany. also produce sedation without clouding of con-
[from Greek, “fitness, opportunity, time”] sciousness. Kava is now widely available in West-
ern countries as an herbal supplement promoted
Kalischer syndrome see sturge–weber syn- for relaxation (e.g., to relieve stress, anxiety, and
drome. tension) and as a remedy for sleeplessness and
Kallmann’s syndrome a hereditary disorder menopausal symptoms, among other uses. How-
characterized by hypogonadism (sometimes in ever, the ability of these supplements to provide
the form of underdeveloped male sexual or- such benefits has not been definitively deter-
gans), mental retardation, color blindness, com- mined, and they have in fact been shown to be
plete anosmia (absence of the sense of smell), ineffective for treating menopausal symptoms.
and unintentional muscle movements. Kall- Additionally, in 2002 the U.S. Food and Drug
mann’s syndrome is transmitted as an X-linked Administration issued a consumer advisory
dominant trait. [Franz Josef Kallmann (1897– warning of the potential risk of rare but serious
1965), German-born U.S. psychiatrist and genet- reactions—including hepatitis, cirrhosis, and
icist] liver failure—associated with use of kava-
Kanner’s syndrome see autistic disorder. containing supplements. Kava has also been as-
[Leo Kanner (1894–1981), Austrian-born U.S. sociated with depression of the central nervous
child psychiatrist] system or coma (particularly in combination
with prescribed anxiolytics), and other less seri-
Kansas v. Hendricks a case resulting in a con-
ous adverse reactions (e.g., skin rash) have been
troversial 1997 U.S. Supreme Court decision that
reported as well. There are several known and
upheld the involuntary civil commitment of
potential interactions of kava with other agents
an offender after he had already completed his
(see drug interactions), including anticoagu-
sentence for a sex crime. The court ruled that
lants, monoamine oxidase inhibitors, and
laws permitting confinement of sex offenders in
drugs metabolized by the cytochrome p450
mental hospitals after they have served their
3A4 enzyme (e.g., clonidine, nefazodone, St.
criminal sentences are not unconstitutional if
John’s wort). Also called ava; kava kava.
the offender remains a threat.
kappa receptor see opioid receptor. K complex a characteristic brief, high-amplitude
karezza n. see carezza. pattern of electrical activity recorded from the
brain during the early stages of sleep. K com-
kat n. see khat. plexes and sleep spindles commonly occur dur-
katasexuality n. a sexual preference for dead ing stage 2 sleep as a normal phenomenon (see
people or human beings with animal-like char- sleep stages) but they may also be associated
acteristics. See necrophilia. with nocturnal epileptic seizures.
Katz Index of Activities of Daily Living
an observer-based measure of the functional keep-awake pills a popular name for stimu-
status of older adults and individuals with lant pills that contain caffeine as the active in-
chronic disorders. An individual is rated regard- gredient and can be obtained without a doctor’s
ing the degree of assistance required to perform prescription. A keep-awake pill usually contains
six basic functions: bathing, dressing, feeding, approximately 100 mg caffeine, equivalent to
toileting, transferring, and continence. Baseline the amount of caffeine in one cup of regular cof-
measurements provide useful feedback when fee or two cups of strong tea.
compared to periodic or subsequent measure- Kegel exercises exercises designed to help
ments. Also called Katz Index of Indepen- women build strength and gain control of the
dence in Activities of Daily Living. pelvic-floor muscles. These exercises are used in
[originally developed in 1963 by Sidney Katz, the treatment of vaginismus and play a role in
20th-century U.S. physician and geriatrician] increasing sexual pleasure. The muscle increases
kava n. an extract of the root of Piper methy- abdominal pressure by contracting, drawing the
sticum, a shrub indigenous to certain southern anus toward the pubis, as when an individual
Pacific islands, where it has an established use as tightens control of the urinary sphincter. The ex-
a mild intoxicant, sedative, and analgesic agent. ercises are therefore also used in the treatment of
319
Kemadrin
stress incontinence. [developed in 1948 by A. H. kinesics technique the analysis of the body
Kegel, 20th-century U.S. gynecologist] language (e.g., facial expressions) of a person.
Kemadrin n. a trade name for procyclidine. The technique is used particularly during the in-
terviewing of a suspect.
kernicterus n. a congenital disorder associated
with excessive levels of orange bile pigment (bili- kinesiology n. 1. the study of the mechanics of
rubin) in the newborn infant. It is characterized body movement, especially their relationship to
by severe jaundice and has the potential of caus- anatomical characteristics and physiological
ing severe damage to the central nervous system. functions. 2. a discipline that encompasses all
Kernicterus is often a complication of rh blood- the sport sciences as well as the professional
group incompatibility. skills for the application of sport and exercise
ketamine n. a drug that is closely related to pcp knowledge. —kinesiological adj. —kinesi-
(phencyclidine). It acts as an antagonist at nmda ologist n.
receptors and was formerly used as a dis- kinesiotherapy n. the application of progres-
sociative anesthetic. Disorientation and per- sive physical exercise and activities to treat indi-
ceptual distortions may result from its use, viduals with functional limitation or to aid
which have limited its utility in surgical anesthe- those interested in improving or maintaining
sia but have made it a sought-after and common general physical and emotional health, formerly
drug of abuse. It is ingested (in the form of tab- called corrective therapy. A kinesiotherapist
lets, capsules, or powder) by drug users for its (formerly a corrective therapist) is a certified
hallucinogenic effects. U.S. trade name: Ketalar. professional who develops a specific treatment
ketoconazole n. an antifungal agent that has plan for each individual, determining appropri-
been suggested as a treatment for depression re- ate therapeutic exercises and physical-education
sistant to conventional drugs, due to its ability to activities and directing their implementation.
inhibit the biosynthesis of steroids. No large- kinetic information in clinical assessment
K scale clinical data support this. Ketoconazole is a and therapy, the observed gestures, postures,
potent inhibitor of numerous cytochrome and other body-language clues used in making
p450 enzymes (particularly CYP3A4), and has an evaluation of a client or patient.
significant interactions with psychotropic drugs Kinsey, Alfred (1894–1956) U.S. zoologist and
that utilize this metabolic path. Its numerous in- sex researcher. Kinsey earned a doctorate of sci-
teractions and propensity to cause liver damage ence at Harvard University in 1920 and then
limit its use. U.S. trade name: Nizoral. moved to Indiana University, where he re-
khat (chat; kat; qat) n. an herbal cns stimu- mained for his entire teaching and research ca-
lant obtained from the leaves and other parts of reer, eventually serving as director of the
an evergreen shrub, Catha edulis, indigenous to Institute for Sex Research. His dissertation and
northeast Africa and the Arabian peninsula. The early research involved studies of the gall wasp,
leaves are traditionally chewed to produce mild but he is best known for his later scientific stud-
stimulant effects (e.g., mental alertness, suppres- ies of human sexual behavior. Fifteen years of in-
sion of appetite and the need for sleep, general terviews with thousands of people culminated in
sense of well-being); they can also be used to two volumes that pioneered the field of sexol-
make a tea. The substance responsible for khat’s ogy: Sexual Behavior in the Human Male (1948)
psychoactive properties is cathinone, a com- and Sexual Behavior in the Human Female (1953).
pound that is structurally similar to amphet- These presented, for the first time, statistics on a
amine. As with amphetamines, physiological range of human sexual behaviors, including
tolerance and dependence and a variety of ad- such controversial issues as extramarital inter-
verse reactions (e.g., behavioral disorganization course, masturbation, and homosexuality. Kin-
and psychosis) may occur with continued or sey is also well known for developing what
high-dose use. The use of khat has spread be- became known as the Kinsey (Six) scale (from 0
yond its traditional boundaries to the United to 6), which provided an index of an individual’s
States and other Western countries. In many of relative position on a continuum from homo-
those places, however, khat is illegal; it is classi- sexual to heterosexual.
fied by the U.S. Drug Enforcement Administra-
Kinsey Institute for Research in Sex,
tion as a Schedule I controlled substance (see
Gender, and Reproduction a private non-
scheduled drug).
profit corporation affiliated with Indiana Uni-
KHOS abbreviation for krantz health opinion versity whose mission is to promote inter-
survey. disciplinary research and scholarship in the
Kiddie Schedule for Affective Disorders fields of human sexuality, gender, and reproduc-
and Schizophrenia (KSADS) see schedule tion. It was founded in 1947 by Alfred kinsey,
for affective disorders and schizophrenia. who served as its first director and carried out
kindness n. benevolent and helpful action in- much of his pioneering research into human
tentionally directed toward another person. sexual behavior there.
Kindness is motivated by the desire to help an- Kirton Adaption–Innovation Inventory
other, not to gain explicit reward or to avoid ex- (KAI) a questionnaire, used chiefly in organiza-
plicit punishment. See altruism. —kind adj. tional settings, that is designed to measure cre-
320
Koffka, Kurt
ativity, cognitive style, and the degree to which kleptolagnia n. a morbid urge to steal, consid-
individuals are adaptive, innovative, or a range ered by some theorists to be associated with sex-
of both in their approach to problem solving. It ual excitement. However, this association is
comprises 33 items (32 scored, 1 unscored) re- controversial, and many consider the urge to be
quiring participants to rate how difficult it is for unrelated to sexual issues.
them to be the person described (e.g., a person kleptomania n. an impulse-control disor-
who is thorough) using a 17-point likert scale der characterized by a repeated failure to resist
format, ranging from “very hard” to “very easy.” impulses to steal objects that have no immediate
[originally developed in 1976 by Michael J. use or intrinsic value to the individual, accompa-
Kirton, British psychologist] nied by feelings of increased tension before com-
kissing behavior the activity of making con- mitting the theft and either pleasure or relief
tact with the lips, usually as a sign of friendship during the act. The stealing is not done out of
or affection. The kiss may involve lip contact anger or in response to a delusion or hallucina-
with any part of the body and with varying de- tion and is not better accounted for by another
grees of pressure. Mouth-to-mouth kissing may disorder, such as conduct disorder or a manic
include extension of the tongues (French kiss). episode. In DSM–IV–TR, kleptomania is included
Kissing behavior possibly is related to the licking in the category impulse-control disorders
behavior manifested by animals. It is not ob- not elsewhere classified. —kleptomaniac
served in all cultures. n.
Kleeblattschädel syndrome a type of birth Klinefelter’s syndrome a disorder in which
defect characterized by a three-lobed skull males are born with an extra X chromosome, re-
caused by upward and lateral bulging of the sulting in small testes, absence of sperm, en-
brain through skull sutures. Affected individuals larged breasts, mental retardation, and abnormal
also have hydrocephalus, severe mental retarda- behavior. Also called XXY syndrome. [Harry F.
tion, and abnormally short limbs. Also called Klinefelter (1912–1990), U.S. physician]
cloverleaf skull. [from German Kleeblatt, Klippel–Feil syndrome a congenital condi- K
“cloverleaf,” and Schädel, “skull”] tion characterized by a short neck, low hairline,
Klein, Melanie (1882–1960) Austrian-born Brit- and a reduced number of vertebrae, some of
ish psychoanalyst. Although she had no formal which may be fused into a single mass. The con-
medical education, Klein trained as a psychoana- dition is often accompanied by deafness and
lyst in Budapest under Hungarian psychoanalyst mental retardation. [Maurice Klippel (1858–
Sandor Ferenczi (1873–1933). Klein was a pio- 1942), French neurologist; André Feil (1884–?),
neer in child analysis. She was the first thera- French neurologist]
pist to use play as an analytic and treatment klismaphilia n. interest in, and arousal from,
technique; she also suggested that the oedipus the use of enemas in sexual activity. See para-
complex, paranoid attitudes, and the super- philia not otherwise specified.
ego originate in very early infancy. While Klein’s
Klonopin n. a trade name for clonazepam.
ideas were not readily accepted by the psychoan-
alytic establishment on the European continent, knockout drops a popular name for a combi-
they found fertile soil in England. Ernest Jones nation of chloral hydrate (formerly in com-
(1879–1958), president of the British Psycho- mon use as a sedative but now rarely employed
Analytical Society, invited her to England, where clinically) and alcohol, used surreptitiously to
her work was sufficiently well received for her produce a sudden loss of consciousness. This
to remain there for the rest of her life. Klein’s combination was called a Mickey Finn and might
theories differed from those of Anna freud, an- be considered an early example of a date-rape
other pioneer of child analysis. While Anna drug.
Freud emphasized the development of the Kocher–Debré–Sémélaigne syndrome a
child’s ego, Klein emphasized oedipal conflicts disorder of infants and children marked by
and the primary object relationship with the weakness and overgrowth of muscles associated
mother (see object relations theory). She with cretinism and mental retardation in some
also developed controversial ideas about the cases. Also called Debré–Sémélaigne syn-
similarities between infant mental life and adult drome. [reported in 1892 by Emil Theodor
neuroses and psychoses. Through her work on Kocher (1841–1917), Swiss surgeon, and in the
the paranoid-schizoid position, she contrib- 1930s by Robert Debré (1882–1978), French pe-
uted to knowledge of schizoid defense mecha- diatrician, and Georges Sémélaigne, 20th-
nisms. See also bad breast; bad object; de- century French pediatrician]
pressive position; ego-splitting; good breast; Koffka, Kurt (1886–1941) German experimen-
good object. tal psychologist. After obtaining his PhD at the
Kleinian adj. denoting or in accordance with the University of Berlin in 1908 under Carl Stumpf
theories and methods of the school of psycho- (1848–1936), Koffka worked with Wolfgang
analysis founded by Melanie klein, including köhler and Max wertheimer on studies that
such concepts as internalization, object re- led to the founding of gestalt psychology.
lations, the depressive position, idealiza- Following a number of research and teaching po-
tion, and the paranoid-schizoid position. sitions in Germany, in the mid-1920s Koffka
321
Köhler, Wolfgang
took a series of teaching positions in the United Africa and is cultivated in South America and the
States before settling into a research professor- West Indies. The active ingredient is caffeine,
ship at Smith College in Northampton, Massa- which comprises about 1.5% of the dry weight of
chusetts, in 1927. He spent the remainder of his the nut. Kola was discovered for the Western
career there, eventually becoming chief spokes- world in 1667 by a Congo missionary, Father
person for Gestalt psychology through articles Carli, who observed that local tribesmen chewed
and books that explained the theory and its ap- the nut before meals.
plications. His most important writings include koprolagnia n. see coprolagnia.
Growth of the Mind (1924) and Principles of Gestalt
Psychology (1935). Koffka’s research centered on koprophemia n. see coprophemia.
visual perception, and his work contributed sig- koro n. a culture-bound syndrome observed
nificantly to the understanding of visual phe- primarily in males in China and southeast Asia.
nomena. More broadly, Gestalt psychology It is an acute anxiety reaction in which the male
presented a holistic view of the mind that con- suddenly fears that his penis is shrinking and
trasted sharply with the reductionist view of- will disappear into his abdomen, bringing death.
fered by behaviorism, another prominent and (In females, the fear is focused on the vulva and
contemporaneous school of psychology. See also nipples.) Individuals may also experience shame
holism; reductionism. if they associate the fear with immoral sexual be-
havior. Also called jinjinia bemar; rok-joo;
Köhler, Wolfgang (1887–1967) German ex-
shook yong; shuk yang; suk-yeong; suo
perimental psychologist. Köhler earned a doc-
yang.
torate at the University of Berlin in 1909,
studying under the psychologist Carl Stumpf Korsakoff’s syndrome a syndrome occurring
(1848–1936) and the physicist Max Planck primarily in cases of severe, chronic alcoholism.
(1858–1947). He subsequently joined Max wert- It is caused by thiamine (vitamin B1) deficiency
heimer and Kurt koffka in developing gestalt and damage to the mammillary bodies. Pa-
K psychology. In 1913 Köhler became director of tients with Korsakoff’s syndrome demonstrate
the Anthropoid Station at Tenerife for 7 years. dense anterograde and retrograde amnesia (see
During this time he published his book The Men- amnesia) that are thought to be due to lesions
tality of Apes (1917), which included his famous in the anterior or dorsomedial nuclei (or both)
studies of insight in nonhuman primates. He of the thalamus. The selective and acute nature
demonstrated persuasively that even chimpan- of the memory disorder in Korsakoff’s syn-
zees can “get an idea” in order to solve a prob- drome sets it apart from alcoholic dementia (see
lem, such as piling up boxes or putting sticks alcohol-induced persisting dementia), a
together to retrieve a piece of fruit placed out syndrome characterized by more global impair-
of their reach (see insight learning). Köhler ments in intellectual functioning that evolve
returned to Germany in 1920, ultimately be- gradually over time. Korsakoff’s syndrome often
coming director of the Psychological Institute at follows an episode of wernicke’s encephal-
Berlin, the most prestigious position for an ex- opathy (see wernicke–korsakoff syndrome).
perimental psychologist in Germany. When the Also called Korsakoff’s disease; Korsakoff’s
Nazis came to power in the 1930s and began psychosis. [first described in 1887 by Sergei
summarily dismissing Jewish and other profes- Korsakoff (1853–1900), Russian neurologist]
sors from German universities, Köhler tried for 2 Kraepelin’s disease a disorder that is charac-
years to resist their policies within the institute terized by depressive symptoms accompanied by
but eventually gave up in frustration, moving psychotic features but does not meet the criteria
to the United States. He became a professor at for a major depressive episode. [first described
Swarthmore College in Pennsylvania for the re- by Emil W. M. G. Kraepelin (1856–1926), Ger-
mainder of his career. Apart from his book on man psychiatrist]
apes, his most famous work includes Gestalt Psy- Kraepelin’s theory the concept of dementia
chology (1929) and The Place of Value in the World praecox, the disorder now known as schizo-
of Facts (1938). See also goodness of configu- phrenia. Kraepelin’s theory emphasized the
ration. progressive intellectual deterioration (dementia)
Kohnstamm test a demonstration frequently and the early onset (praecox) of the disorder.
used in preparing an individual for hypnosis. [first presented in 1898 by Emil Kraepelin]
The participant is asked first to stand next to a Krantz Health Opinion Survey (KHOS) a
wall and press an arm tightly against it for a min- questionnaire to measure patient attitudes to-
ute or two, thus numbing it, and then to step ward treatment and preferences for different ap-
away, whereupon the arm spontaneously rises proaches in health care. Participants indicate
(an occurrence known as Kohnstamm’s phe- whether they agree or disagree with each of 16
nomenon). This demonstrates to the participant statements (e.g., “I usually ask the doctor or
how it feels to yield passively to an external nurse lots of questions about the procedures dur-
force, as in hypnosis. [Oskar Kohnstamm (1871– ing a medical exam”), which are keyed so that
1917), German physician] high scores represent favorable attitudes toward
kola nut (cola nut) the seed of a tree, Cola self-directed care. Also called Health Opinion
acuminata or Cola nitida, that is native to tropical Survey (HOS). [developed in 1980 by David S.
322
kymograph
Krantz (1949– ), U.S. medical psychologist, and tendencies were attributed to endocrine secre-
colleagues at the Uniformed University of the tions. [formulated in the 1920s by German psy-
Health Sciences, Bethesda, Maryland] chiatrist Ernst Kretschmer (1888–1964)]
KSADS abbreviation for Kiddie Schedule for Af-
Kretschmer typology a controversial classifi-
fective Disorders and Schizophrenia. See sche-
cation of individuals based on a “clear biological
dule for affective disorders and schizo-
affinity” between specific physiques and specific
phrenia.
personality tendencies. According to this classi-
fication, the short, stocky (pyknic type) tends to kymograph n. an instrument for recording
be jovial and subject to mood swings; the frail temporal data in psychological or physiologi-
(asthenic type) is likely to be introversive and cal research by tracing the variations of a par-
sensitive; the muscular (athletic type) is usually ticular parameter on a sheet of paper attached
energetic and aggressive; and the dispropor- to a revolving drum. The resulting trace on
tioned (dysplastic type) presents a combination the paper is a kymogram. Computer-output sys-
of traits but tends toward the asthenic. These tems have largely replaced such instruments.
323
Ll
LAAM L-alpha-acetyl-methadol: a long-acting rate articulation should have been acquired. See
opioid agonist that is a chemical analog of also phonological disorder.
methadone. A strong agonist at the mu opioid lalopathy n. any form of speech disorder.
receptor, it is used in the management of
lamotrigine n. an anticonvulsant drug used
opioid dependence because of its ability to sup-
as an adjunct in the treatment of adults with par-
press physical withdrawal symptoms and block
tial seizures and some generalized seizures and
the reinforcing effects of opioids. It has a longer
for maintenance treatment of bipolar disorder.
half-life (about 72 hours) than methadone and
Although ineffective in treating acute manic epi-
therefore needs to be taken only three times a
sodes, it has gained acceptance as a single-drug
week, which is a major advantage over metha-
treatment for acute bipolar depression and
done (which is taken daily). However, its possi-
rapid-cycling bipolar II disorder. Lamotrigine is
ble adverse effects on heart rate and interactions
presumed to exert its anticonvulsant and mood-
with other drugs have limited its clinical use.
stabilizing effects by inhibiting the release of
labeling n. in psychological assessment, classify- glutamate from presynaptic neurons. Serious
ing a patient according to a certain diagnostic skin reactions, including stevens–johnson syn-
category. Patient labeling may be incomplete or drome, have been reported at the start of ther-
misleading, because not all cases conform to the apy, particularly in children. U.S. trade name:
sharply defined characteristics of the standard Lamictal.
diagnostic categories. Landmark Forum see erhard seminar
labeling theory the sociological hypothesis training.
that describing an individual in terms of particu- Langdon Down’s disease see down syn-
lar behavioral characteristics may have a signifi- drome.
cant effect on his or her behavior, as a form of
language deficit an absence, loss, or delay in
self-fulfilling prophecy. For example, de-
the normal speech and language development of
scribing an individual as deviant and then treat-
a child due to some neurological dysfunction.
ing him or her as such may result in mental
disorder or delinquency. Also called societal- language disability any significant difficulty
reaction theory. See also primary deviance. with or impairment of language development or
function. When the difficulty or impairment is
la belle indifférence inappropriate lack of restricted to a specific aspect of language devel-
concern about the seriousness or implications of opment or a specific language function, it is
one’s physical symptoms, often seen in conver- termed specific language disability. When the
sion disorder. difficulty or impairment is more pervasive and
labile adj. 1. liable to change. 2. lacking emo- not restricted to a particular aspect or function,
tional stability. See labile affect. 3. describing the term general language disability is used.
the early stage of memory formation that can be language disorder see speech and language
easily disrupted by factors influencing brain ac- disorder.
tivity. —lability n. language pathology see speech and lan-
labile affect highly variable, suddenly shifting guage pathology.
emotional expression. language retardation delayed acquisition of
laconic speech see poverty of speech. language skills, manifested, for example, by sin-
gle word utterances or unintelligible sounds, due
lacrimation n. crying, especially excessive cry- to neurological causes.
ing.
language therapy see speech and language
lacuna n. (pl. lacunae) a gap or break, such as a therapy.
gap in memory. —lacunar adj.
languishing n. the condition of absence of
lacunar amnesia see localized amnesia. mental health, characterized by ennui, apathy,
lalling n. an infantile form of speech character- listlessness, and loss of interest in life. Compare
ized by the omission or substitution of sounds, flourishing. —languish vb.
particularly the substitution of the [l] sound for Lanterman Developmental Disabilities
other sounds that are more difficult for the Act Californian legislation, introduced in 1969,
speaker to produce, for example, saying “lellow” that sets forth the rights and responsibilities of
for yellow. Lalling is considered a speech disorder people with developmental disabilities and the
when it persists beyond the age at which accu- structure of the system for planning, coordinat-
324
latent stage
ing, and delivering services and supports to which asserted that when specific portions of the
them. This act is noteworthy because, unlike brain were damaged, the disrupted functions
similar statutes in most U.S. states, it has been in- were definitively gone because brain function
terpreted judicially as establishing an entitle- was extremely localized. Lashley’s honors in-
ment to services. In a 1993 class action decision, cluded election to the National Academy of Sci-
reduction in the use of institutional settings ences and the American Academy of Arts and
and movement of institutional residents to com- Sciences. See also law of equipotentiality;
munity settings was ordered, as were specific mass action.
changes to processes for individual planning of Lasthenie de Ferjol syndrome a type of
services and supports. pathomimicry consisting of life-threatening
lapsus linguae see slip of the tongue. hemorrhages caused by secretly self-inflicted
wounds. It is linked with the pathology of
Lariam n. a trade name for mefloquine. mourning and introjection: Patients with this
Larodopa n. a trade name for levodopa. disorder have all experienced traumatic losses.
laryngeal cancer a malignant growth of the The syndrome takes its name from a short story
upper respiratory tract that affects mainly men by French writer Jules Barbey D’Aurevilly (1808–
over the age of 40 and accounts for about 4,200 1889).
deaths each year in the United States. The risk of latah (lattah) n. a culture-bound syndrome
laryngeal cancer increases with cigarette smok- first observed in Malaysia and Indonesia, al-
ing, drinking alcoholic beverages, and living in though similar syndromes have been found in
urban areas; the incidence among cigarette many other parts of the world. The condition
smokers is approximately seven times that of the primarily affects middle-aged women and is
general population. Early symptoms include characterized by an exaggerated startle reaction.
hoarseness or a feeling of soreness or a “lump” in Its major symptoms, besides fearfulness, are imi-
the throat. As the cancer progresses, it interferes tative behavior in speech (see echolalia) and
with breathing and swallowing. Treatment usu- body movements (see echopraxia), a compul-
ally includes surgery or radiation, or both, the sion to utter profanities and obscenities (see
appropriate procedure depending upon the can- coprolalia), command obedience, and disor-
ganization. See also imu; jumping frenchmen
L
cer site and the extent of its growth. If it is possi-
ble to correct the problem by excising only one of maine syndrome; myriachit.
vocal cord, the patient is trained to speak with late luteal phase dysphoric disorder see
the remaining vocal cord. If it is necessary to re- premenstrual dysphoric disorder.
move the entire larynx, the patient is trained to latency stage in psychoanalytic theory, the
speak with the aid of an electronic device or by a stage of psychosexual development in which
technique of swallowing air into the esophagus overt sexual interest is sublimated and the
and forcing it out again while the lips and teeth child’s attention is focused on skills and peer ac-
are manipulated to form speech sounds. How- tivities with members of his or her own sex. This
ever, the vocabulary of words that can be pro- stage is posited to last from about the resolution
duced in this manner is limited. of the oedipus complex, at about age 6, to the
Lashley, Karl Spencer (1890–1958) U.S. psy- onset of puberty during the 11th or 12th year.
chologist. Lashley earned his PhD in zoology Also called latency; latency period; latency
and genetics at Johns Hopkins University in phase; latent stage.
1914. His dominant influences were the zoolo- latent content 1. the hidden or disguised
gist Herbert S. Jennings (1868–1947), behaviorist meanings, wishes, and ideas beneath the mani-
John B. watson, and neuropsychologist Shep- fest content of any utterance or other form of
herd I. Franz (1874–1933). Lashley taught at a communication. 2. in psychoanalytic theory,
number of universities before joining the faculty the unconscious wishes seeking expression in
of Harvard University, where he taught from dreams or fantasies. This unconscious material is
1935 until his retirement in 1955. From 1942 posited to encounter censorship (see censor)
until 1955 he also served as director of the Yerkes and to be distorted by the dream-work into
Laboratories of Primate Biology in Florida. symbolic representations in order to protect the
Lashley was most influential in the fields of ani- ego. Through dream analysis, the latent con-
mal learning, comparative psychology, and neu- tent may be uncovered. See also dream censor-
rophysiology. Perhaps most famous is the work ship.
summarized in his classic Brain Mechanisms and
latent homosexuality gay or lesbian tenden-
Intelligence (1929). In it, he showed that if por-
cies that have never been expressed overtly and
tions of a rat’s brain were damaged (through le-
are usually unrecognized (i.e., repressed) and ac-
sions or partial ablations), any disruption in
tively denied by the individual. Also called un-
learning or ability was only temporary; in time
conscious homosexuality.
the brain could recover its functions unless very
large portions were damaged. In essence, healthy latent need a need that is assumed to be present
portions of the brain could adapt and take over in a person and determines behavior but is not in
the work of damaged portions. Lashley used his that person’s conscious awareness.
research to counter cerebral localization theory, latent stage see latency stage.
325
latent trait theory
latent trait theory a general psychometric surable because it serves to release tension built
theory contending that observed traits, such as up when people listen to an amusing story or
intelligence, are reflections of more basic un- watch an amusing event. Laughter may also re-
observable traits (i.e., latent traits). Several quan- sult when states of threat occur in a safe context
titative models (e.g., item response theory and (see arousal jag) or from an abrupt resolution
factor analysis) have been developed to allow of a cognitive incongruity. In psychoanalytic
for the identification and estimation of these la- theory, laughter may be viewed as a defense
tent traits from manifest observations. against crying or embarrassment. Unrestrained
latent variable a hypothetical, unobservable or paroxysmal laughing spells have been found
characteristic that is thought to underlie and ex- to precipitate cataplectic attacks, to be a com-
plain observed, manifest attributes that are di- mon manifestation in manias, and to be an occa-
rectly measurable. The values of latent variables sional symptom of psychomotor seizure among
are inferred from patterns of interrelationships children, termed gelastic epilepsy. Spasmodic
among the manifest variables. laughter, or gelasmus, is also found in schizo-
phrenia, hysteria, and organic (especially bulbar
late-onset schizophrenia a psychotic state and pseudobulbar) diseases of the brain, as well
that starts after middle age (typically after age
as in choreomania. —laugh vb.
45). It is believed that late-onset schizophrenia is
distinct from early-onset schizophrenia. Launois–le Cleret syndrome see fröhlich’s
late paraphrenia any delusional disorder with syndrome.
onset after age 60. Late paraphrenia is used as a Laurence–Moon–Biedl syndrome an auto-
diagnostic entity in Europe and Britain, but is somal recessive disorder that may be character-
not listed in the DSM–IV–TR. Also called late- ized by some degree of obesity, extra fingers
onset paraphrenia. or toes, below average intelligence, and ocular
lateralization n. the relationship between abnormalities, particularly of the retina. A com-
handedness, eye dominance, footedness, and mon finding is progressive cone and rod de-
hemispheric lateralization. Observed more generation and night blindness. Hypogonadism
frequently in humans than in other primates, (small testicles) and hearing difficulty are often
L lateralization is manifested in the way tasks are associated with the disorder. More than 75%
performed and can also be extrapolated from the of affected individuals tested have mental retar-
effects of localized brain damage. Directional dation. Also called Laurence–Moon–Biedl–
confusion and dyslexia are among disorders di- Bardet syndrome; retinodiencephalic de-
agnosed through lateralization tests. generation. [John Zachariah Laurence (1830–
lateralized readiness potential (LRP) an 1874), British ophthalmologist; Robert C. Moon
event-related potential that is a measure of (1844–1914), U.S. ophthalmologist; Artur Biedl
the difference in activation between the left and (1869–1933), Austrian physician]
right motor areas of the brain. This potential is law of constancy in psychoanalytic theory,
taken to indicate preparation to respond with see principle of constancy.
one hand or the other, since each hand is con-
trolled by the contralateral hemisphere. law of equipotentiality the principle that in-
tact areas of association cortex can take over
lateral thinking creative thinking that delib- some functions of areas that have been de-
erately attempts to reexamine basic assumptions stroyed, that is, different areas can function vir-
and change perspective or direction in order to tually equivalently. Based on behavioral studies
provide a fresh approach to solving a problem. of rats with cortical lesions, the law has subse-
This term is often used synonymously with di- quently been challenged by research involving
vergent thinking. [defined by Maltese-born more specific behavioral tests, which has shown
British psychologist Edward de Bono (1933– )] that areas of association cortex have relatively
later life adjustment adaptation to stress specific functions. Also called principle of
caused by events associated with life as an older equipotentiality. See also mass action. [pro-
adult, including chronic disease, familial loss, posed in 1929 by Karl S. lashley]
and lifestyle changes.
laxative addiction a dependence on the use of
lattah n. see latah. laxatives to induce bowel movements. The ad-
laudanum n. a mixture of alcohol and opium diction is a vicious cycle, in which the use of lax-
once commonly used as an analgesic and anes- atives gradually reduces bowel activity so that
thetic. The mixture was introduced around 1530 further use becomes the only way to avoid con-
by German alchemist and physician Paracelsus stipation. Laxative addiction is often associated
(1493–1541) and was widely consumed as an in- with eating disorders in which laxatives are
toxicating beverage in 18th-century England. routinely used for purging. See also enema ad-
laughing gas see nitrous oxide. diction; klismaphilia.
laughter n. vocal expression of the emotions of lay analysis psychoanalytic therapy performed
amusement, enjoyment, or derision, character- by a person who has been trained in psychoana-
ized by inspiratory and expiratory movements lytic theory and practice but is not a physician
occurring in rapid succession. Laughter is plea- (i.e., a layperson). This is to be distinguished
326
learning disorder
from psychoanalysis performed by a fully ac- robust fit between the concept and post-
credited psychiatrist. traumatic stress disorder.
LCU abbreviation for life-change unit. learned optimism an acquired explanatory
LD 1. abbreviation for learning disability. 2. style that attributes causes for negative events to
abbreviation for learning disorder. 3. abbre- factors that are more external, unstable, and spe-
viation for lethal dose. cific: that is, problems are believed to be caused
L data life data: information about an individual by other people or situational factors, the causes
gathered from his or her life record or life his- are seen as fleeting in nature, and are localized to
tory. See also o data; q data; t data. one or a few situations in one’s life. According to
learned helplessness theory, the manner in
LE abbreviation for lupus erythematosus. which individuals routinely explain the events
leaderless group discussion (LGD) an ex- in their lives can drain or enhance motivation,
change of opinions, ideas, and information re- reduce or increase persistence, and enhance vul-
lated to some topic by the members of a nerability to depression or protect against it,
leaderless group. Such discussions are used in making learned optimism a putative mechanism
training and educational settings to provide par- by which therapy ameliorates depression.
ticipants with insights into their own and oth-
ers’ behaviors in open, unstructured group
learning n. the process of acquiring new and rel-
atively enduring information, behavior patterns,
situations.
or abilities, characterized by modification of be-
leaderless group therapy a form of group havior as a result of practice, study, or experi-
therapy in which leaderless meetings are held ence.
either (a) on an occasional or regularly scheduled
basis as an adjunct to the traditional therapist- learning disabilities specialist an individ-
led process or (b) on an entirely self-directed ual, usually working within an interdisciplinary
basis in which a group always meets without a team of school professionals, who is trained to
designated leader. identify and assist students with problems asso-
ciated with learning disabilities.
leakage n. the unintended revelation that a per-
son has a feeling or motive different from the learning disability (LD) any of various condi- L
one intended to be communicated to others. It tions with a neurological basis that are marked
may be manifested, for example, by frequent by substantial deficits in acquiring certain scho-
speech pauses when a person describes an event lastic or academic skills, particularly those asso-
untruthfully. See verbal leakage. See also de- ciated with written or expressive language.
ception clue. Learning disabilities include learning problems
learned helplessness a phenomenon in which that result from perceptual disabilities, brain in-
repeated exposure to uncontrollable stressors re- jury, and minimal brain dysfunction but ex-
sults in individuals failing to use any control clude those that result from visual impairment
opions that may later become available. Essen- or hearing loss, mental retardation, emotional
tially, individuals learn that they lack behavioral disturbance, or environmental, cultural, or eco-
control over environmental events, which, in nomic factors. For diagnostic purposes, learning
turn, undermines the motivation to make disability is the condition that exists when a
changes or attempt to alter situations. Learned peron’s actual performance on achievement test-
helplessness was first described in 1967 by U.S. ing is substantially (typically two standard de-
psychologists J. Bruce Overmier (1938– ) and viations) below that expected for his or her
Martin E. P. Seligman (1942– ) following exper- established intelligence, age, and grade.
iments in which animals exposed to a series of learning disorder (LD) in DSM–IV–TR, any
unavoidable electric shocks (see aversive stim- neurologically based information-processing
ulus) later failed to learn to escape these shocks disorder characterized by achievement that is
when tested in a different apparatus, whereas an- substantially below that achievement expected
imals exposed to shocks that could be termi- for the age, education, and intelligence of the in-
nated by a response did not show interference dividual, as measured by standardized tests in
with escape learning in another apparatus. A reading, mathematics, and written material. In
syndrome with three features developed: (a) a standard practice, a discrepancy of two standard
motivational deficit characterized by a failure to deviations must exist between general intel-
respond when challenged with further aversive ligence testing scores (as measured by a stand-
events; (b) an associative deficit characterized by ard-normed iq test) and achievement scores (as
impairment of learning from successful coping; measured by a standard-normed achievement
and (c) an emotional deficit characterized by ap- test). A discrepancy of between one and two de-
parent underreactivity to painful events—al- viations can be considered a learning disorder if
though later research revealed by assaying some other special feature is present, such as a
corticoid levels that the animals were very cognitive-processing disorder, a relevant mental
stressed. In the 1970s Seligman extended the disorder, a prominent medical disability, or ex-
concept from nonhuman animal research to ceptional absence from formal education. Major
clinical depression in humans (see helplessness types of learning disorders are disorder of
theory). Subsequent researchers have noted a written expression, mathematics disorder,
327
learning disorder not otherwise specified
nonverbal learning disorder, and reading least squares criterion the principle that one
disorder. This term essentially is synonymous should estimate the values of the parameters of a
with learning disability. model in such a way that will minimize the
learning disorder not otherwise speci- squared error of predictions from the model.
fied in DSM–IV–TR, a learning disorder that least squares regression see stepwise re-
does not meet the diagnostic criteria for any of gression.
the specific disorders of this category but never- leaving the field the act of removing oneself
theless causes significant impairment of aca- from a situation when confronted with seem-
demic achievement, for example, because of ingly insurmountable obstacles, insoluble con-
problems in all three areas of reading, writing, flicts, or intensely frustrating problems. It may
and mathematics. involve physical withdrawal, escape into psy-
learning goal in the analysis of personality and chogenic illness, or some other behavior, such
goal-directed motivation of U.S. personality psy- as distraction or changing the subject during a
chologist Carol Dweck (1946– ), a goal to ac- conversation.
quire mastery of a task or subject matter. Also lécheur n. a man or woman who performs
called mastery goal. cunnilingus or fellatio. A female lécheur is
learning paradigm in abnormal psychology, more properly called a lécheuse. See also oro-
the theory that abnormal behavior is learned genital activity.
through the same processes as other forms of be- Lectopam n. a trade name for bromazepam.
havior. left hemisphere the left half of the cerebrum,
Learning Potential Assessment Device the part of the brain concerned with sensation
(LPAD) a test that dynamically assesses individ- and perception, motor control, and higher level
uals’ learning potential. First used primarily for cognitive processes. The two cerebral hemi-
individuals with mental retardation, it has since spheres differ somewhat in function; for exam-
been used for participants displaying a wide vari- ple, in most people the left hemisphere has
ety of skill levels. The test exists in individual greater responsibility for speech. See hemi-
and group versions; it is dynamic in that the spheric lateralization. Compare right
L examinee receives feedback about his or her per- hemisphere.
formance while actually taking the test. The left-hemisphere consciousness the claim by
LPAD is intended primarily for clinical use, U.S. cognitive neuropsychologist Michael Gaz-
yielding interpretive data to help the examiner zaniga that the hemisphere of the brain that
understand the examinee’s pattern of strengths controls speech (the left hemisphere in most
and weaknesses. [devised in 1985 by Romanian- people) is the seat of consciousness. Others, in-
born psychologist Reuven Feuerstein (1921– ) cluding Roger sperry, have proposed that both
and colleagues] hemispheres are independently conscious (see
learning style see cognitive style. right-hemisphere consciousness).
least effort principle the basic behavioral hy- legal capacity the ability to acquire the knowl-
pothesis that an organism will choose a course of edge and understanding necessary to make a ra-
action that appears to require the smallest tional choice regarding any issue that has legal
amount of effort or expenditure of energy. implications (e.g., entering into contracts, mak-
least restrictive alternative the U.S. legal ing a will, standing trial). See also competency
directive that less treatment rather than more to stand trial.
(e.g., community care versus hospitalization) is legal psychiatry see forensic psychiatry.
the most desirable objective in treating people legal psychology see forensic psychology.
with chronic mental disorder. The principal con-
legasthenia n. a controversial syndrome in
sideration is combining safety concerns with the
which the primary symptom is difficulty in syn-
minimum level of restrictions on personal lib-
thesizing letters into words and analyzing words
erty. This position was emphasized in two deci-
into their component letters, despite adequate
sions of U.S. Court of Appeals Judge David L.
intellectual and perceptual ability.
Bazelon (1910–1993) in 1966: Rouse v. Cameron
and Lake v. Cameron. legibility n. the ease with which an environ-
ment can be cognitively represented, which de-
least restrictive environment (LRE) in the
termines one’s ability to navigate or find one’s
United States, an educational setting that gives a
way within an environment or setting. Land-
student with disabilities the opportunity to re-
marks, the overall shape or configuration of
ceive instruction within a classroom that meets
street grids, and building layout can significantly
his or her learning needs and physical require-
influence legibility. See also cognitive map.
ments. According to the Individuals With Dis-
—legible adj.
abilities Education Act, students with disabilities
should be educated with students who do not Lejeune syndrome see cri du chat syn-
have disabilities to the maximum extent possi- drome.
ble, depending on the nature or severity of their length of stay (LOS) the length of an inpa-
disabilities. See also full inclusion; main- tient’s continuous stay in a hospital. A utili-
streaming. zation review will normally compare the LOS
328
Lewin, Kurt
under review with regional norms, as expressed levels of consciousness levels of awareness
by the average LOS for the relevant diagnosis. ranging from alert wakefulness, through relaxed
lesbianism n. female–female sexual orientation wakefulness, drowsiness, sleep, and deep sleep to
or behavior. The name is derived from Lesbos, an coma. Levels of consciousness can be indexed ei-
Aegean island where the poet Sappho (c. 600 ther behaviorally or by means of electroen-
bce) wrote glowing accounts of erotic activities cephalographic or brain imaging methods.
between women. Also called Sapphism. See levodopa (L-dopa) n. the naturally occurring
also homosexuality. —lesbian adj., n. form of dihydroxyphenylalanine (see dopa), a
Lesch–Nyhan syndrome an X-linked reces- precursor of the neurotransmitter dopamine.
sive disorder associated with deficiency of the Synthetic levodopa is used in the treatment of
enzyme hypoxanthine–guanine phospho- Parkinson’s disease (see dopamine-receptor
ribosyltransferase, overproduction of uric agonists), usually in combination with
acid, and a tendency to compulsions involving carbidopa (see sinemet). U.S. trade names:
self-mutilation by biting the lips and fingers. Af- Dopar; Larodopa.
fected individuals have mental retardation, with Levo-Dromoran n. a trade name for levor-
IQs generally below 50. Motor development de- phanol.
teriorates after the first 6 to 8 months of life,
levomepromazine n. see methotrimepra-
marked by spasticity, chorea (involuntary jerky
zine.
movements), and athetosis (sinuous involuntary
movements). Also called hereditary choreo- Levoprome n. a trade name for metho-
athetosis; hereditary hyperuricemia. [de- trimeprazine.
scribed in 1964 by Michael Lesch (1939– ) and levorphanol n. an opioid analgesic produced
William L. Nyhan (1926– ), U.S. pediatricians] by manipulation of the morphine molecule.
lethal catatonia a form of acute maniacal ex- Levorphanol is approximately four to six times
citement that in some cases leads to unexplained more potent as an analgesic than morphine and
death. Also called Bell’s mania; deadly cata- possesses similar risks of dependence and respi-
tonia; exhaustion death. See also hyper- ratory depression. U.S. trade name: Levo-
mania. [first described in 1849 by U.S. physician Dromoran. L
Luther Vose Bell (1806–1862)] Lewin, Kurt (1890–1947) German-born U.S.
lethal dose (LD) the minimum amount of a psychologist. Lewin earned his PhD from the
drug that is required to cause death. It is gener- University of Berlin in 1916, studying under psy-
ally expressed in terms of the median lethal dose chologist Carl Stumpf (1848–1936). He was
(LD50; LD-50), the amount required to cause heavily influenced by the nascent gestalt psy-
death (within a specified time frame) in 50% of chology as well as by the philosophy of Ernst
nonhuman animals to which the drug is admin- Cassirer (1874–1945). The early part of Lewin’s
istered. See also therapeutic ratio. career was spent at the University of Berlin, but
lethality n. the degree of dangerousness or likeli- in 1933, with the rise of the Nazis in Germany,
hood of death associated with a particular course Lewin (a Jew) emigrated to the United States. He
of action. The word is often used when compar- spent nearly a decade at the University of Iowa’s
ing methods of committing suicide. —lethal Child Welfare Research Station, moving to the
adj. Massachusetts Institute of Technology’s new
Center for Group Dynamics in 1944. He was a
lethality scale a set of criteria used to predict founding member of the Society for the Psycho-
the probability of a suicide or attempted suicide logical Study of Social Issues (SPSSI) and the
occurring. A variety of such scales exist, most in- Commission on Community Interrelations of
cluding gender, prior suicide attempts, and psy- the American Jewish Congress. Lewin is known
chiatric diagnosis and history. for both his theoretical and experimental ac-
lethargy n. low energy level and lack of moti- complishments. He developed a comprehensive
vated behavior, often occurring in depression. and holistic field theory, explaining human
—lethargic adj. behavior as a function of various internal and
leucotomy n. see lobotomy. external forces that together interact in a dy-
namic field. His book Principles of Topological
leukotomy (leucotomy) n. see lobotomy.
Psychology (1936) attempted to formalize and
leuprolide n. an analog of gonadotropin- mathematize field theory. His empirical studies
releasing hormone that opposes the action of have been even more influential. Particularly
androgens and estrogens through inhibition of well known are his social psychological experi-
gonadotropin secretion. It is used for the treatments on the styles of democratic leaders versus
ment of uterine tumors, some forms of preco- authoritarian leaders, on frustration and regres-
cious puberty, and advanced prostate cancer. sion in children, on group cohesion, and on
Because of its potent antiandrogen effects, it has group dynamics, a term he coined in 1939. Op-
been used controversially to perform chemical posing the trend to view science as value-free,
castration in repeat sex offenders. U.S. trade Lewin promoted what he called action research,
name (among others): Lupron. a type of socially engaged research, such as his
level of significance see significance level. research on intergroup relations with the Com-
329
Lewy body dementia
mission on Community Interrelations. See also [introduced by Russian-born U.S. psychotherap-

life space; sensitivity training; t-group. ist Samuel Richard Slavson (1890–1981)]
Lewy body dementia a specific type of de- Librium n. a trade name for chlordiazepox-
mentia associated with the presence of abnor- ide.
mal proteins called Lewy bodies in the brain. It is license n. permission granted by a government
characterized by hallucinations and delusions agency for an individual or organization to en-
occurring early in the disease process, marked gage in a given occupation or business on the
day-to-day fluctuations in cognition, and spon- basis of examination, proof of education, or
taneous parkinsonism. [Frederich Heinrich both rather than on measures of performance.
Lewy (1885–1950), German neurologist] See professional licensing. —licensed adj.
lexical hypothesis the supposition that any —licensure n.
significant individual difference, such as a cen- lie scale a group of items on a test (e.g., the min-
tral personality trait, will be encoded into the nesota multiphasic personality inventory)
natural-language lexicon; that is, there will be a used to help evaluate the general truthfulness of
term to describe it in any or all of the languages a person’s responses on the test.
of the world. Also called fundamental lexical
hypothesis. life-change unit (LCU) a unit of measurement
on the life events rating scale, on which di-
LGD abbreviation for leaderless group discus- verse life experiences are assigned numerical val-
sion. ues in accordance with their stress-generating
libidinal development see psychosexual potential. For example, divorce and death of a
development. spouse or significant other are ranked as high
libidinal stage in psychoanalytic theory, any stress generators on the scale, retirement falls at
of the various defined stages of psychosexual about midscale, and moving to a new house and
development, principally the oral stage, the change in sleeping habits are ranked progres-
anal stage, the phallic stage, and the geni- sively lower. Some research indicates that indi-
tal stage. viduals with a high cumulative LCU score (i.e., a
high potential-stress score) show more health
L libidinal transference in psychoanalysis, the changes than other participants. See also life
transference of the patient’s libido, or feel-
crisis.
ings of love, from his or her parents onto his or
her therapist. life coaching a form of teaching and encour-
agement (one-to-one or coach-to-group) based
libidinal types in psychoanalytic theory, a peron counseling principles of sensitivity to needs
sonality classification based on the distribution
and personality differences.
of libido, or sexual energy, in the psyche. In the
erotic type the libido remains largely in the id life crisis a period of distress and major adjust-
and the main interest is in loving and being ment associated with a significant life experi-
loved. In the obsessional type the libido is ence, such as divorce or death of a family
largely invested in the superego and the indi- member. In studies relating health to life crises,
vidual is dominated by conscience. In the narcis- individuals experiencing recent major stress-
sistic type the libido is primarily invested in the producing experiences are more likely than oth-
ego and the main interest is in self-preservation, ers to show significant alterations in mental and
with little concern for others or for the dictates physical health status.
of the superego. [devised by Sigmund freud] life events important occasions throughout the
libidinization n. see erotization. life span that are either age-related and thus ex-
pected (e.g., marriage, retirement) or unrelated
libido n. 1. in psychoanalytic theory, either the to age and unexpected (e.g., accidents, reloca-
psychic energy of the life instinct in general,
tion). Contextual theories of personality often
or the energy of the sexual instinct in particu-
assume that personality is shaped by reactions to
lar. In his first formulation, Sigmund freud con-
stress produced by critical life events.
ceived of this energy as narrowly sexual, but
subsequently he broadened the concept to in- Life Events Rating Scale an instrument used
clude all expressions of love, pleasure, and self- to measure the relative impact of diverse stress-
preservation. See also eros. 2. in the analytic producing life experiences, changes, and crises.
psychology of Carl jung, the general life force The derived score is expressed in life-change
that provides energy for all types of activities: units.
biological, sexual, social, cultural, and creative. life goal in the individual psychology of Alfred
3. more generally, sexual energy or desire. adler, the individual’s concept of what he or
—libidinal adj. —libidinize vb. —libidinous she could attain in life, seen as a means of com-
adj. pensating for real or imagined inferiority. See
libido-binding activity an activity in which also life plan.
members of a therapy group concentrate life history in therapy and counseling, a sys-
libidinal energies on a specific interest or occu- tematic account of the client’s development
pation, rather than on activities that stimulate from birth to the present, including the mean-
the libido. Also called immobilizing activity. ingful aspects of the client’s emotional, social,
330
lifetime risk
and intellectual development. The account is ative valences, that is, forces or pressures on the
taken by the therapist or counselor directly from individual to approach a goal or move away
the client and may additionally be derived from from a perceived danger.
autobiographical material. life-space interview a form of crisis inter-
life-history method a structured intervention involving techniques and strategies in
view that attempts to summarize historical data which children in day and residential treatment
about events that are relevant to evaluating the are interviewed by staff members during mo-
person’s current functioning. ments of crisis or stress, for example, immedi-
life instinct in psychoanalytic theory, the drive ately after receiving an upsetting letter or after
comprising the self-preservation instinct, being attacked by another child. Efforts are made
which is aimed at individual survival, and the to convert these everyday events into therapeu-
sexual instinct, which is aimed at the survival tic experiences by such means as restoring the
of the species. In the dual instinct theory of children’s belief in themselves and strengthen-
Sigmund freud, the life instinct, or eros, stands ing their ego. [originated by Austrian-born U.S.
opposed to the death instinct, or thanatos. psychologist Fritz Redl (1902–1988)]
Also called erotic instinct. life-span contextualism a perspective on
life lie 1. the false conviction held by some indi- human development that views people as both
viduals that their life plan is bound to fail due to products and producers of their own develop-
other people or to circumstances beyond their ment, interacting throughout life with family,
control. This was postulated as a method of free- peers, and other social groups and institutions.
ing oneself from personal responsibility. [de- life-span developmental psychology the
fined by Alfred adler] 2. any false belief around study of psychological and behavioral change
which an individual’s life is built. across and within individuals from birth
lifeline n. a therapeutic technique used in group through death using a life-span perspective.
or individual therapy in which each individual Such an approach assumes that human develop-
draws lines representing his or her life, marking mental processes are complex, interactive, and
past and future expected events with angles indi- fully understood only in the context of influenc-
cating even, upward, or downward progression ing events. It also assumes that there is no end L
of functioning, as well as specific dates and the state of maturity, that no specific period of the
affect surrounding these events. Discussion of life course is more important or influential than
this diagram with the therapist can enhance another in subsequent development, and that
awareness and understanding of the individual’s not all developmental change is related to chro-
life patterns. nological age.
life plan in the individual psychology of Alfred life-span perspective a general perspective
adler, an individual’s style of life and guiding emphasizing (a) that human development is a
fiction as he or she strives to reach his or her lifelong process of change; (b) that developmen-
life goal. tal change is multidimensional and multidirec-
tional, involving both growth and decline in
life review the tendency of individuals, espe-
one’s performance (e.g., of cognitive tasks); and
cially older adults, to reflect upon and analyze
(c) that there is plasticity in human behavior
past life experiences. Life review, or analytical
throughout the entire life span.
reminiscence, is often made use of in counsel-
ing older adults showing symptoms of mild life stress severe strain produced by critical
depression or people with terminal illness, some- life events or similar experiences, such as fail-
times as an adjunct to psychotherapy. [defined ure at work, marital separation, or loss of a loved
in 1961 by U.S. psychiatrist Robert N. Butler one.
(1927–2010)] lifestyle n. 1. the typical way of life or manner of
life satisfaction the extent to which a person living that is characteristic of an individual or
finds life rich, meaningful, full, or of high qual- group, as expressed by behaviors, attitudes, in-
ity. Numerous standardized measures have been terests, and other factors. 2. in the individual
developed to provide an index of a person’s life psychology of Alfred adler, an individual’s
satisfaction in comparison to various normative characteristic way of overcoming or compensat-
groups. Improved life satisfaction is often a goal ing for feelings of inadequacy. According to
of treatment, especially with older people. See Adler, a lifestyle is first adopted in childhood,
also quality of life. when the key factors informing it will be genetic
endowment, upbringing, and interpersonal rela-
life space in the field theory of Kurt lewin,
tions within the family.
the “totality of possible events” for one person at
a particular time, that is, a person’s possible op- lifetime personality the pattern of behavior
tions together with the environment that con- that dominates a person’s lifestyle between birth
tains them. The life space is a representation of and death. [from the personality theory of U.S.
the environmental, biological, social, and psy- psychologist Henry Alexander Murray (1893–
chological influences that define one person’s 1988)]
unique reality at a given moment in time. Con- lifetime risk the odds of a person being diag-
tained within the life space are positive and neg- nosed with a disease or condition during his or
331
light therapy
her lifetime (usually stated in terms of 70 to 85 teria for a panic attack but features fewer than
years). It is often important for individuals un- four somatic or cognitive symptoms.
dergoing genetic counseling to differentiate limited-term psychotherapy see time-
lifetime risk from the risk of being diagnosed limited psychotherapy.
with the disease in the next 5 or 10 years.
linear adj. describing any relationship between
light therapy see phototherapy. two variables (X and Y) that can be expressed in
the form Y = a + bX, where a and b are numerical
likelihood ratio the ratio of two probabilities,
constants. No coefficient can be raised to a
a/b, where a is the probability of obtaining the
power greater than 1 or be the denominator of a
data observed if a particular research hypothesis
fraction. When depicted graphically, the rela-
(A) is true and b is the probability of obtaining
tionship is a straight line.
the data observed when a different hypothesis
(B) is true. linearity n. a relationship in which one variable
is expressed as a linear function of another vari-
Likert scale a type of direct attitude measure able, that is, all coefficients are to the first
that consists of statements reflecting strong posi- power. Linear relationships are often, but not
tive or negative evaluations of an attitude object. necessarily, straight-line relationships.
Respondents indicate their reaction to each
statement on a response scale ranging from linear model any model for empirical data that
“strongly agree” to “strongly disagree,” and attempts to relate the values of the dependent
these ratings are summed to provide a total atti- variable to linear functions of the independent
tude score. Also called Likert summated rat- variables. Most commonly used statistical tech-
ing procedure. [Rensis Likert (1903–1981), niques (analysis of variance, regression analysis,
U.S. psychologist] etc.) can be represented as linear models.
linear regression a regression analysis that
Lilliputian hallucination a visual hallu- assumes that the predictor (independent) vari-
cination of objects, animals, or people greatly able is related to the criterion (dependent) vari-
reduced in size, which may result from a number able through a linear function.
of conditions, such as delirium tremens, ty-
linear system a system in which the response to
L phoid, or brain tumors in the temporal lobe. The
a complex input is the sum of the separate re-
name is derived from Jonathan Swift’s Gulliver’s
Travels (1726), in which Gulliver journeys to the sponses to the separate components of the input
imaginary land of Lilliput, populated by tiny (this is the principle of superposition). In addi-
people. Also called diminutive visual hallu- tion, another condition (homogeneity) is neces-
cination; microptic hallucination. sary: If an input is increased by a certain factor,
the output must increase by the same factor.
limbic system a loosely defined, widespread linear transformation a transformation of X
group of brain nuclei that innervate each other to Y by means of the equation Y = a + bX, where a
to form a network that is involved in autonomic and b are numerical constants.
and visceral processes and mechanisms of emo-
tion, memory, and learning. It includes portions linguistic–kinesic method the objective
of the cerebral cortex, thalamus, and certain study of disordered behavior in terms of lan-
subcortical structures, such as the amygdala, guage and movement involved in interactions
hippocampus, and septal area. between individuals.
Lioresal n. a trade name for baclofen.
Limbitrol n. a trade name for a combination of
the tricyclic antidepressant amitriptyline and liothyronine n. a pharmaceutical preparation
the benzodiazepine chlordiazepoxide, appro- of L-triiodothyronine, a naturally occurring
priate for the treatment of concurrent anxiety thyroid hormone, used to treat conditions asso-
and depression but not now commonly used. ciated with thyroid deficiency. Occasionally it is
used as an adjunct to standard antidepressant
limited competency a determination by a therapy in the management of depression that
court that a person has the capacity to manage has not responded to standard therapy alone.
some but not all of his or her activities. A limited U.S. trade name (among others): Cytomel.
guardian is appointed to assist the individual in lip biting habitual biting of the lips, which may
exercising certain legal rights, such as the right be a nervous habit, a stereotyped behavior (see
to enter into contracts, get married, provide con- stereotypy), or associated with a disorder, such
sent (e.g., for medical treatment), or vote. as lesch–nyhan syndrome. Also called mor-
limited guardianship a form of legal guard- sicatio labiorum.
ianship of a child or adult with a disability (e.g., lipid-metabolism disorders a group of met-
mental retardation) in which a guardian has au- abolic anomalies characterized by abnormal lev-
thority with respect to some areas of activity els of fatty substances in the blood or other
(e.g., legal, financial, health-related) in which tissues, resulting from genetic, endocrine, or ex-
the ward is not capable. ternal factors or organ failure. Lipid-metabolism
limited symptom attack in DSM–IV–TR, a disorders include Niemann–Pick disease and
discrete episode of intense fear or discomfort in Tay–Sachs disease.
the absence of real danger that meets all the cri- lipodystrophy n. any disorder of lipid metabo-
332
lobotomy
lism. Kinds of lipodystrophy include intestinal inositol phosphates, which are second mes-
lipodystrophy, in which a malabsorption of fats sengers in cellular signaling. Toxic doses are no
from the digestive tract may be associated with more than two to three times the therapeutic
lesions in the central nervous system (as in dose, and serum monitoring is required. Symp-
Whipple’s disease); and progressive lipodys- toms of acute toxicity include tremor, diarrhea,
trophy, marked by a symmetrical loss of subcuta- vomiting, and incoordination; at higher doses,
neous fat deposits and abnormal deposits of fat disturbances of heart rhythm and neurological
around the kidney, heart, and abdominal cavity. function leading to coma and death may occur.
No consistent neurological abnormalities are as- Long-term lithium use can cause thyroid and
sociated with the latter form of lipodystrophy, renal dysfunction in a small percentage of pa-
but nearly 20% of the patients in one study tients. Lithium has been associated with fetal
showed signs of mental retardation. The cause of cardiac malformation (Ebstein’s malformation),
progressive lipodystrophy is unknown. Lipodys- and its use in pregnancy is not recommended.
trophy is also associated with diabetes mellitus U.S. trade names (among others): Eskalith;
in a form marked by loss of subcutaneous fat in Lithobid.
areas injected with insulin; this is known as litigious paranoia a type of paranoid disorder
lipotrophic diabetes mellitus or insulin lipo- characterized by constant quarreling, claims of
dystrophy. Manifestations of lipodystrophy are persecution, and insistence that one’s rights
also often found in people living with HIV. have been breached. The individual usually
lip pursing a facial contortion in which the lips threatens to go to court—and frequently does
protrude in a manner that resembles pouting or so—to seek redress for exaggerated or fancied
a snout. First described (as Schnauzkrampf) by wrongs. Also called paranoia querulans;
German psychiatrist Karl Ludwig Kahlbaum paranoid litigious state.
(1828–1899), it is most commonly associated Little Hans a landmark case of Sigmund
with catatonic schizophrenia. freud’s, illustrating the oedipus complex.
liquidation of attachment the process of Freud traced a child’s phobia for horses to cas-
freeing a patient from a painful situation by un- tration anxiety stemming from masturbation,
raveling the attachments in which he or she is to repressed death wishes toward the father, and L
bound. [defined by French psychologist Pierre to fear of retaliation owing to rivalry with the
Janet (1859–1947)] mother, with displacement of these emotions
onto horses. Freud never actually met the boy
listening n. an essential activity in therapy and
but analyzed him through written communica-
counseling that involves attending to the words
tion with the father. The case was reported in
and actions of the client as well as to the inten-
“Analysis of a Phobia in a Five-Year-Old Boy”
tions conveyed by the words. See also active
(1909).
listening.
living will see advance directive.
listening attitude 1. in a therapeutic setting, a
therapist’s openness to a client’s personal experi- LNNB abbreviation for luria–nebraska neuro-
ence, or a client’s openness to his or her own per- psychological battery.
sonal experience. 2. a behavior set in which a lobe n. a subdivision of an organ, such as the
person expects and prepares to receive a mes- brain or the lungs, particularly when rounded
sage. Italian-born U.S. psychiatrist Silvano Arieti and surrounded by distinct structural bound-
(1914–1982) claimed that a person with schizo- aries, such as fissures. The four main lobes of
phrenia who is habitually prepared to experi- each cerebral hemisphere of the brain are the
ence a hallucination may learn to avoid it when frontal lobe, parietal lobe, temporal lobe,
made aware of this attitude. and occipital lobe. There are also subdivisions
literary psychoanalysis the application of of each of these lobes; for example, the temporal
psychoanalysis and psychoanalytic theory to lit- lobe comprises the inferior, middle, and superior
erary interpretation. temporal lobes. —lobar adj. —lobate adj.
lithium n. an element of the alkali metal group lobectomy n. complete or partial surgical re-
whose salts are used in psychopharmacotherapy moval of a lobe, particularly in the brain. The
as mood stabilizers. Lithium salts were first most frequently performed lobectomy is done
used for the treatment of mania in the 1940s, but for seizure control and involves the anterior tem-
widespread use was limited by their toxicity. poral lobe (see temporal lobectomy).
However, after further investigations into their lobotomy n. incision into various nerve tracts in
role in treating bipolar depression, and better ap- the frontal lobe of the brain. The original sur-
preciation of the appropriate dosage, lithium gical procedure, called prefrontal (or frontal) lo-
salts entered broader clinical practice in the botomy, was introduced in 1936 by Portuguese
1970s. Although its primary indication (appro- neurologist Antonio Egas Moniz (1874–1955):
priate use) is in managing bipolar disorder, lith- Connections between the frontal lobe and other
ium has some efficacy in managing acute manic brain structures—notably the thalamus—were
phases and in reducing relapse. Its mechanism of severed by manipulating a narrow blade known
action remains unclear; it most likely works via as a leukotome inserted into brain tissue through
inhibition of the recycling of inositol from the several small holes drilled in the skull. A second
333
LOC
procedure, called transorbital lobotomy, was de- rhage in the brain, a butterfly rash on the skin).
vised in 1945 and involved the manipulation of 2. the position of a gene on a chromosome.
a pointed instrument resembling an ice pick locus of control a construct that is used to cate-
driven with a mallet through the thin bony wall gorize people’s basic motivational orientations
of the eye socket and into the prefrontal brain. and perceptions of how much control they have
Both procedures were widely used to relieve the over the conditions of their lives. People with an
symtoms of severe mental disorder (including external locus of control tend to behave in re-
depression and schizophrenia) until the advent sponse to external circumstances and to perceive
of antipsychotic drugs in the 1950s. These op- their life outcomes as arising from factors out of
erations have been replaced by more sophisti- their control. People with an internal locus of
cated, stereotactic forms of neurosurgery that are control tend to behave in response to internal
less invasive and whose effects are more certain states and intentions and to perceive their
and less damaging. Also called leukotomy. life outcomes as arising from the exercise of
LOC abbreviation for loss of consciousness. their own agency and abilities. [introduced into
localization of function the concept that psychology by U.S. psychologist Julian Rotter
specific parts of the cerebral cortex are relatively (1916– )]
specialized for particular types of cognitive and logical positivism a philosophical perspective
behavioral processes. Also called cortical lo- that is committed to the principle of verifica-
calization; localization. tion, which holds that the meaning and truth of
localized amnesia a memory loss restricted to all nontautological statements is dependent on
specific or isolated experiences. Also called cir- empirical observation. In the early 20th century,
cumscribed anmesia; lacunar amnesia. the positivists of the so-called Vienna Circle
sought to establish the essential unity of logic,
locked-in syndrome a neurological condition,
philosophy, and science and to distinguish these
due to an injury to the brain, in which the indi-
disciplines from such others as metaphysics, eth-
vidual is conscious but completely paralyzed,
ics, and religion, which were dismissed for their
unable to speak or move. Cognition is intact,
speculative character. The positivist view of sci-
and electroencephalograms (see electroence-
L ence was influential during the period in which
phalography) are normal.
psychology emerged as a science and has had a
locked ward a secured hospital unit in which recognizable influence on the discipline. This is
patients with severe mental disorders reside. The most pronounced in behaviorism and in psy-
present trend is toward elimination of locked chology’s commitment to empirical scientific
wards, since patients may feel they are being in- methods. Logical positivism had waned by the
carcerated and punished for being ill. Other fac- middle of the century. See positivism. See also
tors leading to less frequent use of such wards are physicalism reductionism.
improvements in psychological interventions,
the use of psychoactive drugs, an increase in the logistic regression a statistical technique for
staff–patient ratio, and the concepts of the open the prediction of a binary dependent variable
hospital and therapeutic community. from one or more continuous variables.
loco plant any of certain plants belonging to the logopathy n. a speech disorder of any kind.
genera Astragalus or Oxytropis that grow wild logorrhea n. rapid, uncontrollable, and incoher-
in western North America, particularly in the ent speech, sometimes occurring as part of a
Rocky Mountains, and damage the nerve tissue manic episode. It was formerly known as
of humans and animals that ingest them (loco is hyperlogia or hyperphrasia. Also called verbo-
the Spanish word for “crazy”). The substances mania.
responsible include miserotoxin, swainsonine, logotherapy n. an approach to psychotherapy
and selenium. Symptoms of poisoning include that focuses on the “human predicament,” help-
muscular trembling or incoordination, staggering the client to overcome crises in meaning.
ing gait, and impairment of depth and other sen- The therapeutic process typically consists of ex-
sory perception. In sufficient doses, these toxins amining three types of values: (a) creative (e.g.,
produce irreversible changes in the central ner- work, achievement); (b) experiential (e.g., art,
vous system, including brain lesions and even- science, philosophy, understanding, loving);
tual paralysis, and may cause coma or death. and (c) attitudinal (e.g., facing pain and suffer-
Also called loco weed. ing). Each client is encouraged to arrive at his
locura n. a culture-bound syndrome found or her own solution, which should incorporate
among Latino groups in the United States and social responsibility and constructive relation-
Latin America and attributed to hereditary vul- ships. Also called meaning-centered ther-
nerability, the consequences of stressful and dif- apy. See also existential psychotherapy; ex-
ficult life events, or a combination of the two. istentialism. [developed in the 1950s and
Symptoms include incoherence, agitation, audi- 1960s by Austrian psychiatrist Viktor E. Frankl
tory and visual hallucinations, social dysfunc- (1905–1997)]
tion, erratic behavior, and possibly violence. Lokian personality a personality pattern
locus n. (pl. loci) 1. the place or position of an characterized by the desire to cause distress to
anatomical or pathological entity (e.g., a hemor- others, manipulative behavior, and deceit. The
334
love
name is derived from Loki, the Norse god of mis- eral categories, including declarative memory
chief. and procedural memory. See also secondary
Lolita complex see nympholepsy. memory.
London syndrome explicit and constant resis- long-term potentiation (LTP) enhancement
tance and refusal by hostages to do what captors of synaptic transmission (see synapse), which
expect during a hostage situation, first identified can last for weeks, caused by repeated brief stim-
in 1981 after a hostage-taking incident in Lon- ulations of one nerve cell that trigger stimula-
don. It may result in serious injury and death to tion of a succeeding cell. The capacity for
the resistors. potentiation has been best shown in hippo-
campal tissue. LTP is studied as a model of the
loneliness n. affective and cognitive discomfort neural changes that underlie memory formation
or uneasiness from being or perceiving oneself and it may be a mechanism involved in some
to be alone or otherwise solitary. Psychological kinds of learning. Compare long-term depres-
theory and research offer multiple perspectives: sion.
Social psychology emphasizes the emotional dis-
tress that results when inherent needs for inti- long-term therapy psychotherapy over a pe-
macy and companionship are not met; cognitive riod of many months or years. Classic psycho-
psychology emphasizes the unpleasant and un- analysis, which may last 2–5 years or longer, is
settling experience that results from a perceived a primary example.
discrepancy (i.e., deficiency in quantity or qual- loosening of associations a thought distur-
ity) between an individual’s desired and actual bance demonstrated by speech that is discon-
social relationships. Psychologists from the ex- nected and fragmented, with the individual
istential or humanistic perspectives may see jumping from one idea to another unrelated or
loneliness as an inevitable, painful aspect of the indirectly related idea. It is essentially equivalent
human condition that, nevertheless, may con- to derailment.
tribute to increased self-awareness and renewal. loperamide n. an opioid that slows gastrointes-
longitudinal adj. 1. in anatomy, referring to tinal motility and is used for the treatment of di-
the long axis of the body. 2. in research, refer- arrhea. Because it is not effectively transported
ring to the time dimension, that is, running over across the blood–brain barrier, it has few (if L
an extended period. any) psychotropic effects and its abuse potential
longitudinal design the study of a variable or is low. U.S. trade name: Imodium.
group of variables in the same cases or partici- lorazepam n. a highly potent benzodiazepine
pants over a period of time, sometimes of several approved for the treatment of anxiety and as
years. An example of a longitudinal design is premedication in surgical anesthesia. Unlike
a comparative study of the same group of chil- many other benzodiazepines, it has no active
dren in an urban and a suburban school over metabolic products and therefore requires mini-
several years for the purpose of recording their mal processing in the liver. This, together with
cognitive development in depth. Compare its predictable duration of action, make it a fa-
cross-sectional design. vored drug in the management of alcohol with-
longitudinal stability the degree to which an drawal in patients with liver impairment. U.S.
individual’s possession or expression of a psy- trade name (among others): Ativan.
chological characteristic is consistent over a pe- LOS abbreviation for length of stay.
riod. loss of affect loss of the ability to respond emo-
long-term care facility an extended care tionally, which results in flat affect.
institution, such as a nursing home, that pro- loss of consciousness (LOC) a state in which
vides medical and personal services for patients an organism capable of consciousness can no
who are unable to live independently but do not longer experience events or exert voluntary con-
require the inpatient services of a hospital. trol. Examples of conditions associated with loss
long-term depression (LTD) a long-lasting of consciousness include fainting (syncope),
decrease in the amplitude of neuronal response deep sleep, traumatic brain injury, coma, general
due to persistent weak synaptic stimulation (in anesthesia, narcolepsy, and epileptic absence.
the case of the hippocampus) or strong synaptic love n. a complex yet basically integrated emo-
stimulation (in the case of the cerebellum). tion involving strong feelings of affection and
Compare long-term potentiation. tenderness for the love object, pleasurable sensa-
long-term memory (LTM) a relatively perma- tions in his or her presence, devotion to his
nent information storage system, enabling one or her well-being, and sensitivity to his or her re-
to retain, retrieve, and make use of skills and actions to oneself. Although love takes many
knowledge hours, weeks, or even years after they forms, including concern for one’s fellow hu-
were originally learned. Various theories have mans (brotherly love), parental love, erotic love,
been proposed to explain the biological pro- self-love, and identification with the totality of
cesses by which this occurs and a major distinc- being (e.g., love of God), the triangular the-
tion is made between LTM and short-term ory of love proposes three essential compo-
memory. Additionally, LTM is divided into sev- nents: passion, intimacy, and commitment.
335
lovemap
Social psychological research in this area has fo- LRP abbreviation for lateralized readiness po-
cused largely on passionate love, in which tential.
passion (sexual desire and excitement) is pre- LSD lysergic acid diethylamide: a highly potent
dominant, and companionate love, in which hallucinogen that structurally resembles the
passion is relatively weak and commitment is neurotransmitter serotonin and presumably
strong. exerts its psychoactive effects by acting as a par-
lovemap n. a person’s mental image of the ideal tial agonist at the 5-HT2A serotonin receptor. It
lover, the ideal love relationship, and ideal sex- was originally synthesized from the ergot alka-
ual activity with that partner, expressed in loid lysergic acid in 1938 by Swiss chemist Al-
fantasy and in actual sexual behavior. It incorpo- bert Hoffman, who then discovered its
rates issues of sexual orientation and also of hallucinogenic effects on accidental ingestion in
desire for deviant behaviors (see paraphilia), 1943. At very low doses it is capable of producing
which are called altered lovemaps. [developed visual distortions (sharpened sense of color) or
by New Zealand-born psychologist John Money frank hallucinations, together with feelings of
(1921–2006)] euphoria or arousal; it became a widely used and
love need in maslow’s motivational hierar- controversial recreational drug during the mid-
chy, the third level of the hierarchy of needs, 1960s and early 1970s. The effects of LSD were
characterized by the striving for affiliation and the subject of research during the 1950s as a pos-
acceptance. Also called belongingness and sible model for psychosis, and various attempts
love needs; social need. were made to use LSD as an aid to psychotherapy
(see psychedelic therapy), although they did
love object 1. the person in whom an individual not prove effective. Although the drug is usually
invests the emotions of affection, devotion, and, taken orally, it has been known to be injected
usually, sexual interest. 2. in psychoanalytic the- subcutaneously or intravenously. It can also be
ory, the person who is loved by the individual’s smoked, in which case intoxication is quite
ego, as opposed to the object that satisfies an mild.
instinct.
LSD psychotherapy an experimental tech-
love withdrawal a form of discipline in which nique, used in the 1960s, in which the drug LSD
L parents threaten to withdraw their love and af- (lysergic acid diethylamide) was administered to
fection from children if they misbehave. patients with chronic alcoholism and serious
Lowe’s syndrome see oculocerebrorenal mental disorders (e.g., schizophrenia) as a means
syndrome. of facilitating the process of uncovering and re-
low normal see below average. living memories and increasing the patients’
ability to communicate their thoughts and feel-
low vision reduction of visual capacity (espe- ings. Subsequent research not only failed to
cially visual acuity and visual field), regardless of
confirm therapeutic value but also revealed sig-
the underlying cause, that cannot be corrected
nificant physiological, behavioral, and mental
to the normal range with glasses, contact lenses,
health risks in the therapeutic use of LSD, result-
or medical or surgical treatment. Low vision
ing in the abandonment of the technique. See
causes problems with various aspects of visual
hallucinogen; psychedelic therapy.
performance (e.g., mobility, reading) and is
often associated with a decline in quality of life, LTM abbreviation for long-term memory.
an increased risk of depression, and decreased LTP abbreviation for long-term potentiation.
functional status. Low vision services provided lucid dream a dream in which the sleeper is
to those with this condition include assessment aware that he or she is dreaming and may be able
of an individual’s residual vision and instruction to influence the progress of the dream narrative.
in the use of high-powered optical devices (see Voluntary signaling of prespecified dream fea-
vision rehabilitation). Also called partial tures is also possible.
sight. See also blindness; visual impairment.
lucid interval a period of mental clarity follow-
loxapine n. an antipsychotic introduced into ing a period of delirium, disorganization, or con-
the U.S. market in the early 1970s. Loxapine diffusion brought on by a mental condition, such
fers from the traditional antipsychotics in that it as a psychotic state.
binds strongly to serotonergic as well as
lucidity n. a mental state in which a person may
dopaminergic receptors. Although its chemical
not have complete ability to reason or compre-
structure (see dibenzoxazepine) is similar to
hend complex matters but has adequate mental
that of the atypical antipsychotic clozapine,
powers to be legally responsible for his or her ac-
loxapine has the same antipsychotic, anti-
tions. —lucid adj.
emetic, sedative, and extrapyramidal properties
as the traditional antipsychotic agents. U.S. ludes n. slang for methaqualone.
trade name: Loxitane. Ludiomil n. a trade name for maprotiline.
LPAD abbreviation for learning potential as- Luminal n. a trade name for phenobarbital.
sessment device. lunacy n. 1. an obsolete name for any mental ill-
LRE abbreviation for least restrictive envi- ness. 2. in legal use, an obsolete name for mental
ronment. incompetence or legal insanity. 3. the theory
336
lysinuria
that some forms of mental illness correspond luria’s neuropsychological testing procedures.
with the phases of the moon. See also moon- The battery is available in two versions (Form I
phase studies. —lunatic adj., n. comprising 269 items and Form II comprising
lunatic asylum an obsolete name for a psychi- 279 items) and is used to diagnose general and
atric hospital or a mental institution. specific cerebral dysfunction and to localize
impaired brain areas. It includes 11 clinical
Lunesta n. a trade name for eszopiclone.
scales, each representing different aspects of rele-
Lupron n. a trade name for leuprolide. vant skills: motor functions, tactile functions,
lupus erythematosus (LE) an autoimmune visual functions, rhythm, receptive speech, ex-
disorder causing chronic inflammation of con- pressive speech, writing, reading, arithmetic,
nective tissue and characterized by joint pains, a memory, and intellectual processes; Form II also
butterfly-shaped rash on the nose and cheeks, includes an intermediate-term memory scale.
and scaly red patches on the skin. The condition [originally developed in 1978 by U.S. clinical
may be limited to the skin (discoid lupus ery- psychologists Charles J. Golden (1949– ),
thematosus; DLE) or it may also affect internal Thomas A. Hammeke (1950– ), and Arnold D.
organs, such as the heart, lungs, and central Purisch (1951– )]
nervous system (systemic lupus erythematosus; lust n. a very intense desire, usually associated
SLE) and involve neurological abnormalities, with erotic excitement or arousal.
such as seizures and psychosis.
lust murder an extreme form of sexual sadism
Luria, Alexander R. (1902–1977) Russian
in which an individual experiences sexual
neuropsychologist. Luria earned a degree in
arousal from the murder of a partner during the
medicine in 1937 from the Moscow Medical
sexual act, often including elaborate staging of
School, having already worked in the field of
the act and mutilation of the victim’s body. Also
psychology for over a decade. In the 1920s, be-
called erotophonophilia. See also homicido-
fore his medical training, Luria collaborated
philia.
with Lev vygotsky on the sociocultural theory
of language. During World War II, Luria headed Luvox n. a trade name for fluvoxamine.
psychological services in a brain trauma hospi- lygophilia n. an abnormal desire to be in dark or
tal; following the war he became a faculty mem- gloomy places. L
ber in neuropsychology at Moscow University
Lyme disease a multisystemic illness caused by
and head of the neuropsychological laboratory
spirochete bacteria transmitted through the bite
at the Burdenko Institute of Neurosurgery, from
of an infected deer tick. Initial effects are a red
which he was forced to resign for political rea-
rash around the site of the bite as well as flulike
sons. It is for his research and theories on brain
symptoms of fever, fatigue, headache, and body
trauma and brain function that Luria is perhaps
ache. If left untreated, the disease can result in
best known. He developed a system of neuro-
arthritis, neurological symptoms (e.g., severe
psychological assessment that aided in diag-
headache and temporary paralysis), and prob-
nosis, treatment, and rehabilitation of brain
lems with memory loss, concentration, sleep,
trauma patients. His assessment techniques also
and mood changes. Its manifestation of physi-
proved valuable in the cognitive assessment of
cal, cognitive, and psychiatric symptoms makes
children. Luria’s work became influential out-
it difficult to diagnose. The disease was first rec-
side Russia in the 1960s and 1970s. Some of his
ognized in 1975 after a large number of children
best known books include The Working Brain
in Lyme, Connecticut, and nearby towns were
(1973), Cognitive Development: Cultural and Social
initially diagnosed with rheumatoid arthritis.
Foundations (1976), The Making of Mind (1979),
and Language and Cognition (1982). lysergic acid diethylamide see lsd.
Luria–Nebraska Neuropsychological lysinuria n. the presence of the amino acid
Battery (LNNB) a set of tests to assess the cog- lysine in the urine, due to deficiency of an
nitive functioning of individuals aged 15 years enzyme involved in its metabolism. It is an
and older that is intended to represent a stan- inherited condition associated with muscle
dardized, quantitative version of Alexander weakness and mental retardation.
337
Mm
M 1. abbreviation for memory. 2. symbol for changes in mental status, emotional
mean. disturbance, gastrointestinal disturbances, and
mace n. an aromatic spice made from the fibrous weakness or partial paralysis of the legs. The con-
seed coat of the nutmeg. Mace has been associ- dition may also cause psychosis, behavioral
ated with the euphoric effects produced by changes, erethism, and several other symp-
nutmeg intoxication, although the active ingre- toms. Also called Mad Hatter’s syndrome.
dients of nutmeg are concentrated primarily in madness n. an obsolete name for mental illness
the oil of the nut. or for legal insanity.
Machover Draw-a-Person Test (DAP Test) MAE abbreviation for multilingual aphasia ex-
a projective technique based on the interpreta- amination.
tion of drawings of human figures. The partici- magic n. 1. a system of practices in which hu-
pant is given a sheet of blank paper and asked mans attempt to manipulate natural or super-
first to draw an entire person, without specifica- natural forces through such means as rituals,
tion of details of age, sex, clothing, and so forth, incantations, and spells. Magic had an impor-
and then to draw another person, without any tant social role in many prescientific societies,
specification other than that it must be of oppo- where its practitioners often held great power
site sex from the first. The examiner, relying on and authority. In the modern world, magical be-
his or her individual clinical experience, then in- lief has survived most obviously as an under-
terprets the drawings and any verbalizations the ground esoteric tradition but also in many
participant made while creating them in order to popular superstitions and “New Age” practices.
formulate a description of the participant’s per- Magical rituals can be said to differ from reli-
sonality and identify signs of pathology. Various gious rituals in that they involve a direct attempt
features of the drawings that are assessed include to control certain physical facts (e.g., the
sequence of sex (whether a male or female is weather), as opposed to a supplication to a
drawn first), the order in which body parts are higher power or powers. 2. in some individuals
drawn, distortions, omissions, size, and cloth- with obsessive-compulsive disorder, at-
ing, as well as more structural elements, such as tempts to allay anxiety by invoking certain num-
direction of pencil strokes, shadings, and era- bers or performing certain rituals. See also
sures. Analogous to this test is the Machover magical thinking. —magical adj.
Draw-a-House Test (DAH Test). [developed in
magical thinking the belief that events or the
1949 by Karen Machover (1902–1996), U.S. psy-
behavior of others can be influenced by one’s
chologist]
thoughts, wishes, or rituals. Magical thinking is
macrobiotics n. a theory of nutrition that is typical of children up to 4 or 5 years of age, after
based on achieving balance and harmony be- which reality thinking begins to predominate.
tween foods that are classified, according to the
magic bone see voodoo death.
Chinese concept, as either yin or yang (the two
opposite but contrary principles governing the magic circle a group technique, usually used
universe in Chinese philosophy). Macrobiotic with children, who gather in a circle and discuss
diets consist mainly of whole grains and vegeta- personal issues and concerns. A variation for use
bles, with fruit and occasional fish; animal prod- in school was developed by U.S. psychiatrist Wil-
ucts are avoided. Food is prepared and cooked in liam Glasser (1925– ) to increase motivation
particular ways to preserve the yin and yang for learning.
characteristics. [introduced to the West by Japa- magic mushroom see psilocin.
nese educator George Ohsawa (1893–1966)] magic omnipotence see cosmic identifica-
macrocephaly n. a condition in which the tion.
head is abnormally large in relation to the rest of Magna Mater Carl jung’s archetype of the pri-
the body. It can result in moderate to severe mordial mother image, based on the Great
mental retardation with impaired vision and sei- Mother of the Roman gods, Cybele. She repre-
zures. Also called megalocephaly. Compare sents that which is loving, sustaining, and foster-
microcephaly. —macrocephalic adj. ing of growth and creativity. See also mother
MADD abbreviation for mothers against archetype. [Latin: “great mother”]
drunk driving. magnetic resonance imaging (MRI) a
Mad Hatter’s disease a condition caused by noninvasive diagnostic technique that uses
chronic mercury poisoning and characterized by the responses of hydrogen in tissue molecules
338
mal de pelea
to strong magnetic impulses to form a three- preventing relapse. Drugs that may be used for
dimensional picture of body organs and tissues maintenance include methadone (see metha-
(e.g., the brain) with more accuracy than done maintenance therapy), antipsychotics,
computed tomography. See also functional lithium, and antidepressants. Prophylactic main-
magnetic resonance imaging. tenance alone, however, does not eliminate re-
magnetoencephalography (MEG) n. the lapse; for several conditions, evidence suggests
measurement of the magnetic fields arising from that psychotherapy must also be included
the electrical activity of the brain, using a device to minimize relapse. Although maintenance
called a magnetoencephalograph (MEG). See also therapy is often continued indefinitely, patients
superconducting quantum interference should be periodically reassessed to determine if
device. such treatment is still necessary.
magnitude of effect see effect size. major depressive disorder a depressive dis-
order in which the individual has experienced
maieutic technique in psychotherapy, a com-
at least one major depressive episode but
monly used form of socratic dialogue in
has never experienced a manic episode, mixed
which pertinent questions are asked to achieve
episode, or hypomanic episode. Also called
understanding on the part of the person being
major depression.
questioned. The questioner often already knows
the answers. [from Greek maieutikos, literally: re- major depressive episode an episode of a
lating to midwifery or acting as a midwife] mood disorder in which, for at least 2 weeks,
the individual has either persistent depressed
main effect the consistent total effect of a par-
mood or anhedonia as well as at least four other
ticular independent variable on a dependent
symptoms. These other symptoms include: poor
variable over all other independent variables in
or increased appetite with significant weight loss
an experimental design. It is separate from, but
or gain; insomnia or excessive sleep; psycho-
may be obscured by, an interaction effect.
motor agitation or psychomotor retarda-
mainlining n. slang for taking illicit drugs by in- tion; loss of energy with fatigue; feelings of
travenous injection. See intravenous drug worthlessness or inappropriate guilt; reduced
usage. —mainliner n. ability to concentrate or make decisions; and re-
mainstreaming n. 1. the placement of chil- current thoughts of death, suicidal ideation,
dren with disabilities into regular classroom en- or attempted suicide. All of these symptoms
vironments on a part-time basis, such that they cause significant distress or impair normal func- M
attend only some regular education classes dur- tioning (social, occupational, etc.). One or more
ing the school day and spend the remaining major depressive episodes are a characteristic
time in special education classes. The aim is to feature of major depressive disorder and bi-
offer each child the opportunity to learn in an polar II disorder and often occur in bipolar I dis-
environment that has the highest probability of order (see bipolar disorder).
facilitating rehabilitation efforts and supporting major tranquilizer see antipsychotic.
academic growth, although some critics have
maladaptation n. a condition in which biolog-
denounced the practice as requiring that chil-
ical traits or behavior patterns are detrimental,
dren with disabilities “earn” their opportunity to
counterproductive, or otherwise interfere with
participate in a regular classroom. See also full
optimal functioning in various domains, such as
inclusion; least restrictive environment.
successful interaction with the environment and
2. the return of recovered or deinstitutionalized
effectual coping with the challenges and stresses
patients to the community, where they receive
of daily life. Compare adaptation. —mala-
rehabilitative assistance directed toward helping
daptive adj.
them achieve as full and normal a life as possi-
ble. maladjustment n. 1. inability to maintain
effective relationships, function successfully in
maintaining cause an influence in a person’s
various domains, or cope with difficulties and
environment that tends to maintain and rein-
stresses. 2. any emotional disturbance of a rela-
force maladaptive behavior. An example is the
tively minor nature. —maladjusted adj.
required participation at cocktail parties of a pro-
fessional person with alcoholism. malaise n. a vague feeling of general illness, dis-
comfort, or uneasiness.
maintenance therapy treatment or therapy
designed to maintain patients in a stable con- mal de ojo a culture-bound syndrome, re-
dition and to promote gradual healing or pre- ported in many Mediterranean regions, that is
vent relapse. It usually (but not always) refers to characterized by fever, sleep disturbances, and
maintenance drug therapy (maintenance phar- gastrointestinal problems. It most commonly af-
macotherapy or prophylactic maintenance). Drug fects children; the Spanish name translates to
therapy is generally divided into three phases— evil eye.
acute, continuation, and maintenance—roughly mal de pelea a culture-bound syndrome
corresponding to intervals of 1 month, 6 months, found in Puerto Rico that is similar to amok. In-
and a year or longer. Patients who respond in the dividuals experience a period of brooding and
acute and continuation phases may be placed on then suddenly become violent and attack others
maintenance pharmacotherapy in the hopes of around them (the Spanish name literally means
339
maldevelopment
“fighting sickness”). Also called Puerto Rican or unfair treatment during childhood, has been
syndrome. posited to be the basis for social withdrawal, hos-
maldevelopment n. the abnormal develop- tility, and, in some cases, mental disorder of a
ment of an individual because of genetic, di- persecutory nature. [first described by U.S. psy-
etary, or external factors that interfere with chiatrist Harry Stack Sullivan (1892–1949)]
growth of tissues and bodily functions. malformation n. any abnormality of structure:
male climacteric a hypothetical period in a deformity.
some men’s lives that has been compared to fe- malice aforethought the mental elements of
male menopause (see climacteric). Popularly premeditation and deliberation or extreme dis-
known as male menopause, it occurs some 10 regard for human life that are required for a per-
years later than in women and appears to be as- son to be convicted of first-degree murder.
sociated with declines in the levels of various malignant adj. 1. describing a disorder that gets
hormones, such as testosterone. Symptoms, progressively worse or is resistant to treatment,
when they occur, include fatigue, problems with eventually causing death. 2. describing a tumor
memory and concentration, decreased sexual that invades and destroys tissues and may also
desire, erectile dysfunction, and (in some cases) spread to other sites (i.e., undergo metastasis).
depression. Also called andropause; male See cancer; neoplasm. Compare benign.
climacterium.
mali-mali n. a culture-bound syndrome
male continence see ejaculatio retardata; found in the Philippines, with symptoms similar
coitus reservatus. to those of latah.
male erectile disorder in DSM–IV–TR, persis- malingering n. the deliberate feigning of an ill-
tent or recurrent inability in a man to achieve or ness or disability to achieve a particular desired
maintain an erection adequate to complete the outcome (e.g., financial gain or escaping respon-
sex act. It causes marked distress and impair- sibility, punishment, imprisonment, or military
ment of interpersonal relations and is not due to duty). For example, it may take the form of fak-
the physiological effects of a physical disorder, ing mental illness as a defense in a trial, faking
medication, or a substance of abuse. The disor- physical illness to win compensation, and, in
der may be lifelong or acquired and either situa- sport, faking an injury or misinforming people
tional (occurring only in certain situations or of one’s state of rehabilitation in order to avoid
M with certain partners) or generalized (occurring practicing or playing. Malingering is distin-
in all situations). See also erectile dysfunc- guished from factitious disorder in that it in-
tion; impotence. volves a specific external factor as the
male homosexual prostitution sexual con- motivating force. —malingerer n.
tact between males for the financial or other malnutrition n. a state of health characterized
gain of one of the participants. Studies indicate by an improper balance of carbohydrates, fats,
that a social hierarchy exists among male prosti- proteins, vitamins, and minerals in the diet with
tutes, as in female prostitution. Lowest in status respect to energy needs as reflected in physical
are the street hustlers, who are usually teenage activity. Malnutrition may be due to excessive
boys and not necessarily gay themselves; next intakes of food categories, as in obesity and
are the bar hustlers; and highest in prestige are hypervitaminosis (see vitamin a toxicity; vi-
the call boys, who do not solicit in public. tamin d toxicity), as well as inadequate levels.
maleness n. the quality of being male in the Dietary deficiencies are associated with many
anatomical and physiological sense by virtue of physical and psychological disorders. For exam-
possessing the XY combination of sex chromo- ple, nicotinic acid deficiency is marked by de-
somes. Compare masculinity. pression and other mental disturbances (see
pellagra). See also kwashiorkor; marasmus;
male orgasmic disorder in DSM–IV–TR, per- vitamin deficiency.
sistent or recurrent delay in, or absence of, male
orgasm during sexual stimulation that produces malpractice n. professional misconduct or neg-
arousal. The man’s age and the quality and dura- ligent behavior on the part of a practitioner (e.g.,
tion of stimulation are considered in making this a psychotherapist, psychiatrist, doctor, lawyer,
diagnosis, which does not apply if the condition or financial adviser) that may lead to legal ac-
is due only to the effects of drugs, medications, tion.
or medical conditions. mal puesto see rootwork.
male sexual disorder any problem in sexual maltreatment n. abuse or neglect of another
function experienced by males. See hypoactive person, which may involve emotional, sexual, or
sexual desire disorder; male orgasmic dis- physical action or inaction, the severity or
order; premature ejaculation; primary chronicity of which can result in significant
erectile dysfunction; secondary erectile harm or injury. Maltreatment also includes such
dysfunction. actions as exploitation and denial of basic needs
malevolent transformation the feeling that (e.g., food, shelter, medical attention).
one lives among enemies and can trust no one. mammalingus n. the act of suckling the breast
This attitude, purported to be the result of harsh during sexual intercourse, particularly in terms
340
manipulation check
of the concept, proposed by British psychoana- mania a potu see idiosyncratic intoxica-
lyst Ernest Jones (1879–1958), that the act rep- tion.
resents a type of fellatio. Mammalingus is distin- maniac n. 1. a lay term for a mentally or emo-
guished from the normal interest and pleasure tionally disturbed person, particularly one who
derived from caressing or orally stimulating the is considered dangerous to others. 2. an obsolete
breasts as a part of sexual activity. name for a person who experiences mania. See
mammillary body either of a pair of small, also manic.
spherical nuclei at the base of the brain, slightly manic 1. adj. relating to mania. 2. n. an obsolete
posterior to the infundibulum (pituitary stalk), name for a person experiencing a manic epi-
that are components of the limbic system. Also sode.
called corpus mammillare. manic-depressive illness see bipolar disor-
managed behavioral health organiza- der.
tion (MBHO) a health maintenance organiza- manic episode a period lasting at least 1 week
tion (see hmo) that specializes in the manage- characterized by elevated, expansive, or irritable
ment, administration, and provision of health mood with three or more of the following symp-
care benefits with an emphasis on behavioral toms: an increase in activity or psychomotor
health. agitation; talkativeness or pressured speech;
managed care any system of health care deliv- flight of ideas or racing thoughts; inflated self-
ery that regulates the use of member benefits esteem or grandiosity; a decreased need for
to contain expenses. The term originally referred sleep; extreme distractibility; and involvement
to prepaid health plans (e.g., hmos) but is now in pleasurable activities that are likely to have
applied to many different kinds of reimburse- unfortunate consequences, such as buying
ment and utilization review mechanisms. It is sprees, foolish investments, sexual indiscretions,
also used to denote the organization of health or reckless driving. All of these symptoms impair
care services and facilities into groups to increase normal functioning and relationships with oth-
cost-effectiveness. Managed care organizations ers. One or more manic episodes are characteris-
(MCOs) include HMOs, ppos (preferred provider tic of bipolar I disorder (see bipolar disorder).
organizations), point of service plans (POSs), See also mixed episode.
exclusive provider organizations (EPOs), physi- manic state a condition that meets all the crite-
cian–hospital organizations (PHOs), inte- ria for a manic episode or a hypomanic epi-
grated delivery systems (IDSs), and inde-
M
sode with regard to symptoms but not
pendent practice associations (IPAs). necessarily the duration required.
mandated reporting the legal requirement in manifest anxiety in psychoanalysis, anxiety
the United States that psychologists and other with overt symptoms that indicate underlying
human services personnel (e.g., social workers emotional conflict or repression.
and nurses) report any suspected or known cases
Manifest Anxiety Scale see children’s man-
of child abuse or neglect. Those who fail to re-
ifest anxiety scale; taylor manifest anxiety
port such cases may be subject to legal and pro-
scale.
fessional sanctions.
manifestation n. an observable expression, in-
mandibulofacial dysostosis see treacher dication, or sign of a physical or psychological
collins syndrome. condition.
mandrake n. the root or other parts of the plant manifest content 1. the matter that is overtly
Mandragora officinarum, traditionally used as an expressed and consciously intended in any utter-
anesthetic, aphrodisiac, hallucinogen, and folk ance or other form of communication. 2. in psy-
remedy for asthma, whooping cough, stomach choanalytic theory, the images and events of a
ulcers, and other conditions. The name derives dream or fantasy as experienced and recalled
from the supposed resemblance of the root to by the dreamer or fantasist, as opposed to the la-
the human form; -drake (from the Old English tent content, which is posited to contain the
word for dragon) alludes to the alleged magical hidden meaning. See also dream analysis;
powers of the plant. A member of the nightshade dream censorship; dream-work.
family, it contains the anticholinergic alkaloids
scopolamine, mandragorine, and hyoscya- manifest goal in evaluation research, an
mine, which are poisonous and potentially fatal. openly stated, objectively defined goal or objec-
Symptoms of poisoning include flushing, tive of an organization or program. Manifest
pupillary dilation, dry mucous membranes, and goals are specified by indicators of success and
dry mouth, progressing to visual disturbances, assessed in an evaluation program.
hallucinations, restlessness, agitation, delirium, manifest variable a variable that is directly
and possibly death from respiratory failure. observed or measured, as opposed to one whose
value is inferred (see latent variable).
mania n. 1. a manic episode or, sometimes, a
hypomanic episode. 2. excitement, overactiv- manipulation n. conscious behavior designed
ity, and psychomotor agitation, often ac- to exploit, control, or otherwise influence others
companied by impaired judgment. 3. excessive to one’s advantage.
preoccupation with a particular activity or idea. manipulation check any means by which an
341
manipulative behavior
experimenter evaluates the efficacy of the exper- modern clinical practice. U.S. trade name:
imental manipulation, that is, verifies that the Ludiomil.
manipulation affected the participants as in- marasmus n. a condition, usually occurring in
tended. infancy, that is characterized by apathy, with-
manipulative behavior see manipulation. drawal, and emaciation (from Greek marasmos,
mannosidosis n. a rare and progressive disorder “consumption”) resulting from severe protein–
involving deficient activity of an enzyme (α- energy malnutrition. If left untreated, it can re-
mannosidase) needed to metabolize the sugar sult in delayed physical and cognitive develop-
mannose. Affected individuals have slow motor ment and, in some cases, death. Marasmus tends
development, mental retardation, and hypo- to occur mostly in developing countries, often as
tonic (flaccid) muscles, although these effects a result of premature or abrupt weaning, famine,
vary in magnitude. Laboratory tests may reveal or vitamin insufficiency due to limitations in
brain and liver levels of mannose 8 to 10 times food variety. It can, however, occur in developed
normal. It is thought to be an autosomal reces- nations as well—for example, in children living
sive trait. in poor rural and urban areas, children with
chronic disease, and children who are institu-
MANOVA acronym for multivariate analysis
tionalized. Also called infantile atrophy. See
of variance.
also kwashiorkor.
mantra n. 1. in Hinduism and Buddhism, a sa-
cred utterance, such as a syllable, phrase, or
marathon group an encounter group that
meets in seclusion for a long period, usually
hymn (often in Sanskrit). 2. any verbal formula
varying from 6 hours to several days. Marathon
used for spiritual, religious, or meditative pur-
groups are based on the theory that a single, ex-
poses to help block out extraneous thoughts and
tended session will elicit more intense interac-
induce a state of relaxation that enables the indi-
tions, foster a greater sense of intimacy and
vidual to reach a deeper level of consciousness.
sharing, and encourage a freer expression of feel-
See also concentrative meditation; tran-
ings as the time elapses than a series of shorter,
scendental meditation. Compare yantra.
interrupted sessions. They are often organized
manual arts therapy training in industrial around addressing a single issue or related set of
arts, such as woodworking and metalworking, issues. See also time-extended therapy.
for therapeutic purposes as part of the rehabilita-
marginal consciousness the background
M tion process. See also occupational therapy.
contents of consciousness that, although
manual-assisted therapy see manualized above the threshold of awareness, are not the
therapy. center of attention. Marginal stimuli are not
manual-based therapy see manualized equivalent to subliminal stimuli (see sublimi-
therapy. nal perception).
manualized therapy interventions that are marginal frequency the sum of any one of
performed according to specific guidelines for the rows or columns in a data matrix, such as a
administration, maximizing the probability table of students classified by sex and area of
of therapy being conducted consistently across study. In this example, the number of female
settings, therapists, and clients. Also called students, regardless of area of study, would be
manual-assisted therapy; manual-based one marginal frequency, and the number of
therapy. students enrolled in a specific area of study,
MAO abbreviation for monoamine oxidase. regardless of sex, would be another. Also called
MAOI (MAO inhibitor) abbreviation for marginal.
monoamine oxidase inhibitor. margin of error a statistic expressing the con-
maple-sugar urine disease (MSUD) a disor- fidence interval associated with a given
der of amino acid metabolism involving a defi- measurement; it is an allowance for a slight mis-
ciency of enzymes required for processing the calculation or an acceptable deviation. The
amino acids leucine, isoleucine, valine, and larger the margin of error for the sample data,
alloisoleucine. The urine and sweat of affected the less confidence one has that the results ob-
individuals have a distinctive maple-syrup odor. tained are accurate for the entire population of
Other characteristics include mental retarda- interest.
tion, increased muscle tension, altered reflexes, marijuana (marihuana) n. see cannabis.
and convulsions. Special diets, dialysis, and Marinesco–Sjögren syndrome an auto-
transfusions are among the therapeutic mea- somal recessive hereditary disorder marked by
sures needed. Also called maple-syrup urine cataracts, short stature, cerebellar ataxia
disease. (incoordination of voluntary movements), and
maprotiline n. a tetracyclic antidepressant mental retardation. Affected individuals have
closely related to the tricyclic antidepres- cataracts in both eyes; some have very small
sants. Like the tricyclic agents, it can cause ad- heads (see microcephaly). Cerebellar ataxia is
verse anticholinergic effects and serious present at infancy, and mild to moderate mental
disturbances in heart rhythm; its use has there- retardation becomes evident. Affected individu-
fore declined, and it is rarely encountered in als may live well past middle age but often lose
342
masculinity–femininity test
their ability to walk because of progressive mus- to present themselves in a favorable light. Test
cle weakness. [reported in the 1930s by Georges scores are often used in research where people
Marinesco (1864–1938), Romanian neurologist, might be inclined to bias their behavior in a so-
and Torsten Sjögren (1896–1974), Swedish phy- cially desirable direction, rather than being per-
sician] fectly frank. Although currently available in a
Marinol n. a trade name for dronabinol. See variety of forms, the Marlowe–Crowne scale as
tetrahydrocannabinol. it was originally developed in 1960 consisted of
33 self-descriptive statements (e.g., “I am some-
marital adjustment the process by which times irritated by people who ask favors of me”)
married couples attain mutual gratification and to which participants responded “true” or
achieve common goals while simultaneously “false.” [David Marlowe (1931–1990) and Doug-
maintaining an appropriate degree of individu- las P. Crowne (1928– ), U.S. psychologists]
ality. Especially important to marital adjustment
are (a) the sharing of experiences, interests, and Maroteaux–Lamy syndrome an inherited
values; (b) respect for the partner’s individual disorder of connective tissue and skeletal devel-
needs, aims, and temperament; (c) maintenance opment. It is marked by dwarfism of the trunk
of open lines of communication and expression and extremities and in some cases delayed clo-
of feeling; (d) clarifying roles and responsibili- sure of the cranial sutures and maldevelop-
ties; (e) cooperation in decision making, prob- ment of the facial bones. Mental retardation and
lem solving, and rearing of children; and (f) deafness often accompany the condition. Also
attainment of mutual sexual gratification. called mucopolysaccharidosis VI; systemic
mucopolysaccharidosis. [Pierre Maroteaux
marital conflict open or latent antagonism
(1926– ), French geneticist; Maurice Lamy
between marriage partners. The nature and in-
(1895–1975), French physician]
tensity of conflicts varies greatly, but studies in-
dicate that the prime sources are often sexual Marplan n. a trade name for isocarboxazid.
disagreement, child-rearing differences, temper- marriage n. the social institution in which two
amental differences (particularly the tendency of (or, less frequently, more) people commit them-
one partner to dominate), and, to a lesser extent, selves to a socially sanctioned relationship in
religious differences, differences in values and which sexual intercourse is legitimated and
interests, and disagreements over money man- there is legally recognized responsibility for any
agement. offspring as well as for each other. Although M
marital counseling see marriage counsel- there are exceptions, the marital partners typi-
ing. cally live together in the same residence. See also
marital schism a condition of open discord be- closed marriage; collusional marriage;
tween marital partners, which puts a strain on common-law marriage; domestic partner-
the marriage and may lead to separation or di- ship; group marriage; nontraditional mar-
vorce. riage; open marriage; same-sex marriage;
symbiotic marriage; synergic marriage;
marital skew a defective family pattern in traditional marriage. —marital adj.
which the pathological behavior of the domi-
nant partner is accepted by the other partner. See marriage counseling couples counseling
also collusional marriage. when the couples are married. Also called mari-
tal counseling.
marital subsystem the relationship between
two spouses or partners in a family and their par- marriage-enrichment group a support or
ticular interactional rules for cooperation, con- therapy group in which married couples meet
flict, and conflict resolution over marital issues under the guidance of a professional or non-
(e.g., child rearing). professional leader to discuss marriage-related
problems and issues. See also couples therapy.
marital therapy see couples therapy.
marketing orientation in the existential psy- marriage therapy see couples therapy.
choanalysis of Erich fromm, a character pattern masculinity n. possession of social role behav-
in which the individual regards people as com- iors that are presumed to be characteristic of a
modities and evaluates personal worth in terms man, as contrasted with maleness, which is ge-
of salability. Attributes perceived as leading to netically determined. —masculine adj.
business or social success are valued more than masculinity–femininity test any test de-
knowledge, creativity, integrity, or dedication. signed to measure the degree of masculinity or
According to Fromm, the marketing orientation femininity in participants. The earliest was the
contributes to shallow relationships and alien- Terman–Miles Attitude–Interest Analysis Test
ation from self and society. Also called market- (1938); others, usually in inventory form, are the
ing character. See also exploitative orien- minnesota multiphasic personality inven-
tation; hoarding orientation. tory, the guilford–zimmerman tempera-
Marlowe–Crowne Social Desirability ment survey, and the Gough Femininity Scale.
Scale (M–C SDS) a widely used research scale The bem sex role inventory is one of the
that attempts to assess the degree to which par- few masculinity–femininity tests to include an-
ticipants answer questions in such a manner as drogyny.
343
masked depression
masked depression 1. a condition in which an by Abraham maslow, which he developed as a

individual experiencing a major depressive ep- reaction against the determinism of the theories
isode complains of physical symptoms (e.g., of Sigmund freud and B. F. skinner. physio-
headache, backache) rather than mood distur- logical needs (air, water, food, sleep, sex, etc.)
bance, and no organic cause of the physical are at the base; followed by safety and security
symptoms can be found. 2. a hypothesized state (the safety needs); then love, affection, and
in which symptoms other than those normally gregariousness (the love needs); then prestige,
associated with depression are held to be a result competence, and power (the esteem needs);
of underlying depression. This view has been dif- and, at the highest level, aesthetic needs, the
ficult to test or verify and is no longer popular. need for knowing, and self-actualization (the
metaneeds).
masked homosexuality theoretically, an un-
conscious form of same-sex sexual orientation in Maslow’s theory of human motivation
which a person seeks in heterosexual activities the humanistic view of motivation proposed by
the pleasures presumed to be obtained only in Abraham maslow, in which the higher human
same-sex acts, such as oral or anal intercourse. needs for understanding, aesthetic values, self-
This hypothesized transposition, however, is es- realization, and peak experiences are em-
sentially rendered meaningless because hetero- phasized. Maslow contrasted the metamotiva-
sexual couples may engage routinely in (for tion arising from such metaneeds with the
example) oral sex with no indication that such deficiency motivation arising from physical
activities are exclusively related to gay or lesbian needs, insecurity, and alienation.
tendencies. masochism n. the derivation of pleasure from
Maslach Burnout Inventory (MBI a experiencing pain and humiliation. The term
method for the evaluation of burnout on three generally denotes sexual masochism but is also
dimensions: emotional exhaustion, deperson- applied to other experiences not involving sex,
alization, and reduced personal accomplish- such as martyrdom, religious flagellation, or as-
ment. It consists of 22 statements about feelings ceticism. In psychoanalytic theory, masochism
and attitudes to which participants respond in is interpreted as resulting from the death in-
terms of frequency on a 7-point scale ranging stinct or from aggression turned inward be-
from “never” to “every day.” [Christina Maslach cause of excessive guilt feelings. [Leopold Sacher
(1946– ), U.S. psychologist] Masoch (1835–1895), Austrian writer] —mas-
M ochist n. —masochistic adj.
Maslow, Abraham Harold (1908–1970) U.S.
psychologist. Maslow earned his PhD in 1934 masochistic fantasies fantasies of being
from the University of Wisconsin, where he whipped, choked, or otherwise hurt or abused as
studied with the primatologist Harry Harlow an expression of masochistic tendencies, partic-
(1905–1981). Initially a behaviorist but frus- ularly as a means of achieving sexual excite-
trated by what he perceived as its limitations, ment. See sexual masochism.
Maslow broadened his orientation to include the masochistic personality disorder a person-
subjective in human experience, so becoming a ality disorder in which individuals persistently
founder of humanistic psychology. Maslow and characteristically obtain gratification or
originated the concept of a hierarchy of needs freedom from guilt feelings as a consequence of
that motivate all individuals (see maslow’s mo- humiliation, self-derogation, self-sacrifice, wal-
tivational hierarchy): According to this con- lowing in misery, and, in some instances, sub-
cept, the ultimate goal of being human is self- mitting to physically sadistic acts. This disorder
actualization; only when a person’s basic was listed in DSM–III–TR as self-defeating per-
needs are met can self-actualization occur. His sonality disorder.
emphasis on self-fulfillment made him a leader
mass action the generalization of U.S. psychol-
in the human-potential movement of the
ogist Karl S. Lashley (1890–1958) that the size of
1960s and 1970s. Maslow’s most influential
a cortical lesion, rather than its specific location,
works include his Theory of Human Motivation
determines the extent of any resulting perfor-
(1943), Toward a Psychology of Being (1968), and
mance decrement. Proposed in 1929 following
The Farther Reaches of Human Nature (1971). A
experimental observations of the effects of dif-
founder of the American Association for Hu-
ferent brain lesions on rats’ ability to learn a
manistic Psychology in 1962, and cofounder of
complex maze, the concept reflects Lashley’s be-
the Journal of Humanistic Psychology, Maslow was
lief that large areas of the cortex function to-
elected president of the American Psychological
gether in learning and other complex processes.
Association in 1967. See also maslow’s theory
See also equipotentiality.
of human motivation; deficiency motiva-
tion; humanistic perspective; metamotiva- massage n. the structured stroking or kneading
tion; personality structure. of a body area or of the entire body by hand or by
a mechanical or electrical device. Manual mas-
Maslow’s being psychology see being psy- sage is usually administered for therapeutic and
chology. rehabilitative purposes because the hands can
Maslow’s motivational hierarchy the hier- detect abnormalities, such as swellings or muscle
archy of human motives, or needs, as described spasms. Among the benefits of massage are im-
344
mathematics disorder
proved circulation, the promotion of relaxation outpatient clinics. Also called psychotherapy
and healing from injury, and release from ten- matching.
sion and psychological stress. Massage may also materialism n. 1. the philosophical position
be performed in a fluid environment, as in a that everything, including mental events, is
whirlpool bath. composed of physical matter and is thus subject
mass contagion a form of contagion in to the laws of physics. From this perspective, the
which behaviors, attitudes, or affect rapidly mind is considered to exist solely as a set of brain
spread throughout large groups or populations, processes (see mind–body problem). Such phi-
including those who are widely dispersed across losophies can be traced back to ancient times but
a large area. gained a new impetus from advances in the
physical sciences beginning in the 17th century.
mass hysteria see collective hysteria. 2. a value system that emphasizes the pursuit
mass reflex 1. an indiscriminate response of and acquisition of material goods and luxuries,
many body effectors to a single stimulus, as in typically perceived by the individual as a mea-
“freezing” with fear. 2. a life-threatening condi- sure of personal worth and achievement, often
tion associated with spinal cord injury in which at the expense of moral, psychological, and so-
uncontrolled activation of both autonomic and cial considerations. 3. the position that the
somatic motor systems occurs. causes of behavior are to be found in the material
mass suicide the deliberate ending of the lives of the body, particularly the nervous system. See
of all or most of the members of an intact social also identity theory; physicalism. Compare
group or aggregate by the members themselves, idealism. —materialist adj., n. —materialis-
either directly through self-injurious behavior or tic adj.
indirectly by choosing a course of action that maternal attitudes attitudes of the mother to-
will very likely be fatal. Examples include ex- ward her children, particularly those attitudes
tremely hazardous missions undertaken by com- that play an important role in her children’s
bat units (see altruistic suicide) and the health, character formation, emotional adjust-
suicides of nearly all the members of the People’s ment, and self-image, as well as in her own self-
Temple (Jonestown mass suicide), the 70 mem- perception as a mother.
bers of the Order of the Solar Temple in Europe maternal behavior the actions of female ani-
and Canada between 1994 and 1997, and the 39 mals associated with caring for their young.
Heaven’s Gate followers of Marshall Appelwhite These can range from nursing in mammals and M
in San Diego in 1997. Mass suicide often occurs feeding in other species to protection, thermo-
at the command of a charismatic leader and may regulation, and teaching skills to the young.
be provoked not by despair but by the desire to maternal deprivation lack of adequate nur-
seek a “higher state of existence” promised by turing for a young animal or child due to the ab-
the leader. Also called collective suicide. sence or premature loss of, or neglect by, its
Compare cluster suicides. mother or primary caregiver, postulated to nega-
MAST acronym for michigan alcoholism tively impact a child’s emotional development
screening test. by disrupting attachment formation. See also
mastery goal see learning goal. failure to thrive; marasmus.
maternal drive the motivation of female ani-
masturbation n. manipulation of one’s own mals to care for offspring.
genital organs, typically the penis and clitoris,
for purposes of sexual gratification. The act is maternal PKU a condition in women that is
usually accompanied by sexual fantasies or secondary to successful treatment of phenyl-
erotic literature, pictures, or videos. Masturba- ketonuria through dietary intervention begin-
tion may also include the use of mechanical dening at birth. Expectant mothers with high
vices (e.g., vibrators) or self-stimulation of other levels of blood phenylalanine are at risk of giving
organs, such as the anus or nipples. —mastur- birth to offspring with high rates of congenital
bate vb. heart defects, intrauterine growth retardation,
mental retardation, and microcephaly (a small
mata elap see amok. head). Treatment entails dietary management
matched samples two or more samples that for the expectant mother before and during
are equivalent to one another with respect to cer- pregnancy to reduce blood levels of phenyl-
tain relevant variables. alanine.
matching patients the process of prescribing maternity blues see baby blues.
specific interventions or choosing specific thera- mathematics disorder in DSM–IV–TR, a
pists for particular patients or diagnostic groups learning disorder in which mathematical
of patients to improve compliance with or effec- ability is substantially below what is expected
tiveness of treatment. The process is based on given the person’s chronological age, formal ed-
the diagnoses, needs, problems, and characteris- ucation experience, and measured intelligence.
tics of particular patients; on therapist variables, It may involve (among other problems) difficul-
such as race, ethnicity, and experience levels; ties in counting, learning multiplication tables,
and on setting variables, such as inpatient or understanding mathematical problems and per-
345
matricide
forming mathematical operations, reading nu- MBI abbreviation for maslach burnout inven-
merical symbols, and copying numbers. tory.
matricide n. 1. the killing of one’s own mother. MBTI abbreviation for myers–briggs type indi-
2. a person who kills his or her own mother. cator.
Compare patricide. —matricidal adj. McClelland, David (1917–1998) U.S. psychol-
matrix n. 1. a context or environment within ogist. McClelland was awarded his doctorate at
which something else is enclosed, embedded, Yale University in 1941. He taught at Connecti-
originates, or develops. 2. a rectangular ordered cut College and Wesleyan University before
arrangement (array) of numbers in rows and joining the faculty at Harvard University, where
columns. he remained from 1956 until 1987. He then
maturational crisis a life-changing event, taught at Boston University until his death.
such as marriage or retirement, that often is McClelland is best known for his empirical and
encountered during the typical course of devel- theoretical contributions to the study of person-
opment and that requires significant psycholog- ality and motivation. With John W. Atkinson
ical, behavioral, or other adjustments. Also (1923–2003) he developed a method of quantita-
called developmental crisis; normative cri- tively scoring the thematic apperception test
sis. (TAT), using it to assess individual achievement
motivation. In later years he conducted re-
maturational lag slowness or delay in some search on power motivation. Representative
aspects of neurological development that may writings include his classic The Achieving Society
affect cognition, perception, and behavior. (1961), Human Motivation (1985), and Power: The
maturation hypothesis a generalization that Inner Experience (1975). McClelland received the
some behaviors and processes, such as language American Psychological Association’s Award for
acquisition, are innate but do not appear until Distinguished Scientific Contributions in 1987
appropriate organs and neural systems have ma- and was elected a fellow of the American Acad-
tured. emy of Arts and Sciences. See also need for
maturity rating an evaluation of behavior on achievement.
a particular trait in comparison with a relevant MCE abbreviation for medical care evalua-
peer-group norm. tion.
M matutinal insomnia a less common name for MCI abbreviation for mild cognitive impair-
terminal insomnia. ment.
Maudsley Personality Inventory see ey- MCMI abbreviation for millon clinical
senck personality inventory. multiaxial inventory.
maximum-security unit a section of a men- McNaughten rule (McNaughton rule;
tal institution reserved for patients who are M’Naghten rule) a rule for defining insanity
likely to harm themselves or others. that focuses on the cognitive state of the defen-
May, Rollo (1909–1994) U.S. psychologist, psy- dant at the time of committing the act with
choanalyst, and existentialist. May earned his which he or she is charged. It states that to plead
PhD in clinical psychology at Columbia Univer- insanity, the accused must be “laboring under
sity in 1949 and spent the bulk of his career at such a defect of reason, from disease of the mind,
the William Alanson White Institute in New as not to know the nature and quality of the
York City, where he served as training analyst act he was doing, or if he did know it, he did not
and president of the institute for many years. A know that what he was doing was wrong.” The
broad-ranging thinker who incorporated classi- rule was established in 1843 by judges in Eng-
cal, religious, and philosophical studies into his land after the trial of Daniel McNaughten,
views on psychology and psychotherapy, May who believed the government was persecuting
is best known as a proponent of humanistic him and killed prime minister Sir Robert Peel’s
psychology and a spokesperson for the exis- secretary in mistake for the prime minister.
tential psychology movement. He was partic- Also called right-and-wrong test; right-or-
ularly concerned with combating feelings of wrong test. See also american law institute
emptiness, cynicism, and despair by emphasiz- model penal code insanity test; criminal
ing basic human values, such as love, free will, responsibility; irresistible impulse rule;
and self-awareness. Among his most influential partial insanity.
writings are Existence: A New Dimension in Psychi- MCO abbreviation for managed care organization
atry and Psychology (1958, coauthored by Ernest (see managed care).
Angel and Henri Ellenberger), The Meaning of M–C SDS abbreviation for marlowe–crowne
Anxiety (1950), and Love and Will (1969). social desirability scale.
MBD 1. abbreviation for minimal brain dam- MDA n. 3,4-methylenedioxyamphetamine: a syn-
age. 2. abbreviation for minimal brain dys- thetic hallucinogen of the phenylisopropyl-
function. amine family (see phenylethylamines). Because
MBHO abbreviation for managed behavioral at low doses it acts as a cns stimulant and
health organization. euphoriant, MDA was once proposed as an aid
346
medial temporal lobe
347
median
hemisphere. It contains the pyriform area, the medical audit a systematic evaluation of the ef-
amygdala, and the hippocampus. fectiveness of diagnostic and treatment proce-
median n. the score that divides a distribution dures. A retrospective medical audit is based on
into two equal-sized halves. a review of a patient’s charts after he or she has
been discharged; a concurrent medical audit is
median-cleft-face syndrome a congenital conducted while the patient is still under treat-
disorder characterized by defective fusion of
ment.
structures in the midline of the face. The cleft
may involve the eyes, the tip of the nose, the pal- medical care evaluation (MCE) a health care
ate, and the premaxilla. About 20% of affected review in which an assessment of the quality of
individuals have some degree of mental retarda- care and its utilization is made. It will include an
tion. investigation of any suspected problems, analy-
sis of the problems identified, and a plan for cor-
median effective dose see effective dose. rective action.
mediated response a response that is elicited medical family therapy a form of psycho-
by a stimulus and is subsequently responsible for therapy that combines a biopsychosocial sys-
the initiation of a behavior. tems approach with family systems theory to
mediate experience conscious awareness and help individuals and their families deal with the
interpretation of external events and stimuli. health problems of the individual. This therapy
Mediate experience provides meaning and addi- emphasizes collaboration with others—physi-
tional information not contained in the event cians, nurses, occupational therapists, nutrition-
or stimulus itself. It is contrasted with immedi- ists, and the like—in the individual’s health care
ate experience: the elements or characteristics of team.
the event or stimuli as perceived directly and medical history in psychology, the portion of
without interpretation. introspection makes the developmental history, or anamnesis, that
use of immediate experience in analyzing the focuses on the patient’s health throughout life,
contents of mediate experience. [defined by Wil- including congenital or acquired illnesses and
helm wundt] disorders. The object is to uncover, where possi-
mediation n. in dispute resolution, use of a neu- ble, clues to the cause of the patient’s current
tral outside person—the mediator—to help the psychological condition.
contending parties communicate and reach a medical model 1. the concept that mental and
M compromise. The process of mediation has emotional problems are analogous to biological
gained popularity, for example for couples in- problems, that is, they have detectable, specific,
volved in separation or divorce proceedings (see physiological causes (e.g., an abnormal gene or
divorce mediation). damaged cell) and are amenable to cure or im-
mediation theory the hypothesis that stimuli provement by specific treatment. 2. in evalua-
affect behavior indirectly through an intervention research, a systems-analysis approach to
ing process, as opposed to a simpler stimulus–reevaluation that considers the interrelatedness of
sponse model. For example, cognitive therapists all the factors that may affect performance and
maintain that the effect an external event has on monitors possible side effects of treatment. The
an individual is influenced by the individual’s medical model is in contrast to the engineering
thoughts and perceptions of that event. model, which is a simple comparison of gains for
mediator n. 1. a process or system that exists be- different groups, some of which have been ex-
tween a stimulus and a response, between the posed to the program of interest.
source and destination of a neural impulse, or medical psychology 1. an area of applied psy-
between the transmitter and receiver of commu- chology devoted to psychological questions
nications. 2. a person—for example, a lawyer or arising in the practice of medicine, including
psychologist—who helps contending parties emotional reactions to illness; treatment compli-
communicate and reach a compromise. See also ance; attitudes toward terminal illness and im-
divorce mediation; mediation. 3. in statisti- pending death; psychological means of relieving
cal analyses of the interrelations among vari- pain (e.g., hypnotic suggestion); and reactions to
ables, a variable that accounts for an observed disability. 2. see prescribing psychology.
relation between two other variables. medical psychotherapy psychotherapy that
mediator variable see intervening vari- makes use of medication and other medical tech-
able. niques in the treatment of mental illness.
Medicaid n. a joint federal and state program, in- medical rehabilitation the process of restor-
stituted by law in 1965 (Title XIX of the Social ing to the fullest possible degree the physical
Security Act), that provides medical benefits for functioning of an individual who has a physio-
people with low incomes and limited resources. logical or anatomical impairment. See also re-
Medicaid programs follow broad federal guide- habilitation.
lines but each state determines specific benefits medical social worker a licensed social
and amounts of payments. worker, usually with a master’s degree in social
Medicaid Waiver see home and community- work, who assists patients and their families
based services. with health-related problems in such areas as
348
Megan’s law
employment, finances, living arrangements, matics and statistics to analyze historical data. In
marriage, child care, social life, and emotional clinical psychology, his research focused on di-
adjustment. agnosis and classification of mental disorders
Medicare n. a federal program of health insur- using quantitative methods that revolutionized
ance operated by the Health Care Financing Ad- the field by developing computerized scoring
ministration of the U.S. Department of Health techniques for psychological tests. Meehl also
and Human Services for those over 65, certain applied his statistical expertise to problems in
younger people with disabilities, and people the history and philosophy of science, publish-
with end-stage renal disease. Monies from paying many articles in those fields. Representative
roll taxes and premiums from subscribers are de- works include Clinical Versus Statistical Predic-
posited in trust funds to meet the expenses of the tion: A Theoretical Analysis and a Review of the Evi-
insured. Medicare consists of two programs: Part dence (1954; reprinted 1996) and Selected
A includes inpatient costs and Part B provides Philosophical and Methodological Papers (1991).
supplementary medical insurance. Among his many honors were the American Psy-
chological Association’s awards for Distin-
medication n. psychoactive drugs that aid in guished Scientific Contributions and for
the treatment of affective and behavioral disor- Outstanding Lifetime Contribution to Psychol-
ders. Until recently, in the United States only ogy, and membership of the National Academy
medical physicians could legally prescribe psy- of Sciences and the American Academy of Arts
choactive drugs, but prescription privileges have and Sciences.
now been extended to psychologists in the mili-
tary and to those in New Mexico and Louisiana. mefloquine n. a chemical analog of quinine
Overmedication—the taking of more than the used in the treatment of malarial infections and
prescribed dose of a drug or drugs—may occur prevention of malaria. It has been associated
when medication is not properly monitored. with seizures or psychological disturbances, in-
Self-medication is usually associated with indi- cluding sleep disturbance, depression, panic at-
viduals who use drugs or alcohol inappropriately tacks, and psychotic symptoms. Although such
to alleviate emotional problems. reactions are rare, mefloquine should not be
taken by individuals with histories of depres-
medication-induced movement disorder
sion, generalized anxiety disorder, psychosis, or
any movement disorder that occurs as an ad-
seizure disorders. U.S. trade name: Lariam.
verse effect of medication. It may involve rigid-
ity, tremor, hypertonia (increased muscle tone), MEG abbreviation for magnetoencephalo- M
and other motor symptoms and is commonly graphy or magnetoencephalograph.
seen after treatment with antipsychotic drugs. megadose pharmacotherapy a dosing strat-
See tardive dyskinesia. egy popular in the 1970s and 1980s in the
meditation n. profound and extended contem- United States and other countries, generally in-
plation or reflection, sometimes in order to volving the rapid administration of very high
attain an altered state of consciousness. doses of an antipsychotic drug in the hopes that
Traditionally associated with spiritual and reli- this would hasten an antipsychotic response. It
gious exercises, it is now increasingly also used was based on the presumption that rapid block-
to provide relaxation and relief from stress. See ade of postsynaptic dopamine D2 receptors
also concentrative meditation; mindful- would lead to faster resolution of psychotic
ness meditation; transcendental medita- symptoms. This strategy was largely ineffective
tion. in producing a more rapid response and had nu-
merous adverse effects, such as severe movement
medulla n. 1. the central or innermost region of
disorders and death due to neuroleptic malig-
an organ, such as the adrenal medulla, the cen-
nant syndrome. Research published in the late
tral portion of the adrenal gland. Compare cor-
1980s showed that lower doses were as effective
tex. 2. see medulla oblongata. —medullary
as higher doses and had fewer adverse conse-
adj.
quences. Because of the lack of clinical benefit
medulla oblongata the most inferior (lowest), and the high incidence of adverse side effects as-
or caudal (tailward), part of the hindbrain. It sociated with megadose pharmacotherapy, it has
contains many nerve tracts that conduct im- fallen into disuse. Also called rapid neuro-
pulses between the spinal cord and higher brain leptization.
centers, as well as autonomic nuclei involved in
the control of breathing, heartbeat, and blood megalocephaly n. see macrocephaly. —me-
pressure. Also called myelencephalon. galocephalic adj.
Meehl, Paul Everett (1920–2003) U.S. psy- megalomania n. a highly inflated conception
chologist. Meehl received his PhD in psychology of one’s importance, power, or capabilities, as
from the University of Minnesota and served on can be observed in many individuals with mania
the faculty there for the remainder of his career. and paranoid schizophrenia. In the latter, mega-
Both a practicing psychotherapist and an aca- lomania is often accompanied or preceded
demic psychologist, Meehl made important con- by delusions of persecution. See delusion of
tributions to research in the fields of clinical grandeur.
psychology and cliometrics, the use of mathe- Megan’s law U.S. legislation requiring that con-
349
megavitamin therapy
victed but released sex offenders register with cific information or a specific past experience
the authorities so that communities will be noti- that is recalled. 3. the hypothesized part of the
fied of their presence in a particular neighbor- brain where traces of information and past expe-
hood. More formally known as the Community riences are stored (see memory system). See also
Notification Act, it was initially passed in New associative memory; constructive memory;
Jersey in 1994 after a repeat sex offender mur- explicit memory; immediate memory; im-
dered a 7-year-old girl named Megan Nicole plicit memory; long-term memory; short-
Kanka; it became a federal law in 1996. term memory.
megavitamin therapy the use of very high memory disorder any impairment in the abil-
doses of vitamins and mineral supplements, par- ity to encode, retain, or retrieve information or
ticularly vitamin C (ascorbic acid), nicotinic acid representations of experiences. A notable exam-
(niacin), vitamin B6(pyridoxine), and magne- ple is amnesia. Memory disorders may be partial
sium, to treat certain mental disorders. Such an or global, mild or severe, permanent or transi-
approach is not widely adopted, and effective- tory, anterograde (pertaining to difficulty with
ness is uncertain. new information) or retrograde (pertaining to
melancholia n. an archaic name for depression, difficulty with previously known information).
which still has some popular currency. —mel- The cause may be medical conditions leading to
ancholic adj. structural lesions of the brain or metabolic dis-
ruption of brain function, aging, psychological
melancholia agitata a 19th-century term for trauma, fugue states, or intrapsychic conflicts.
catatonic excitement. It is occasionally still
used for agitated depression.
memory distortion any inaccurate or illusory
recall or recognition, such as déjà vu, a false
melancholic features features that may be as- memory, or a memory illusion.
sociated with a major depressive episode.
memory-enhancing drugs see nootropic.
These include loss of pleasure in most or all ac-
tivities or inability to take pleasure in anything memory hardening an increased conviction,
that normally elicits this feeling, together with with the passage of time, that false memories
three or more of the following: The depressed or pseudomemories are accurate. The phenom-
mood is experienced as quite distinct from nor- enon is of particular concern in the context of
mal sadness; it is worse in the morning; and eyewitness testimony and hypnosis.
M there is early morning awakening, psychomotor memory impairment the loss of memory as-
agitation or retardation, loss of appetite or sociated with memory disorders.
weight, or excessive guilt feelings. memory loss see memory impairment.
melatonin n. a hormone, produced mainly by memory retraining strategies to help individ-
the pineal gland as a metabolic product of the uals with neurological deficits improve their
neurotransmitter serotonin, that helps to regu- ability to process information in working mem-
late seasonal changes in physiology and may ory. These strategies are typically applied with
also influence puberty. It is implicated in the ini- patients with brain injury or Alzheimer’s disease
tiation of sleep and in the regulation of the and those with HIV/AIDS who are experiencing
sleep–wake cycle. Melatonin has been investi- memory problems.
gated in clinical studies as a hypnotic and for the
memory span the number of items that can
management of circadian rhythm sleep dis-
be recalled immediately after one presentation.
orders. Although these studies are as yet incon-
Usually, the items consist of letters, words, num-
clusive, melatonin is widely available as an over-
bers, or syllables that the participant must repro-
the-counter medication.
duce in order. A distinction may be drawn
Mellaril n. a trade name for thioridazine. between visual memory span and auditory
melodic intonation therapy (MIT) speech memory span, depending on the nature of the
therapy that uses melody to regain or improve presentation. See also digit span.
speech in individuals with certain kinds of memory system any of several different kinds
aphasia, motor speech disorder, or expres- of memory that are hypothesized to be located
sive language disorder. Based on the theory in separate brain areas and primarily employed
of right-hemisphere dominance for music, MIT in different sorts of memory tasks. Examples of
trains the speaker to intone, or “sing,” text in hypothesized systems include working mem-
pitches and rhythms that parallel natural spoken ory (a temporary store used in manipulating
prosody. MIT is primarily an auxiliary to other information), semantic memory (general
forms of speech therapy. knowledge), episodic memory (memories of
memorandum as a whole see objective psy- one’s personal past), and procedural memory
chotherapy. (habits and skills).
memory n. 1. the ability to retain information memory trace a hypothetical modification of
or a representation of past experience, based on the nervous system that encodes a representa-
the mental processes of learning or encoding, tion of information or experience.
retention across some interval of time, and ménage à trois 1. a sexual relationship involv-
retrieval or reactivation of the memory. 2. spe- ing three people who are members of the same
350
mental defective
household, for example, a married couple and development of an ovum and secretion of
the husband’s mistress sharing an apartment. 2. estrogen within the ovary, in a graafian follicle,
three people having sex together (see troilism). culminating in ovulation, which occurs half way
menarche n. the first incidence of menstrua- through the cycle. The estrogen stimulates thick-
tion in a female, marking the onset of puberty. ening of the endometrium of the uterus in prep-
The age at which menarche occurs varies among aration to receive a fertilized ovum. The luteal
individuals and cultures: It tends to occur earlier phase begins immediately after ovulation, when
in Western countries, possibly associated with the ruptured follicle becomes the corpus luteum
better nutrition. —menarcheal adj. and secretes progesterone, which inhibits fur-
ther secretion of releasing hormone (and hence
meningitis n. inflammation of the meninges, of FSH and LH). If fertilization does not occur,
the three membranous layers that cover the this phase ends with menstruation and a repeat
brain and spinal cord, usually due to infection of the follicular phase.
by bacteria, viruses, or fungi. Symptoms include
high fever, nausea, vomiting, stiff neck, and menstrual taboo any culture-bound tradition
headache. Bacterial meningitis includes menin- associated with menstruating women, typically
gococcal meningitis and tuberculous meningitis. involving physical separation from men, absten-
Viral (or aseptic) meningitis is a milder non- tion from sexual intercourse, or the exclusion of
bacterial disease; causes include the mumps, women from certain daily activities (e.g., the
poliomyelitis, herpes viruses, and the echo- preparation of food).
viruses (which mainly affect young children dur- menstruation n. a periodic discharge of blood
ing the summer). If untreated or not treated and endometrial tissue from the uterus through
promptly, many types of meningitis can result the vagina that occurs in fertile women as part of
in confusion, lethargy, coma, and eventually the menstrual cycle. Also called menses;
death. menstrual (or monthly) period.
meningomyelocele n. protrusion of the spinal mental adj. 1. of or referring to the mind or to
cord and its covering meninges through a de- processes of the mind, such as thinking, feeling,
fect in the spinal column. This results in an sensing, and the like. 2. phenomenal or con-
external sac containing cerebrospinal fluid, sciously experienced. In contrast to physiologi-
poorly formed meninges, and a malformed spi- cal or physical, which refer to objective events or
nal cord. Also called myelomeningocele. See processes, mental denotes events known only
privately and subjectively; it may refer to the M
spina bifida.
cognitive processes involved in these events,
menkeiti n. see myriachit. to differentiate them from physiological pro-
menopausal depression severe dysphoria cesses.
occurring during the female climacteric mental aberration a pathological deviation
(menopause), particularly among women who from normal thinking, particularly as a symp-
have had a prior tendency to depression. tom of a mental or emotional disorder.
menopause n. the period during which men- mental age (MA) a numerical scale unit derived
struation ceases at the end of the reproductive by dividing an individual’s results in an intelli-
cycle in women. See climacteric. —meno- gence test by the average score for other people
pausal adj. of the same age. Thus, a 4-year-old child who
menorrhagia n. excessive bleeding during scored 150 on an iq test would have a mental age
menstruation. Also called epimenorrhagia. of 6 (the age-appropriate average score is 100;
mens rea the malicious or blameworthy state of therefore, MA = (150/100) × 4 = 6). The MA mea-
mind (Latin, “guilty mind”) that must be proved sure of performance is not effective beyond the
in addition to the actus reus (the illegal act) in age of 14.
order to establish criminal responsibility and mental apparatus see psychic apparatus.
secure a conviction. It involves a conscious disre- mental asthenia subjective loss of mental
gard for the law, which is presumed to be known strength characterized by lack of energy or moti-
by the defendant. For some crimes the mens rea vation for mental tasks, often expressed as con-
may be recklessness or negligence rather than a centration difficulty.
deliberate intention to bring about certain con- mental asymmetry an unbalanced relation-
sequences. Also called criminal intent. ship between mental processes, as in individuals
menstrual cycle a modified estrous cycle that with hypercalcemia syndrome (Williams syn-
occurs in most primates, including humans (in drome), who may exhibit severe impairment in
which it averages about 28 days). The events of visuospatial abilities while possessing good to
the cycle are dependent on cyclical changes in exceptional language abilities.
the concentrations of gonadotropins secreted mental ataxia see intrapsychic ataxia.
by the anterior pituitary gland, under the con-
mental balance integration of mental pro-
trol of gonadotropin-releasing hormone,
cesses.
and can be divided into two phases. In the
follicular phase, follicle-stimulating hormone mental confusion see confusion.
(FSH) and luteinizing hormone (LH) stimulate mental defective an obsolete name for a per-
351
mental deficiency
son with mental retardation, intellectual disabil- logical assessment and intervention (psychol-
ity, or learning disability. ogy, psychiatry, neurology, social work, etc.).
mental deficiency another (and now seldom This type of care includes but is not limited
used) name for mental retardation, sometimes to psychological screening and testing, psycho-
referring to severe or profound mental retarda- therapy and family therapy, and neuropsycho-
tion with known organic causes. logical rehabilitation. See also mental health
services.
mental development the progressive changes
in mental processes due to maturation, learning, mental health clinic an outpatient facility for
and experience. See cognitive development. the diagnosis and treatment of psychological
mental diplopia the experience of illusions, and behavioral problems.
hallucinations, or false memories with concur- mental health counselor a certified mental
rent awareness that these experiences are not health professional who provides counseling ser-
real and are an abnormal occurrence. vices either independently or as part of a treat-
mental disease an obsolete name for a mental ment team.
disorder. mental health nursing see psychiatric
mental disorder any condition characterized nursing.
by cognitive and emotional disturbances, abnor- mental health program a treatment, preven-
mal behaviors, impaired functioning, or any tion, rehabilitation, or educational service of-
combination of these. Such disorders cannot be fered by a community mental health center or
accounted for solely by environmental circum- other entity, for the purpose of maintaining or
stances and may involve physiological, genetic, improving the mental health of an individual or
chemical, social, and other factors. Specific clas- community.
sifications of mental disorders are elaborated in
mental health services any interventions—
the American Psychiatric Association’s Diagnos-
assessment, diagnosis, treatment, or counsel-
tic and Statistical Manual of Mental Disorders (see
ing—offered in private, public, inpatient, or out-
dsm–iv–tr) and the World Health Organiza-
patient settings that are aimed at the
tion’s international classification of dis-
maintenance or enhancement of mental health
eases. Also called mental illness; psychiatric
or the treatment of mental or behavioral disor-
disorder; psychiatric illness.
ders in individual and group contexts.
M mental energy see psychic energy.
mental health worker a member of a mental
mental examination a comprehensive evalu- health treatment team who assists professional
ation of an individual’s behavior, attitudes, and staff in a wide range of services.
intellectual abilities for the purpose of establish-
ing or ruling out pathology. mental history a record of information re-
lating to a person’s mental health (see case his-
mental fog see clouding of consciousness.
tory). A mental history, which may be com-
mental function any cognitive process or ac- piled by means of structured or unstructured
tivity, such as thinking, sensing, or reasoning. interviews, usually covers the history of both
mental handicap the condition of being un- the client and family members.
able to function independently in the commu- mental hospital see psychiatric hospital.
nity because of arrested or delayed cognitive See also mental institution; private mental
development or any severe and disabling mental hospital; public mental hospital.
disorder. Its use is generally discouraged nowa-
days in preference to mental retardation and mental hygiene a general approach aimed at
other terms considered more objective and less maintaining mental health and preventing
offensive. Also called mental disability. mental disorder through such means as educa-
tional programs, promotion of a stable emo-
mental healing the process of alleviating or at- tional and family life, prophylactic and early
tempting to alleviate mental or physical illness
treatment services (see primary prevention),
through the power of the mind, typically utiliz-
and public health measures. The term itself is
ing such methods as visualization, suggestion,
now less widely used than formerly.
and the conscious manipulation of energy flow.
See also faith healing; psychic healing. mental hygiene clinic a former name for a
mental health clinic or a community men-
mental health a state of mind characterized by
tal health center.
emotional well-being, good behavioral adjust-
ment, relative freedom from anxiety and dis- mental illness see mental disorder.
abling symptoms, and a capacity to establish mental institution a treatment-oriented facil-
constructive relationships and cope with the ority in which patients with mental retardation or
dinary demands and stresses of life. See also severe psychological disorder are provided with
flourishing; normality. supervised general care and therapy by trained
mental health care a category of health care psychologists and psychiatrists as well as auxil-
service and delivery involving scientific and pro- iary staff. The patients of a mental institution
fessional disciplines across several fields of will generally be those who are unable to func-
knowledge and technology involved in psycho- tion independently as outpatients when sup-
352
mental subnormality
ported by psychoactive drugs. See also psy- the mind. This term is often used synonymously
chiatric hospital. with cognitive process. See also higher men-
mentally defective an obsolete and pejorative tal process.
descriptor for a person with mental retardation. mental representation a hypothetical entity
mental map 1. a mental representation of the that is presumed to stand for a perception,
world or some part of it based on subjective thought, memory, or the like in the mind during
perceptions rather than objective geographical cognitive operations. For example, when doing
knowledge. Such a map will normally prioritize mental arithmetic, one presumably operates on
the individual’s neighborhood, city, and nation mental representations that correspond to the
and give prominence to more distant places ac- digits and numerical operators; when one imag-
cording to personal experience (e.g., vacations), ines looking at the reverse side of an object, one
cultural connections (e.g., family history or lan- presumably operates on a mental representation
guage links), and the level of coverage in the of that object; when one repeats a phone num-
mass media. The map will also incorporate the ber aloud while dialing, one presumably oper-
individual’s negative or positive feelings about ates on mental representations of the names of
these places, which will often reflect conven- the digits. However, there is no consensus yet as
tional ideas or stereotypes. Research suggests to what mental representations might be. See
that mental maps vary widely with nationality, thinking.
region, ethnicity, gender, education, and socio- mental retardation (MR) in DSM–IV–TR, a
economic class. 2. any internal representation of disorder characterized by intellectual function
two-dimensional or three-dimensional space. that is significantly below average: specifically
See cognitive map. that of an individual with a measured IQ of 70 or
below on tests with a standard deviation of 15,
mental mechanism in psychodynamics, the
whose adaptive behavior is impaired, and in
psychological functions, collectively, that help
whom the condition is manifested during the
individuals meet environmental demands, pro-
developmental period, defined variously as
tect the ego, satisfy inner needs, and alleviate in-
below the ages of 18 or 22. In infants, diagnosis
ternal and external conflicts and tensions.
is based on clinical judgment. Mental retarda-
Among them are (a) language, which enables ex-
tion may be the result of brain injury, disease, or
pression of thoughts; (b) memory, which stores
genetic causes and is typically characterized by
information needed in solving problems; and (c) M
an impairment of educational, social, and voca-
perception, which involves recognition and in-
tional abilities. See mild mental retardation;
terpretation of phenomena. In addition, in psy-
moderate mental retardation; profound
choanalytic and psychodynamic theory, various
mental retardation; severe mental retar-
defense mechanisms, such as rationalization
dation; unspecified mental retardation.
and compensation, help to prevent anxiety
Also called intellectual disability, which is
and protect self-esteem.
increasingly the preferred term.
mental model any internal representation of
Mental scale see bayley scales of infant and
the relations between a set of elements, as, for
toddler development.
example, between workers in an office or depart-
ment, the elements of a mathematics or physics mental set a temporary readiness to perform
problem, the terms of a syllogism, or the config- certain psychological functions that influences
uration of objects in a space. Such models may response to a situation or stimulus, such as the
contain perceptual qualities and may be abstract tendency to apply a previously successful tech-
in nature. They can be manipulated to provide nique in solving a new problem. It is often deter-
dynamic simulations of possible scenarios and mined by instructions but need not be.
are thought to be key components in decision mental status the global assessment of an indi-
making. In the context of ergonomics, for exam- vidual’s cognitive, affective, and behavioral state
ple, a mental model of a system or product as revealed by mental examination that covers
would include its various attributes, rules for op- such factors as general health, appearance,
eration and handling, and expectations regard- mood, speech, sociability, cooperativeness, fa-
ing use and consequences and would be used to cial expression, motor activity, mental activity,
guide the individual’s interactions with the sys- emotional state, trend of thought, sensory
tem or product in question. awareness, orientation, memory, information
mental patient organization a club or level, general intelligence level, abstraction and
other organization established to provide social interpretation ability, and judgment.
and recreational activities to former mental pa- mental status examination (MSE) a com-
tients and to help them maintain their morale prehensive work-up of a patient, based on inter-
and readjust to community life. Many mental views, tests, and other sources of information
patient organizations are independent, but oth- and including details of mental status, personal-
ers are affiliated with clinics, hospitals, and men- ity characteristics, diagnosis, prognosis, and
tal health associations or centers. See ex-patient treatment options.
club. mental subnormality an obsolete name for
mental process any process that takes place in mental retardation.
353
mental tension
mental tension mental activity, usually in- ment constitutes sexual harassment and that
volving unpleasant emotions. victims do not bear the burden of demonstrating
mental topography see topographical psy- they were harmed by the harassment.
chology. merycism n. see rumination.
mentoring n. the provision of instruction, en- mescal buttons see peyote.
couragement, and other support to an individ- mescaline n. a hallucinogen derived from the
ual (e.g., a student, youth, or colleague) to aid his peyote cactus and long used by indigenous peo-
or her overall growth and development or the ples of the southwestern United States and cen-
pursuit of greater learning skills, a career, or tral America. Its effects often include nausea and
other educational or work-related goals. Numer- vomiting as well as visual hallucinations involv-
ous mentoring programs exist today within oc- ing lights and colors; they have a slower onset
cupational, educational, and other settings; they than those of lsd and usually last 1–2 hours.
use frequent communication and contact be- Mescaline is the oldest classic hallucinogen
tween mentors and their respective protégés as known to Western science; its pharmacology
well as a variety of other techniques and proce- was defined in 1896, and its structure was veri-
dures to develop positive productive relation- fied by synthesis in 1919. It is a substituted
ships. phenylethylamine, and its likely mechanism
meperidine n. a synthetic opioid used in the of action is via the 5-HT2 serotonin receptor.
acute management of moderate to severe pain Mescaline is classified by the U.S. Drug Enforce-
(see opioid analgesic). It is an agonist at the ment Administration as a Schedule I controlled
mu opioid receptor and has the side effects of substance (see scheduled drug).
other opioid analgesics. Fatal reactions have mesmerism n. an old name, used in the mid-
resulted when meperidine is administered to 18th through the mid-19th centuries, for hyp-
patients taking monoamine oxidase inhibitors nosis. See animal magnetism. [Franz Anton
(MAOIs), and it should therefore not be used in Mesmer (1733–1815), Austrian physician and an
patients who have taken MAOIs within 14 days. early proponent of hypnosis] —mesmerist n.
Patients taking phenothiazine antipsychotics or —mesmeric adj.
tricyclic antidepressants concurrently with me-
peridine may experience severe respiratory mesmerize vb. an archaic word for hypnotize.
depression. Also called pethidine. U.S. trade mesocortical system a network of dopa-
M name (among others): Demerol. minergic neurons in the brain that consists of
mephenytoin n. see hydantoin. the medial prefrontal cortex and the ante-
rior cingulate gyrus. It has connections to
meprobamate n. one of the drugs introduced
other parts of the limbic system, and its activity
into the U.S. market in the early 1950s as an al-
is related to emotion, reward, and substance
ternative to the barbiturates. It was commonly
abuse.
and widely prescribed in the 1950s and 1960s for
daytime sedation and the treatment of anxiety. mesolimbic system a network of dopamin-
Meprobamate is a less potent respiratory depres- ergic neurons in the brain consisting of the
sant than the barbiturates unless taken in combi- nucleus accumbens, amygdala, and olfactory tu-
nation with other CNS depressants, such as bercle. Its activity is related to emotion, reward,
alcohol and opioids. Like the barbiturates, use and substance abuse.
of meprobamate has been almost completely mesomorph n. a constitutional type (somato-
supplanted by the benzodiazepines. U.S. trade type) in sheldon’s constitutional theory
name: Miltown. See also sedative, hypnotic, of personality characterized by a muscular,
and anxiolytic drugs. athletic physique, which—according to this the-
mercy n. kindness, compassion, or leniency to- ory—is highly correlated with somatotonia.
ward a transgressor, toward someone over whom Also called mesomorphic body type. See
one has power or authority, or toward someone also body-build index. —mesomorphic adj.
in distress. —mesomorphy n.
mercy killing a direct action intended to end mesoridazine n. a first-generation (typical or
what would otherwise be the prolonged agony conventional) antipsychotic of the piperidine
of a dying person or animal. The concept has phenothiazine class. Mesoridazine is a low-
been known since ancient times: Warriors often potency agent that is a metabolic product of
were expected to kill a desperately wounded thioridazine. Like the latter drug, its use is as-
comrade or enemy. Severely injured animals are sociated with life-threatening disturbances in
also put out of their misery by mercy killing. See heart rhythm (prolongation of the Q-T interval
also assisted death; euthanasia. potentially leading to torsades de pointes syn-
Meridia n. a trade name for sibutramine. drome; see electrocardiographic effect). It
should not be administered to individuals taking
Merital n. a trade name for nomifensine. other drugs that prolong the Q-T interval or who
Meritor Savings Bank v. Vinson a case re- have a history of heart rhythm disturbances, and
sulting in an influential 1986 U.S. Supreme it is appropriate for the treatment of schizophre-
Court ruling that a hostile work environ- nia only in individuals who have not responded
354
metapsychology
to other antipsychotic agents. U.S. trade name: example, some people have negative attitudes
Serentil. toward anger in themselves or anyone else; oth-
messenger RNA (mRNA) a type of rna that ers like to encourage anger. Some are ashamed of
carries instructions from a cell’s genetic material being too happy; others strive for such a state.
(usually dna) to the protein-manufacturing ap- metamemory n. awareness of one’s own mem-
paratus elsewhere in the cell and directs the as- ory processes, often involving a conscious at-
sembly of protein components in precise accord tempt to direct or control them. It is an aspect of
with those instructions. The instructions are em- metacognition.
bodied in the sequence of bases in the mRNA, ac- metamorphosis n. a change in form or struc-
cording to the genetic code. ture, typically from one developmental stage
Messiah complex the desire and compulsion to another. See also sexual metamorphosis.
to redeem or save others or the world. The indi- —metamorphose vb.
vidual may harbor the delusion of being divine. metamotivation n. in the humanistic psy-
See also jehovah complex. chology of Abraham maslow, those motives
Mestinon n. a trade name for pyridostigmine. that impel an individual to “character growth,
meta-analysis n. a quantitative technique for character expression, maturation, and develop-
synthesizing the results of multiple studies of a ment,” that is, the motivation that operates on
phenomenon into a single result by combining the level of self-actualization and transcen-
the effect size estimates from each study into a dence in the hierarchy of needs (see maslow’s
single estimate of the combined effect size or motivational hierarchy). In Maslow’s view,
into a distribution of effect sizes. metamotivation is distinct from the motivation
operating in the lower level needs, which he calls
metabolic defect any deficiency in the struc-
deficiency motivation, and it emerges after
ture or enzymatic function of protein molecules
the lower needs are satisfied. Also called being
or in the transport of substances across cell
motivation; B-motivation; growth moti-
membranes due to inborn errors of metabo-
vation. See metaneeds. See also maslow’s
lism or disturbances caused by toxic agents or
theory of human motivation.
dietary excesses (e.g., alcoholism or cholesterol-
rich foods). metaneeds pl. n. in the humanistic psychol-
ogy of Abraham maslow, the highest level of
metabolic–nutritional model a system of
needs that come into play primarily after the M
studying mental disorders in which the empha-
lower level needs have been met. Metaneeds
sis is on long-term assessments of the influence
constitute the goals of self-actualizers and in-
of such factors as toxins and deprivations in pop-
clude the needs for knowledge, beauty, and cre-
ulations.
ativity. In Maslow’s view, the inability to fulfill
metabolic screening examination procedures them results in metapathology. Also called
used in predicting or diagnosing possible in- being values; B-values. See metamotiva-
born errors of metabolism (e.g., phenyl- tion. See also maslow’s theory of human mo-
ketonuria). The procedures include routine tivation.
blood tests for newborns, genetic counseling
metapathology n. in the humanistic psy-
of parents with known familial metabolic defi-
chology of Abraham maslow, the state of
ciencies, and amniocentesis.
vague frustration or discontent experienced
metabolic tolerance see pharmacodynamic by individuals who are unable to satisfy their
tolerance. metaneeds (e.g., specific creative, intellectual,
metabolism n. the physical and chemical pro- or aesthetic needs). See also metamotivation;
cesses within a living cell or organism that are maslow’s theory of human motivation.
necessary to maintain life. It includes catabo- metaphor therapy a system that focuses on
lism, the breaking down of complex molecules the symbolic meaning of language and the use of
into simpler ones, often with the release of en- metaphors in therapy. It is theorized that meta-
ergy; and anabolism, the synthesis of complex phors may provide means for restructuring
molecules from simple ones. [term coined by thinking and approaches to problem solving in
German physiologist Theodor Schwann (1810– treatment. [developed by U.S. psychotherapist
1882)] —metabolic adj. Richard R. Kopp (1942– )]
metacognition n. awareness of one’s own cog- metapsychological profile in psychoanaly-
nitive processes, often involving a conscious at- sis, a systematic profile of a patient’s intra-
tempt to control them. The so-called tip-of-the- psychic functioning, in contrast to a mere list of
tongue phenomenon, in which one struggles symptoms; such a profile offers a picture of his or
to “know” something that one knows one her entire personality. The technique was devel-
knows, provides an interesting example of meta- oped by Anna freud in 1965.
cognition. —metacognitional adj.
metapsychology n. the study of, or a concern
Metadate n. a trade name for methylpheni- for, the fundamental underlying principles of
date. any psychology. The term was used by Sigmund
metaemotion n. one’s awareness of and atti- freud to denote his own psychological theory,
tude toward one’s own and others’ emotions. For emphasizing its ability to offer comprehensive
355
metastasis
explanations of psychological phenomena on a its sedative or cns depressant properties. It

fundamental level. Freud’s criteria for a meta- is available in tablet and injectable forms. U.S.
psychology were that it should explain a psy- trade name: Robaxin.
chical phenomenon in terms of (a) its dynamics, methodological behaviorism a form of be-
(b) its topology, and (c) its economic aspects. haviorism that concedes the existence and real-
Although these specific criteria apply most ity of conscious events but contends that
clearly to Freud’s own theory, the notion of the only suitable means of studying them sci-
metapsychology as explanation at a fundamen- entifically is via their expression in behavior.
tal and comprehensive level continues to be a Compare radical behaviorism. See neobe-
useful construct. —metapsychological adj. haviorism.
metastasis n. see cancer. methotrimeprazine n. a low-potency anti-
meth n. slang for methamphetamine. psychotic of the aliphatic phenothiazine class.
methadone n. a synthetic opioid analgesic In the United States, it is currently used only for
that is used for pain relief and as a substitute for the treatment of pain. Also called levomepro-
heroin in methadone maintenance therapy. mazine. U.S. trade name: Levoprome.
It is quite effective when orally ingested and has methyldopa n. a drug used for treating hyper-
a long duration of action, both preventing with- tension. It acts as an agonist at alpha-
drawal symptoms and blocking the reinforcing adrenergic receptors in brainstem centers
effects of heroin. U.S. trade name (among oth- that control the vascular system. When stimu-
ers): Dolophine. lated by methyldopa, these receptors, which act
methadone maintenance therapy a drug- via an inhibitory feedback mechanism, slow the
rehabilitation therapy in which those with her- release of catecholamines from central neurons
oin dependence are prescribed a daily oral dose involved in the regulation of blood pressure. U.S.
of methadone to blunt craving for opioid drugs. trade name: Aldomet.
A controversial treatment, it is nonetheless 3,4-methylenedioxyamphetamine n. see
widely considered the most effective approach mda.
to heroin addiction. 3,4-methylenedioxymethamphetamine
Methadrine n. a trade name for methamphet- n. see mdma.
amine hydrochloride. methylphenidate n. a stimulant related to
M methamphetamine n. a cns stimulant the amphetamines and with a similar mecha-
whose chemical structure is similar to that of nism of action. It is an indirect agonist of
amphetamine but that has a more pronounced catecholamine neurotransmission, blocking the
effect on the central nervous system. It is used reuptake of catecholamines from the synaptic
for treating attention-deficit/hyperactivity dis- cleft and stimulating presynaptic release of cat-
order in children and as a short-term aid to obe- echolamines. Unlike amphetamine, methyl-
sity treatment in adults. Like all amphetamines, phenidate is more potent as a reuptake blocker
methamphetamine is prone to abuse and de- than as a releasing agent. Methylphenidate is
pendence. It can be smoked, snorted, ingested used as an adjunct to antidepressant therapy and
orally, or injected. After the initial rush—it in- to increase concentration and alertness in pa-
creases activity levels and induces a general tients with brain injuries, brain cancer, or de-
sense of well-being—a state of high agitation mentia. It is officially approved by the U.S. Food
that can lead to violence is experienced by some and Drug Administration for the treatment of
users. Long-term abuse is associated with nerve attention-deficit/hyperactivity disorder (ADHD)
damage and behavioral and mental status and narcolepsy in both children and adults.
changes, including psychosis. U.S. trade name: In children with ADHD, methylphenidate in-
Desoxyn. creases attention and decreases impulsivity and
methaqualone n. a synthetic drug with seda- physical overactivity, leading to improvement
tive and hypnotic effects, unrelated chemically in academic and social functioning, at least
to other sedatives, and having a potency roughly while the drug is being administered. Potential
equal to that of pentobarbital. It is used to long-term side effects in children include growth
treat patients who are unable to tolerate barbitu- suppression, which may occur at least tran-
rate drugs. In small doses, the drug depresses the siently in some children taking these drugs. It
sensory cortex; in larger doses, it affects the spi- is not recommended to use methylphenidate
nal reflexes. It has caused more deaths from or other stimulants in children without concur-
overdose than such drugs as PCP and heroin. rent behavioral therapy or counseling. Methyl-
Trade name: Quaalude. See sedative, hyp- phenidate is a drug of potential abuse; it is
notic, and anxiolytic drugs. classified by the U.S. Drug Enforcement Admin-
istration as a Schedule II controlled substance
methocarbamol n. a member of a group of
(see scheduled drug). U.S. trade names
centrally acting muscle relaxants used as an
(among others): Concerta; Metadate; Ritalin.
adjunctive agent in the management of
musculoskeletal pain. Because methocarbamol methylphenyltetrahydropyridine n. see
does not directly reduce skeletal muscle tension, mptp.
its therapeutic action is thought to be due to methylxanthines pl. n. methylated derivatives
356
midazolam
of xanthines (stimulant plant alkaloids) with comprises 25 yes–no questions, such as “Do you
similar pharmacological actions. The most com- ever feel guilty about your drinking?” or “Are
mon are caffeine (1,3,7-trimethylxanthine), you able to stop drinking when you want to?”.
the active ingredient in coffee; theobromine Various other forms of the instrument are avail-
(3,7-dimethylxanthine), the active ingredient able, including the 10-question Brief MAST
in cocoa; and theophylline (1,3-dimethyl- (BMAST) and the 13-question Short MAST
xanthine), the active ingredient in tea. At (SMAST). [developed in 1971 by U.S. psychiatrist
low doses methylxanthines cause CNS stimula- Melvin L. Selzer at the University of Michigan,
tion and arousal; at high doses, anxiety, agita- Ann Arbor]
tion, and coma may result. Methylxanthines Mickey Finn see knockout drops.
also relax bronchial muscles: Some (e.g.,
theophylline) have been used in the medical microcephaly n. a condition in which the head
management of reactive airway disease, al- is abnormally small in relation to the rest of
though they have now largely been supplanted the body. There are numerous causes and ma-
by newer agents. nifestations. Mental retardation ranging from
moderate to profound often accompanies micro-
methysergide n. an ergot derivative used in cephaly. See also primary microcephaly;
the treatment of migraine headaches. It reduces pure microcephaly. Compare macrocephaly.
the frequency and intensity of migraine attacks —microcephalic adj.
in most individuals and is thought to act by op-
posing the action of serotonin (see serotonin microgeny n. the series of small steps that lead
antagonists). Methysergide is closely related to up to a patient’s symptoms or to an individual’s
lsd and has similar effects at some tissue sites. specific behavior or mental processes. The term
Side effects of methysergide include light- is used in the psychodynamic approach.
headedness or dizziness, nausea or vomiting, eu- micromelia n. a developmental defect marked
phoria, insomnia, and unsteadiness. U.S. trade by abnormal shortness or smallness of the limbs,
name: Sansert. sometimes associated with mental retardation.
metonymic distortion a cognitive distur- microphthalmos–corneal opacity–spas-
bance, observed in schizophrenia, in which re- ticity syndrome a presumably hereditary dis-
lated but inappropriate verbal expressions are order of children born with microcephaly,
used in place of the proper expression. For exam- small eyes with opaque corneas, spastic diplegia
ple, a person may say that he or she had three (spasticity in both legs or both arms), and men- M
menus (instead of three meals) a day. tal retardation. Scissoring (crossing) of the legs is
metonymy n. in speech pathology, a distur- a common sign in such patients.
bance in which imprecise or inappropriate micropsychosis n. psychotic episodes of very
words and expressions are used. See metonymic brief duration (minutes to hours) that occur dur-
distortion. —metonymic adj. ing times of stress. Micropyschoses have been
Metrazol shock treatment a form of shock observed primarily in borderline personality
therapy involving the intravenous injection of disorder and pseudoneurotic schizophre-
Metrazol, a trade name for pentylenetetrazol, a nia, although the latter is no longer a valid diag-
powerful cns stimulant that induces convul- nostic entity.
sions and coma. Because the procedure pro- microptic hallucination see lilliputian
duced intense feelings of dread, and the hallucination.
incidence of fatality was high, it is now rarely microsleep n. a brief interval of dozing or loss of
used. Also called Metrazol therapy; Metrazol awareness that occurs during periods when a
treatment. [introduced in 1934 by Hungarian person is fatigued and trying to stay awake while
psychiatrist Ladislas von Meduna (1896–1964)] doing monotonous tasks, such as driving a car,
Meyer’s theory the theory of mental illness looking at a computer screen, or monitoring
proposed by Swiss-born U.S. psychiatrist Adolf controls. Such periods of “nodding off” typically
Meyer (1866–1950), who believed that mental last for 2–30 s and are more likely to occur in the
disorders resulted from behavior patterns that predawn and mid-afternoon hours. They in-
developed as faulty responses to specific situa- crease the risk of accidents.
tions. He advocated a holistic approach (see microsocial engineering a technique of con-
psychobiology) to diagnosis and treatment of flict resolution among family members in which
mental disorders. a behavioral contract is established through
mianserin n. an antidepressant with a mecha- a specific schedule of responsibilities, privileges,
nism of action similar to that of the related com- sanctions for violations, and bonuses for compli-
pound mirtazapine. Mianserin is marketed in ance.
several countries (e.g., under the trade name midazolam n. a highly potent, short-acting
Tolvon) but not in the United States. benzodiazepine used chiefly for the induction
Michigan Alcoholism Screening Test of anesthesia or conscious sedation for operative
(MAST) a widely used measure designed to pro- procedures. It is available in a form for intrave-
vide a rapid screening for problematic alcohol nous or intramuscular administration and as
consumption, alcohol abuse, and alcoholism. It a syrup for oral administration. Because of its
357
midbrain
potential to induce respiratory depression (par- Individuals with MCI are at increased risk for de-
ticularly when used as a sedating agent in veloping alzheimer’s disease.
nonsurgical situations), its short half-life, and mild depression a mild form of depression,
the need for continuous monitoring of respira- typically minor depressive disorder or a
tory and cardiac function, midazolam has little, major depressive episode with mild or few
if any, application in mental health settings. It symptoms.
has reportedly been used as a date-rape drug.
U.S. trade name: Versed. mild mental retardation a diagnostic and
classification category applying to those with
midbrain n. a relatively small region of the IQs of 50 to 69, comprising 80% of people with
upper brainstem that connects the forebrain mental retardation. These individuals usu-
and hindbrain. Also called mesencephalon. ally develop good communication skills and
middle-child syndrome a hypothetical con- reach a sixth-grade level of academic perfor-
dition purported to be shared by all middle-born mance in their late teens, but may not develop
children, based on the assumption that middle beyond the social skill levels typical of adoles-
children in a family develop personality charac- cents. Usually they are able to learn life and vo-
teristics that are different from first-born and cational skills adequate for basic self-support and
later born children. Current research indicates independent living.
that a child’s birth order in a particular family milieu n. (pl. milieux) in psychology and psy-
may have small, subtle influences on personality chiatry, the social environment, especially the
and intelligence but not strong and consistent atmosphere and character of the home, neigh-
effects on psychological outcomes. See also borhood, school, workplace, and so on as they
birth order. affect the personality and adjustment of the in-
dividual.
middle insomnia a period of sleeplessness that
occurs after falling asleep normally, with diffi- milieu therapy psychotherapeutic treatment
culty in falling asleep again. It is a common based on modification or manipulation of the
symptom of a major depressive disorder. client’s life circumstances or immediate environ-
Compare initial insomnia; terminal insom- ment. Milieu therapy attempts to organize the
nia. social and physical setting in which the client
lives or is being treated in such a way as to pro-
midlife crisis a period of psychological distress mote healthier, more adaptive cognitions, emo-
M occurring in some individuals during the middle tions, and behavior. See also environmental
years of adulthood, roughly from ages 35 to 65. therapy; therapeutic community.
Causes may include significant life events and
health or occupational problems and concerns. military psychology the application of psy-
See also age crisis. [term coined in 1965 by Ca- chological principles, theories, and methods to
nadian consulting organizational psychologist the evaluation, selection, assignment, and train-
Elliot Jaques (1917–2003)] ing of military personnel, as well as to the design
of military equipment. This field of applied psy-
midpoint n. the point or value halfway between chology also includes the application of clinical
the highest and lowest values in a frequency and counseling techniques to the maintenance
distribution. of morale and mental health in military settings
Mignon delusion a variation of the family- and covers human functioning in a variety of en-
romance fantasy in which children believe that vironments during times of peace and war.
their parents are actually foster parents and their military stress models models for assessing
real families are of distinguished lineage. The stress in military operations and strategies for
name is derived from the child character in Goe- coping with it. Factors affecting the number of
the’s novel Wilhelm Meister’s Apprenticeship military personnel that become stress casual-
(1796). ties include the nature of the operation in
Migranal n. a trade name for dihydro- which they are involved, the intensity of the
ergotamine. conflict, the number of battle casualties occur-
ring, and the size, cohesion, and leadership of
migration adaptation adjustment to a new the unit in which they are serving.
community or area, which involves withstand-
Miller, Neal Elgar (1909–2002) U.S. psycholo-
ing the stresses of geographic mobility (e.g., leav-
gist. Miller received his doctorate in psychology
ing familiar surroundings, adapting to unfamiliar
from Yale University in 1935, working with Wal-
surroundings and customs). Though stressful,
ter Miles (1885–1978) and Clark hull. After a
such factors have not been proved to be a com-
postdoctoral year studying psychoanalysis in Vi-
mon source of mental illness.
enna, he taught at Yale for 30 years before mov-
mild cognitive impairment (MCI) a transi- ing in 1966 to Rockefeller University, where he
tional condition between normal healthy aging remained for the remainder of his career. Miller’s
and early dementia, characterized by a memory abiding interest was in the motivational aspects
impairment greater than would be expected for of reward and drive reduction and in the applica-
age and education. Other cognitive functions are tions of experimental work to clinical psychol-
intact, and activities of daily living are normal. ogy. Much of his early research attempted
358
mind-cure movement
to reconcile Sigmund freud’s theories of psy- is considered more the province of humans and
chopathology with Ivan pavlov’s learning of human consciousness than of organisms in
theory, through the laboratory study of experi- general. 5. human consciousness regarded as an
mentally induced pathological behavior. His immaterial entity distinct from the brain. See
work was fundamental to the fields of learning cartesian dualism. 6. the brain itself and its
and motivation, clinical psychology, and espe- activities: in this view, the mind essentially is
cially the newer field of behavioral medicine, both the anatomical organ and what it does. 7.
of which he is regarded as a founder. Among his concentration or focused attention. 8. intention
books that are considered to be classics are Social or volition. 9. opinion or point of view. 10. the
Learning and Imitation (1941) and Personality and characteristic mode of thinking of a group, such
Psychotherapy (1950), both coauthored with as the criminal mind or the military mind.
John Dollard (1900–1980). His many honors in- mindblindness n. a deficit in theory of mind
cluded the National Medal of Science, the Ameri- that is characteristic of people with autism. A
can Psychological Association’s Distinguished person with mindblindness cannot “read the
Scientific Contributions Award, and election to minds” of others, that is, understand their be-
the National Academy of Sciences. havior in terms of belief–desire reasoning.
Milligan annihilation method a type of [first described by British psychologist Simon
electroconvulsive therapy in which three Baron-Cohen (1958– )]
treatments are administered the first day, fol- mind–body intervention therapeutic ap-
lowed by two treatments daily until the desired proaches that focus on harnessing the power of
level of regression is achieved. the mind to bring about change in the body
milling around the initial stage in an encoun- or achieve reduction of symptoms of disease or
ter group, during which participants discuss disorder. The various techniques used include re-
trivial topics in order to avoid exposing them- laxation training (e.g., autogenic training,
selves to new people and new interpersonal pro- progressive relaxation), meditation, prayer,
cesses. and creative arts therapy. See also comple-
Millon Clinical Multiaxial Inventory mentary and alternative medicine.
(MCMI) a true–false questionnaire, consisting of mind–body problem the problem of account-
175 items, that is widely used to assess clinical ing for and describing the relationship between
conditions and personality disorders in psychi- mental and physical processes (psyche and M
atric patients in the United States. First pub- soma). Solutions to this problem fall into six
lished in 1977, it has been revised twice; the broad categories: (a) interactionism, in which
most recent version, MCMI–III, includes 24 mind and body are separate processes that never-
scales arranged into four groups: clinical person- theless exert mutual influence (see cartesian
ality patterns, severe personality pathology, clin- dualism); (b) parallelism, in which mind and
ical syndromes, and severe clinical syndromes. body are separate processes with a point-to-
Additionally, there are four corrections scales to point correspondence but no causal connection;
help detect random or dishonest responding. (c) idealism, in which only mind exists and the
base rate scores are used in interpreting results. soma is a function of the psyche; (d) double-
[Theodore Millon (1929– ), U.S. psychologist] aspect theory, in which body and mind are both
Miltown n. a trade name for meprobamate. functions of a common entity; (e) epipheno-
menalism, in which mind is a by-product of
mind n. 1. most broadly, all intellectual and psy- bodily processes; and (f) materialism, in which
chological phenomena of an organism, en- body is the only reality and the psyche is nonex-
compassing motivational, affective, behavioral, istent. Categories (a) and (b) are varieties of du-
perceptual, and cognitive systems; in other alism; the remainder are varieties of monism. In
words, the organized totality of the mental and the context of psychopathology, two central
psychic processes of an organism and the struc- questions arising from the mind–body problem
tural and functional cognitive components on are which sphere takes precedence in the genesis
which they depend. The term, however, is often and development of illness and how does each
used more narrowly to denote only cognitive ac- sphere affect the other. Also called body–mind
tivities and functions, such as perceiving, at- problem.
tending, thinking, problem solving, language,
learning, and memory. The nature of the rela- mind control 1. an extreme form of social in-
tionship between the mind and the body, influence used to indoctrinate an individual in the
cluding the brain and its mechanisms or attitudes and beliefs of a group, usually one that
activities, has been, and continues to be, the sub- is religious or political in nature. See brain-
ject of much debate. See mind–body problem. washing. 2. the control of physical activities of
2. the substantive content of such mental and the body, particularly autonomic functions, by
psychic processes. 3. consciousness or aware- mental processes. See autogenic training;
ness, particularly as specific to an individual. 4. a biofeedback; transcendental meditation;
set of emergent properties automatically de- yoga. See also mind–body intervention.
rived from a brain that has achieved sufficient mind-cure movement a self-help movement
biological sophistication. In this sense, the mind in the 19th century that assumed that physical
359
mindfulness
health was the product of “right” thinking, usu- the diagnosis of dementia. The patient is asked
ally regarded as optimism, self-affirmation, and simple questions relating to orientation (e.g.,
self-regulation of moods. “What day is today?”) and required to perform
mindfulness n. full awareness of one’s internal simple tasks (e.g., remember the names of three
states and surroundings: the opposite of absent- common objects, fold a piece of paper in half,
mindedness. The concept has been applied to write an intelligible sentence) assessing memory,
various therapeutic interventions—for example, attention and calculation, and language. Also
mindfulness-based cognitive behavior ther- called Folstein Mini-Mental State Exami-
apy, mindfulness-based stress reduction, mind- nation. [devised in 1975 by U.S. psychiatrists
fulness for addictions, and mindfulness Marshal F. Folstein (1941– ), Susan E. Folstein
meditation—to help people avoid destructive (1944– ), and Paul R. McHugh ]
or automatic habits and responses by learning to minimization n. cognitive distortion con-
observe their thoughts, emotions, and other sisting of a tendency to present events to oneself
present-moment experiences without judging or or others as insignificant or unimportant.
reacting to them. —mindful adj. Minimization often involves being unclear or
mindfulness meditation a type of medita- nonspecific, so the listener does not have a com-
tion in which thoughts, feelings, and sensations plete picture of all the details and may be led to
are experienced freely as they arise. Mindfulness draw inaccurate or incomplete conclusions. See
meditation is intended to enable individuals to also denial.
become highly attentive to sensory information Minnesota Multiphasic Personality In-
and to focus on each moment as it occurs. See ventory (MMPI) a personality inventory
also mindfulness; transcendental medita- first published in 1940 and now one of the most
tion. Compare concentrative meditation. widely used self-report tools for assessing per-
mindsight n. a proposed mode of visual percep- sonality. It has broad applications across a range
tion, hypothesized to work in parallel with ev- of mental health, medical, substance abuse, fo-
eryday vision, in which a person registers a rensic, and personnel screening settings as a
nonvisual sense of change in visual information measure of psychological maladjustment. The
before conscious awareness of the change original inventory consisted of 550 true–false
through actually “seeing” it. [proposed by 21st- items grouped into nine scales reflecting com-
century Canadian psychologist and computer mon clinical problems: hypochondria, depres-
M scientist Ronald A. Rensink] sion, hysteria, psychopathic deviate, masculine–
feminine interest, paranoia, psychasthenia (i.e.,
mineralocorticoid n. any corticosteroid anxiety), schizophrenia, and hypomania. The re-
hormone that affects ion concentrations in body sults were scored by the examiner or by com-
tissues and helps to regulate the excretion of salt puter to determine the participant’s personality
and water. In humans the principal mineralo- profile as well as any tendency to lie or to fake
corticoid is aldosterone. good or bad. The version currently in use, the
minimal brain damage (MBD) 1. a mild de- MMPI–2 (1989), features 567 true–false ques-
gree of brain damage that is presumed to exist tions that assess symptoms, attitudes, and beliefs
because of the presence of a constellation of that relate to emotional and behavioral prob-
soft signs, which may include short attention lems, including substantial revisions of the origi-
span, distractibility, impulsivity, hyperactivity, nal items and the addition of new scales. The
emotional lability, poor motor coordination, early 1990s saw the publication of a version
visual-perceptual disturbance, language difficul- of the instrument, the MMPI–A, with content
ties, and learning problems. These symptoms items specifically relevant to adolescents aged
occur among a number of conditions involving 14–18. The instrument’s 478 items help identify
neurologically based disturbance, including personal, social, and behavioral problems (e.g.,
attention-deficit/hyperactivity disorder, family issues, eating disorders, chemical depend-
learning disorders, communication disor- ency). [originally developed by U.S. psychologist
ders, and developmental coordination Starke Rosecrans Hathaway (1903–1984) and
disorder. 2. an old name for attention- U.S. psychiatrist John Charnley McKinley
deficit/hyperactivity disorder. (1891–1950) at the University of Minnesota]
minimal brain dysfunction (MBD) 1. a rel- minor n. a person who is not legally an adult.
atively mild impairment of brain function that is minor depressive disorder a mood disorder
presumed to account for a variety of soft signs in which, for at least 2 weeks, the individual has
seen in certain learning or behavioral disabil- either persistent depressed mood or anhedonia
ities. These signs include hyperactivity, impul- as well as at least two of a range of other symp-
sivity, emotional lability, and distractibility. toms. These other symptoms include: poor or
Also called minimal cerebral dysfunction. increased appetite with significant weight loss or
2. an old name for attention-deficit/hyper- gain; insomnia or excessive sleep; psycho-
activity disorder. motor agitation or psychomotor retarda-
Mini-Mental State Examination (MMSE) tion; loss of energy with fatigue; feelings of
an instrument used extensively to provide a worthlessness or inappropriate guilt; reduced
quick assessment of cognitive status as a tool for ability to concentrate or make decisions; and re-
360
misanthropy
current thoughts of death, suicidal ideation, mirror reading 1. reading in a pattern that is
or attempted suicide. These symptoms do not the reverse of that generally followed. 2. a task in
meet the criteria for dysthymic disorder and, which a person must read words that are pre-
according to proposed formal diagnostic criteria, sented one at a time in mirror image. 3. a prefer-
they must occur in an individual who has never ence for reading mirror-reversed rather than
had a major depressive episode. However, in normally written words.
clinical practice, a diagnosis of minor depressive mirror sign 1. the inability to recognize the re-
disorder is widely applied to people who have flection of oneself in a mirror. 2. the tendency to
significant symptoms of, but fail to meet the look at oneself in a reflecting surface (window,
full criteria for, major depressive disorder, re- mirror, etc.) frequently and for an extended pe-
gardless of their history of depression. See also riod of time. [first described in 1927 by Paul
depressive disorder not otherwise speci- Abely as an early symptom of schizophrenia]
fied.
mirror technique 1. the conscious use of ac-
minority stress the physiological and psycho- tive listening by the therapist in psychother-
logical effects associated with the adverse social apy, accompanied by reflection of the client’s
conditions experienced by ethnic and racial affect and body language in order to stimulate a
minorities, lesbians, gay men, bisexual and sense of empathy and to further the develop-
transgender individuals, and others who are ment of the therapeutic alliance. 2. in psy-
members of stigmatized social groups. Common chodrama, a technique in which an auxiliary
sources of minority stress include experiencing ego imitates a client’s behavior patterns to show
prejudice, discrimination, harassment, or verbal that person how others perceive and react to him
or physical violence; expecting or experiencing or her. Also called mirroring.
rejection by others; concealing one’s minority mirror transference in psychoanalysis, a
identity; and internalizing negative societal atti- transference technique used in the treatment
tudes about one’s social group that results in a of narcissistic personality disorders in
negative self-view. The concept frequently is in- which the patients’ grandiose selves are reacti-
voked by researchers to explain the increased vated as a replica of the early phase of their lives
rates of depression, suicide, anxiety, substance when their mothers established their sense of
abuse, workplace problems, body image prob- perfection by admiring their exhibitionistic be-
lems, eating disorders, high blood pressure, car- havior. This “reactivation process” helps to re-
diovascular disease, and other mental and store the patient’s self-esteem.
M
physical conditions among members of minor-
ity or marginalized groups. Conversely, research- mirror writing the production of individual
ers have hypothesized certain protective factors letters and whole word strings in reverse direc-
that help ameliorate the adverse health out- tion. Mirror writing is characterized by an inver-
comes of minority stress. These include personal sion of letters and words such that they appear
characteristics, such as resilience and an effec- reversed unless viewed in a mirror. It is related to
tive coping strategy, and social support strephosymbolia. Also called palingraphia;
mechanisms, such as cohesion. [coined in 1995 retrography.
by Israeli-born U.S. social psychologist Ilan H. mirtazapine n. an antidepressant whose mech-
Meyer] anism of action differs from that of most other
antidepressants. It is considered to be a mixed-
minor tranquilizer see anxiolytic. function antidepressant in that two separate
mirroring n. 1. reflecting or emulating speech, actions result in increased neurotransmission of
affect, behavior, or other qualities in psycho- norepinephrine and serotonin. By binding to
therapeutic contexts. A therapist may adopt the presynaptic α2-adrenoreceptors (see adrenergic
movements, speech style, or locutions of a cli- receptor; autoreceptor), it enables contin-
ent, and vice versa, to indicate comprehension ued release of norepinephrine from presynaptic
of what is being said or to reflect bonding, either neurons. It also acts as a serotonin-receptor
unconsciously or with the intent of empathiz- agonist at postsynaptic 5-HT1 receptors. Other
ing. 2. the positive responses of parents to a actions of mirtazapine include potent antago-
child that are intended to instill internal self- nism of other serotonin receptors and histamine
respect. 3. see mirror technique. receptors, but it does not inhibit the reuptake
of serotonin or norepinephrine. Sedation and
mirror phase the stage in development occur- weight gain are common adverse effects of mir-
ring around 6–18 months of age when the infant tazapine, probably due to its potent ability
becomes able to imagine himself or herself as an to block the histamine H1 receptor. Unlike
autonomous ego in the image of the parent and many other antidepressants, in most patients
also starts to recognize his or her reflection in a mirtazapine does not cause sexual dysfunction.
mirror. In sum, the child begins to acquire a self- Rarely, agranulocytosis has been associated
image. French psychoanalyst Jacques Lacan with its use. U.S. trade name: Remeron.
(1901–1981), who introduced the phrase, saw
this as marking the start of the infant’s transition misandry n. hatred or contempt for men. Com-
from the realm of the imaginary to that of the pare misogyny. —misandrist n., adj.
symbolic. See also name-of-the-father. misanthropy n. a hatred, aversion, or distrust
361
misattribution
of human beings and human nature. —misan- to a convicted defendant that supports the argu-
thrope n. —misanthropic adj. ment for a more lenient sentence. Examples of
misattribution n. an incorrect inference as to mitigating factors are the defendant’s youth,
the cause of an individual’s or group’s behavior personal or family circumstances, or dimin-
or of an interpersonal event. For example, ished responsibility. Also called mitigating
misattribution of arousal is an effect in which circumstance. Compare aggravating fac-
the physiological stimulation generated by one tor.
stimulus is mistakenly ascribed to another mixed-effects model a statistical procedure
source. See also attribution theory. for analyzing data from experimental designs
miscarriage n. see abortion. that use one or more independent variables
whose levels are specifically selected by the re-
misidentification n. 1. failure to identify indi-
searcher (fixed factors; e.g., male and female)
viduals correctly due to impaired memory or a
and one or more additional independent vari-
confused state, as in dementia or alcoholic in-
ables whose levels are chosen randomly from a
toxication or sometimes in mania. 2. failure to
wide range of possible values (random factors;
recognize people or objects due to a delusion
e.g., age). See also fixed-effects model.
that they have been transformed (delusional
misidentification). See misidentification syn- mixed emotions two or more emotions, differ-
drome. ing in feeling quality and action tendency,
elicited by the same event. For example, a father
misidentification syndrome a disorder
may be happy that his son is getting married but
characterized by the delusional misidentifica-
sorrowful if the marriage takes the son away
tion of oneself, other people, places, or objects.
from home; a person may become angry at an in-
The misidentification may be expressed as the
sult from a superior and also frightened by the
mistaken belief that a person has altered his
implications for his or her employment. Also
or her identity in some way, either physically
called mixed feelings. See ambivalence.
or psychologically, or that some place or object
has undergone some aspect of transformation. mixed episode an episode of a mood disorder
Also called delusional misidentification lasting at least 1 week in which symptoms meet-
syndrome. See also capgras syndrome; fre- ing criteria for both a major depressive epi-
goli’s phenomenon; intermetamorphosis sode and a manic episode are prominent over
M syndrome. the course of the disturbance. One or more
misinformation effect a phenomenon in mixed episodes may be a feature of bipolar I dis-
which a person mistakenly recalls misleading in- order (see bipolar disorder).
formation that an experimenter has provided, mixed feelings see mixed emotions.
instead of accurately recalling the correct infor- mixed-function antidepressants antide-
mation that had been presented earlier. The mis- pressants that act primarily via more than one
information effect is studied in the context of major neurotransmitter system. The term is
eyewitness memory. often applied to the snris (e.g., venlafaxine),
misocainia (misocainea) n. see misoneism. which inhibit the reuptake of both norepineph-
misogamy n. hatred of or aversion to marriage. rine and serotonin, to distinguish them from the
—misogamist n. ssris (selective serotonin reuptake inhibitors).
Also called dual-action antidepressants.
misogyny n. hatred or contempt for women.
Compare misandry. —misogynist n. —mis- mixed model see mixed-effects model.
ogynistic adj. mixed neurosis in psychoanalysis, a condition
misologia n. an aversion to speaking or arguing. in which a patient shows symptoms of two or
Also called misology. more neuroses. The term is rarely used now.
misoneism n. an extreme resistance to change mixed receptive-expressive language
and intolerance of anything new, sometimes ex- disorder in DSM–IV–TR, a communication
pressed as an obsessive desire to maintain rou- disorder characterized by levels of language
tines and preserve the status quo. It is often comprehension and expressive language devel-
associated with autistic disorder. Also called opment substantially below the expected level of
misocainia. —misoneist n. verbal or nonverbal intellectual ability, as dem-
onstrated by scores on standardized, individu-
misopedia n. a hatred of children. Also called
ally administered measures of both receptive
misopedy.
and expressive language development or func-
mistress n. a woman with whom a married man tional assessment. The deficit interferes substan-
has a continuing sexual relationship, usually tially with scholastic, academic, or occupational
without the knowledge of his wife. The man may achievement or social interactions and is not
provide for the woman, but the relationship is due solely to mental retardation, motor speech
not one of prostitution. disorders, sensory deficit, environmental depri-
MIT abbreviation for melodic intonation vation, or a pervasive developmental disorder.
therapy. mixed schizophrenia 1. a form of schizophre-
mitigating factor a fact relating to a crime or nia in which either both negative and positive
362
moderate mental retardation
symptoms are prominent or neither is promi- modality n. 1. a particular therapeutic tech-

nent. [defined in 1982 by U.S. psychiatrist nique or process. 2. a medium of sensation, such
Nancy C. Andreasen and Scott A. Olsen] 2. his- as vision or hearing. See sense.
torically, a form of schizophrenia that is mani- modality profile in multimodal therapy, a
fested by symptoms of two or more of the four list of problems and proposed treatments across
major types of schizophrenia described by Ger- the seven parameters (modalities) explored in
man psychiatrist Emil Kraepelin (1856–1926) the approach. The parameters, or dimensions
and Swiss psychiatrist Eugen Bleuler (1857– (e.g., affect, sensation), are considered to be dis-
1939): simple, paranoid, catatonic, and hebe- tinct yet interactive. The profiles are created
phrenic (disorganized). specifically with clients for descriptive and ther-
mixoscopia n. a form of voyeurism in which apeutic purposes.
an orgasm is achieved by observing sexual inter-
mode n. 1. a characteristic manner of behavior or
course between the person one loves and an-
way of doing things, as in a technique. 2. the
other person.
most frequently occurring score in a batch of
mixoscopia bestialis a type of sexual devi- data, which is sometimes used as a measure of
ancy in which a person is excited or aroused by central tendency.
watching another individual have coitus with an
model n. 1. a graphic, theoretical, or other type
animal.
of representation of a concept (e.g., a disorder) or
MMECT abbreviation for multiple monitored of basic behavioral or bodily processes that can
electroconvulsive treatment. be used for various investigative and demonstra-
MMPI abbreviation for minnesota multiphasic tive purposes, such as enhancing understanding
personality inventory. of the concept, proposing hypotheses, showing
MMPI–2 abbreviation for the revised version of relationships, or identifying epidemiological
the minnesota multiphasic personality in- patterns. 2. see modeling.
ventory. modeling n. 1. a technique used in cognitive
MMPI–A abbreviation for the version of the min- behavior therapy and behavior therapy in
nesota multiphasic personality inventory which learning occurs through observation and
designed for use with adolescents. imitation alone, without comment or reinforce-
MMSE abbreviation for mini-mental state ex- ment by the therapist. 2. in developmental psy-
amination. chology, the process in which one or more M
individuals or other entities serve as examples
MMT abbreviation for multimodal therapy. (models) that a child will emulate. Models are
mnemonic n. any device or technique used to often parents, other adults, or other children,
assist memory, usually by forging a link or asso- but may also be symbolic, for example, a book or
ciation between the new information to be re- television character. See also social learning
membered and information previously encoded. theory.
For instance, one might remember the numbers modeling effect a type of experimenter effect
in a password by associating them with familiar in which a participant is unwittingly influenced
birth dates, addresses, or room numbers. to give responses similar to the responses the ex-
Moban n. a trade name for molindone. perimenter would give if the experimenter were
moclobemide n. an antidepressant drug that is a participant.
a reversible monoamine oxidase inhibitor modeling theory the idea that changes in be-
(RIMA) and relatively selective for monoamine havior, cognition, or emotional state result from
oxidase A. It therefore lacks many of the food observing someone else’s behavior or the conse-
interactions that limit the use of irreversible, quences of that behavior. See observational
nonselective MAO inhibitors. Moclobemide has learning; social learning theory.
not yet been approved for use in the United
States. model psychosis psychotic symptoms (e.g.,
delusions, hallucinations, disorientation, dis-
modafinil n. a cns stimulant used for the organized speech) deliberately produced by a
treatment of narcolepsy. Its exact mechanism of psychotomimetic drug, such as LSD, for pur-
action is unclear, but modafinil may exert its poses of research. This technique was particu-
stimulant effects by decreasing GABA-mediated larly popular during the 1950s and 1960s.
neurotransmission (see gamma-aminobutyric
acid) and potentiating glutamate transmis- moderate depression a major depressive ep-
sion. Modafinil may therefore serve as an alter- isode whose severity and number of symptoms
native agent for patients who are intolerant of do not meet the criteria for acute depression
amphetamines and related stimulants, which but exceed the criteria for mild depression.
have a different mechanism of action. Because it moderate mental retardation a diagnostic
inhibits the cytochrome p450 2C19 enzyme and classification category applying to those
and induces the cytochrome P450 3A4 enzyme, with IQs of 35 to 49, comprising about 12% of
it may have clinically significant interactions people with mental retardation. These indi-
with drugs metabolized via those enzymes. U.S. viduals rarely progress beyond the second grade
trade name: Provigil. in academic subjects. Although often poorly co-
363
moderator variable
ordinated, they can learn to take care of them- single substance, whether this is identified as
selves and to develop sufficient social and mind, matter, or God. In the context of the
occupational skills to be able to perform un- mind–body problem, monism is any position
skilled or semiskilled work under supervision in that avoids dualism. —monist adj., n. —mo-
sheltered and supportive environments, as well nistic adj.
as in regular workplaces where accommodations monoamine hypothesis the theory that de-
are made. pression is caused by a deficit in the production
moderator variable in statistics, a variable or uptake of monoamines (serotonin, norepi-
that alters the relationship between other vari- nephrine, and dopamine). This theory has been
ables. In regression analysis, for example, it is used to explain the effects of monoamine
a variable that is unrelated to a criterion variable oxidase inhibitors, but is now regarded as too
but is retained in the regression equation be- simplistic.
cause of its significant relationship to other pre-
monoamine oxidase (MAO) an enzyme that
dictor variables.
breaks down and inactivates monoamines, in-
modesty n. 1. absence of self-importance or cluding the neurotransmitters serotonin, nor-
conceit. 2. propriety in appearance, dress, de- epinephrine, and dopamine. It is found in most
meanor, and social behavior. —modest adj. tissues and, in humans, exists in two forms,
module n. 1. in cognitive theory, a hypothetical MAO-A and MAO-B. MAO-B is the predominant
center of information processing that is pre- enzyme in the brain, whereas MAO-A is found
sumed to be relatively independent and highly primarily in the gastrointestinal tract (it ac-
specialized in its operations, such as a language counts for only 20% of brain monoamine
module or face-processing module. 2. in neuro- oxidase). Drugs that inhibit MAO (see mono-
science, a unit of a region of the central nervous amine oxidase inhibitor) are used to treat de-
system. For example, regions of the neocortex pression. There is some evidence that inhibition
in the brain are divided into cortical columns of of MAO-A, which primarily degrades serotonin
basically similar structure. —modular adj. and norepinephrine, may lead to greater antide-
mogilalia n. difficulty or hesitancy in speaking pressant effects than inhibition of MAO-B,
(e.g., stuttering). Also called molilalia. which primarily degrades dopamine.
molar approach any theory or method that monoamine oxidase inhibitor (MAOI;
M stresses comprehensive concepts or overall MAO inhibitor) a group of antidepressant
frameworks or structures. drugs that function by inhibiting the activity
molar behavior a large but unified segment, or of the enzyme monoamine oxidase in pre-
holistic unit, of behavior, such as kicking a ball. synaptic neurons, thereby increasing the
Compare molecular behavior. amounts of monoamine neurotransmitters (se-
rotonin, norepinephrine, and dopamine) avail-
molecular behavior behavior that can be ana- able for release at the presynaptic terminal.
lyzed into smaller, more specific units, such as There are two categories of MAOIs: irreversible
reflexes. Compare molar behavior. and reversible inhibitors. Irreversible MAOIs
molecular genetics the branch of biology that bind tightly to the enzyme and permanently in-
is concerned with the structure and processes of hibit its ability to metabolize any monoamine.
genetic material at the molecular level. This may lead to dangerous interactions with
molestation n. the act of making sexual ad- foods and beverages containing the amino acid
vances toward a person who does not want tryptophan or tyramine, which are present in
them. Molestation generally implies sexual fon- many foods, particularly those produced by en-
dling or touching an individual “without lawful zymatic action or by aging (e.g., cheeses, pre-
consent.” When the victim of molestation is a served meats and fish). A hypertensive crisis (a
child or a person who is mentally challenged, it potentially fatal rise in blood pressure) may re-
may be assumed that he or she does not have the sult from these interactions, a phenomenon that
capacity to give lawful consent. See also sex of- is sometimes known as the “cheese effect.” Irre-
fense. —molest vb. versible MAOIs are of two classes: hydrazines
molilalia n. see mogilalia. related to isoniazid (see isocarboxazid;
phenelzine), and nonhydrazines, of which
molindone n. a conventional (typical or first-
tranylcypromine (U.S. trade name: Parnate) is
generation) antipsychotic of the dihydro-
the only agent used for mental disorders in the
indolone class. It is of intermediate potency
United States. Reversible inhibitors of mono-
and has few anticholinergic side effects. Until
amine oxidase (RIMAs) do not bind irreversibly
the advent of the atypical, or second-generation,
to the enzyme, thereby freeing it to take part in
antipsychotics, it was frequently used, usually in
the metabolism of amino acids and other
low doses, for the management of psychoses ac-
amines. RIMAs may be less prone to producing
companying medical conditions (e.g., HIV-
a hypertensive crisis, which would obviate
related dementia). U.S. trade name: Moban.
the need for dietary restrictions on tyramine-
mongolism n. an obsolete name for down syn- containing foods. Examples of RIMAs are
drome. moclobemide and brofaromine, which are
monism n. the position that reality consists of a available in Europe but have not yet been ap-
364
mood disorder due to a general medical condition
proved for use in the United States. The avail- identical DNA. For every 1,000 pregnancies there
ability of other effective antidepressants lacking are, on average, 3–4 MZ twins. Also called iden-
the drug–food interactions of the MAOIs has led tical twins. Compare dizygotic twins. See
to a precipitous decline in their use, particularly also twin study.
of the irreversible agents. mood n. 1. any short-lived emotional state, usu-
monodrama n. in group therapy, a role- ally of low intensity (e.g., a cheerful mood, an ir-
playing technique in which a member of the ritable mood). 2. a disposition to respond
group acts out a scene alone. The member’s be- emotionally in a particular way that may last
havior is then evaluated by the group. for hours, days, or even weeks, perhaps at a low
monogamy n. 1. a mating system in which two level and without the person knowing what
individuals mate exclusively with each other. prompted the state. Moods differ from emo-
Recent genetic studies of paternity indicate that tions in lacking an object; for example, the
some offspring of male–female pairs exhibiting emotion of anger can be aroused by an insult,
monogamy are not related to the father, leading but an angry mood may arise when one does not
to a distinction between social monogamy, in know what one is angry about or what elicited
which there is an appearance of a close pair the anger. Disturbances in mood are characteris-
bond, and genetic monogamy, in which there tic of mood disorders.
is exclusive mating. Many species, including mood-altering drugs substances that change
human beings, display serial monogamy, in the affective state of the individual through
which there is an exclusive social bond with pharmacological action, usually without cloud-
each of a series of sexual partners at different ing of consciousness. They include certain tran-
times during the individual’s life. 2. tradition- quilizing, sedating, and antidepressant agents.
ally, marriage to only one spouse at a time. Com- mood congruent relating to a consistency or
pare polygamy. —monogamous adj. agreement between a particular expressed feel-
monoideism n. obsessive preoccupation with a ing and the general emotional context within
single idea to the exclusion of anything else. which it occurs. Thus, crying at a time of sadness
monomania n. 1. extreme enthusiasm or zeal or personal distress is viewed as mood congru-
for a single subject or idea, often manifested as ent. Similarly, in psychiatric diagnosis, the term
a rigid, irrational idea. See also idée fixe. 2. an relates to a consistency between the expression
obsolete name for a pattern of abnormal behav- of a particular symptom or behavior with those
characteristics or patterns of ideation or action
M
ior with reference to a single subject in an other-
wise apparently normally functioning in- used to classify a particular mental disorder. In
dividual. —monomaniac n. both instances, inconsistencies are described as
monopediomania n. sexual interest in and mood incongruent.
arousal by people who have only one leg. mood-congruent psychotic features delu-
monophagism n. a pathological eating behav- sions or hallucinations that are thematically
ior in which the individual habitually eats only consistent with either depressed or manic mood
one type of food or only one meal a day. and may occur in severe major depressive epi-
sodes, manic episodes, or mixed episodes.
monophasic sleep a sleep pattern in which
sleeping occurs in one long period once a day, mood-dependent memory a condition in
typically at night. Both it and biphasic sleep (see which memory for some event can be recalled
polyphasic sleep) contribute to physical and more readily when one is in the same emotional
emotional health and greater alertness. See also mood (e.g., happy or sad) as when the memory
sleep–wake cycle. was initially formed. See also context-specific
learning; state-dependent memory.
monosomy n. see autosome. —monosomic
adj. mood disorder in DSM–IV–TR, a psychiatric
disorder in which the principal feature is a pro-
monosomy 5p see cri du chat syndrome. longed, pervasive mood disturbance, such as
monosymptomatic circumscription a a depressive disorder (e.g., major depres-
mental disorder characterized by a single symp- sive disorder, dysthymic disorder) or bi-
tom. polar disorder, mood disorders due to
monotherapy n. the use of a single method or a general medical condition, substance-
approach to treat a particular disorder or pre- induced mood disorder, and mood disorder
senting symptom, as opposed to the use of a not otherwise specified, which does not meet
combination of methods. An example is the use the diagnostic criteria for any of the specific
of only pharmacotherapy, instead of phar- mood disorders. A mood disorder is also called
macotherapy and psychotherapy in combina- an affective disorder.
tion, to treat depression. mood disorder due to a general medical
monozygotic twins (MZ twins) twins, al- condition in DSM–IV–TR, significant and per-
ways of the same sex, that develop from a single sistent mood disturbance (with depressive symp-
fertilized ovum (zygote) that splits to produce toms, manic symptoms, or both) associated with
two individuals who carry exactly the same com- a medical condition and believed to be caused
plement of genes; that is, they are clones, with directly by the physiological effects of that con-
365
mood incongruent
dition. A variety of medical conditions may ing from the repressed oedipus complex. It is a
cause mood disturbance, including Parkinson’s nonsexual form of masochism.
disease, Huntington’s disease, stroke, hyper- or moral therapy a form of psychotherapy from
hypothyroidism, some infections (e.g., hepatitis, the 19th century based on the belief that a per-
AIDS), and certain cancers (e.g., pancreatic). son with a mental disorder could be helped by
mood incongruent see mood congruent. being treated with compassion, kindness, and
mood-incongruent psychotic features dignity in a clean, comfortable environment
delusions or hallucinations whose content does that provided freedom of movement, opportuni-
not include manic or depressed themes. They ties for occupational and social activity, and re-
may occur in severe major depressive epi- assuring talks with physicians and attendants.
sodes, manic episodes, or mixed episodes. This approach advocating humane and ethical
treatment was a radical departure from the pre-
mood induction any method for producing a vailing practice at that time of viewing the “in-
negative or positive change in mood, often by sane” with suspicion and hostility, confining
selectively reminding individuals of pleasant or them in unsanitary conditions, and routinely
unpleasant aspects of their lives. abusing them through the use of such practices
moodiness n. an affective state characterized as mechanical restraint, physical punishment,
by irritability or dysphoria combined with sen- and bloodletting. Moral therapy originated in
sitivity to negative interpersonal cues. —moody the family-care program established in the Gheel
adj. colony, Belgium, during the 13th century, but
mood stabilizer any of various drugs used in came to fruition in the 19th century through the
the treatment of cyclic mood disorders (bipolar efforts of Philippe Pinel and Jean Esquirol (1772–
disorders and cyclothymic disorder). Be- 1840) in France, William Tuke (1732–1822) in
cause they reduce the symptoms of mania or England, and Benjamin Rush (1745–1813), Isaac
manic episodes, mood stabilizers are sometimes Ray (1807–1881), and Thomas Kirkbride (1809–
known as antimanics. lithium is usually the 1883) in the United States. The therapeutic
first-line medication for bipolar I disorder, community of today has its roots in this move-
but anticonvulsants, such as valproic acid, ment. Also called moral treatment.
carbamazepine, and oxcarbazine, are becoming moratorium n. in Erik erikson’s theory of psy-
more commonly used for this condition and are chosexual development, the experimental pe-
M now preferred for other cyclic disorders. The riod of adolescence in which, during the task of
calcium-channel blocker verapamil is also discovering who one is as an individual separate
being investigated as a mood stabilizer. Mood from family of origin and as part of the broader
stabilizers are occasionally used in the manage- social context, young people try out alternative
ment of severe affective lability found in some roles before making permanent commitments to
personality disorders (e.g., borderline personal- an identity. Adolescents who are unsuccessful
ity disorder). Because of the potential for self- at negotiating this stage risk confusion over their
injurious behavior in bipolar disorders and per- role in life. See erikson’s eight stages of de-
sonality disorders, great caution must be taken velopment; identity versus identity confu-
when prescribing medications that are poten- sion.
tially lethal in overdose. morbid adj. unhealthy, diseased, or otherwise
mood swings oscillations in mood, particularly abnormal.
between feelings of happiness and sadness, rang- morbid dependency excessive reliance on or
ing in intensity from normal fluctuations to need for another person or situation such that
cyclothymia (see cyclothymic disorder) or a the dependent person has difficulty functioning
bipolar disorder. independently. See dependency need.
moon-phase studies research into the possible morbidity n. a pathological (diseased) condi-
relationship between the phases of the moon tion or state, either organic or functional.
and episodes of violence or mental disorder. The
relationship has long been expressed in folklore, morbidity rate the incidence of disease, ex-
folk medicine, and language itself (e.g., the pressed as a ratio denoting the number of people
words lunacy and lunatic). Methodologically in a population who are ill or have a specific dis-
sound studies of the effects of moon phase on ease compared with the number who are well.
behavior are infrequent. morbidity risk in epidemiology, the statisti-
moral development the gradual formation of cal chance that an individual will develop a cer-
an individual’s concepts of right and wrong, tain disease or disorder. The probability is often
conscience, ethical and religious values, social expressed in terms of risk factors, using 1.0 as a
attitudes, and behavior. Some of the major theo- base: The larger the number, the greater the mor-
rists in the area of moral development are Sig- bidity risk.
mund freud, Jean piaget, and Erik erikson. morbid jealousy see delusional jealousy.
moral masochism in psychoanalytic theory, morbid obesity obesity that causes disease.
the unconscious need for punishment by au- The excess body weight begins first to interfere
thority figures caused by unconscious guilt aris- with agility and then day-to-day movement. As
366
motivation
the obesity increases, the massive weight of tis- use of the same analogy, but with a less dramatic
sue on the chest interferes with breathing. Af- conclusion. By contrast, le grand mort (the great
fected people gradually develop hypoxemia death) of Elizabethan poets visualizes death as
(decreased blood oxygen) and sleep apnea (peri- the ultimate tumultuous orgasm.
odic cessation of breathing while asleep), which mortido n. in psychoanalytic theory, the energy
may result in chronic fatigue and somnolence of the death instinct and counterpart to the
and, eventually, high blood pressure, pulmonary libido. See also destrudo. [defined in 1936
hypertension, myocarditis, right-sided heart fail- by Austrian psychoanalyst Paul Federn (1872–
ure, and ultimately death. See also body mass 1950)]
index.
mother archetype in Carl jung’s analytic
moria n. an obsessive or morbid desire to joke, as psychology, the primordial image of the gener-
in some cases of dementia, particularly when ative and sustaining mother figure that has oc-
the humor is inappropriate. curred repeatedly in various cultural concepts
Morita therapy a therapy for shinkeishitsu and myths since ancient times and is located
consisting of an initial 7-day period of strict and within the collective unconscious. See also
isolated bed rest followed by step-by-step occu- archetype; magna mater.
pational therapy and final reintegration into mother figure 1. a person who occupies the
job and family. A central concept is the attain- mothering role in relation to a child: a mother
ment of arugamama, an attitude of acceptance surrogate. 2. in psychoanalytic theory, a per-
toward one’s self and one’s feelings. [Shoma son onto whom the patient transfers feelings
Morita (1874–1938), Japanese psychiatrist] and attitudes that he or she had toward the real
morning-after pill a popular name for post- mother. Also called mother substitute.
coital, or emergency, oral contraception. It con- mothering n. the process of nurturing, caring
sists of two doses of a progestin, or a combined for, and protecting a child by a mother or mater-
formulation of a progestin and an estrogen, nal figure.
taken at spaced intervals no later than 72 hours
after intercourse.
Mothers Against Drunk Driving (MADD)
an organization whose mission is to stop drunk
morning-glory seeds seeds of the plant Rivea driving and to support its victims. It was known
corymbosa, which contain psychoactive agents as Mothers Against Drunk Drivers until 1984. See
and have been used as hallucinogens, notably self-help group. M
in 16th-century Mexico.
mother–son incest sexual activity between
morphine n. the primary active ingredient in mother and son, which is rarer than father–
opium, first synthesized in 1806 and widely used daughter incest. See also phaedra complex.
as an analgesic and sedative, especially in termi-
nally ill cancer patients (see opiate; opioid
mother substitute 1. see mother figure. 2.
see mother surrogate.
analgesic). Prolonged administration or abuse
can lead to dependence and to withdrawal mother surrogate a substitute for an individ-
symptoms on cessation. The substance is 10 ual’s biological mother (e.g., a sister, grand-
times as potent as opium. See opioid abuse; mother, stepmother, or adoptive mother), who
opioid dependence; opioid intoxication; assumes the responsibilities of that person and
opioid withdrawal. may function as a role model and significant at-
tachment figure. U. S. psychologist Harry Har-
morphophilia n. interest in sexual partners
low’s (1905–1981) classic research with young
whose body characteristics (e.g., height, weight,
monkeys demonstrated that monkeys preferred
or skin and hair color) are very different from
a mother surrogate covered in cloth to one that
one’s own.
was simply a wire frame, even though the latter
morsicatio buccarum habitual biting of the was the source of food. Also called mother fig-
inside of the cheeks (buccal mucosa), sometimes ure; surrogate mother.
causing lesions or the formation of white excess
tissue.
motility psychosis an obsolescent name for a
bipolar disorder that has as a prominent fea-
morsicatio labiorum see lip biting. ture extreme psychomotor agitation or psy-
mortality n. the death rate in a population. chomotor retardation.
mortality salience the cognitive accessibility motivated forgetting a memory lapse moti-
of thoughts about the inevitability of one’s vated by a desire to avoid a disagreeable recollec-
death. Such thoughts are believed by some theo- tion. It is one of the cognitive mechanisms that
rists to be a motivating force behind a diverse set has been suggested as a cause of delayed memo-
of actions designed to defend oneself or one’s so- ries of childhood trauma.
cial group. motivation n. 1. the impetus that gives purpose
mort douce primarily in literary contexts, a or direction to human or animal behavior and
peaceful death (French, literally “sweet death”) operates at a conscious or unconscious level (see
in which all tensions are released in a manner unconscious motivation). Motives are fre-
reminiscent of the fulfillment of sexual inter- quently divided into (a) physiological, primary,
course. Petit mort (little or quiet death) makes or organic motives, such as hunger, thirst, and
367
motivational enhancement therapy
need for sleep, and (b) personal, social, or sec- motor cortex the region of the frontal lobe of
ondary motives, such as affiliation, competition, the brain responsible for the control of volun-
and individual interests and goals. An important tary movement. It is divided into two parts. The
distinction must also be drawn between internal primary motor cortex, or motor area, is the
motivating forces and external factors, such as main source of neurons in the corticospinal
rewards or punishments, that can encourage or tract. The secondary (or nonprimary) motor cor-
discourage certain behaviors. See extrinsic mo- tex, made up of the premotor area and the
tivation; intrinsic motivation. 2. in condi- supplementary motor area, is specialized for
tioning, the variables, collectively, that alter planning upcoming movements and learning
the effectiveness of reinforcers. 3. a person’s new movements. Lesions in the primary motor
willingness to exert physical or mental effort in cortex due to stroke or traumatic injury usually
pursuit of a goal or outcome. 4. the act or process cause initial paralysis that may improve to a con-
of encouraging others to exert themselves in dition involving weakness and poor muscle
pursuit of a group or organizational goal. The tone. Lesions in the secondary motor cortex usu-
ability to motivate followers is an important ally cause complex disruptions in motor plan-
function of leadership. —motivate vb. —moti- ning for complex movements (see apraxia).
vated adj. —motivational adj. Also called motor strip.
motivational enhancement therapy a motor disorder loss of the ability to perform
transtheoretical treatment, based on the stages simple or complex acts or skills because of tem-
of change, that matches clients to interven- porary or permanent damage to tissues in the
tions on the basis of individual differences in premotor or motor areas of the central nervous
readiness to change. This treatment was initially system. The cause of the damage may be a con-
applied to substance abuse but has now general- genital or inherited defect, injury, surgical exci-
ized to other problem behaviors. sion, or a psychochemical factor.
motivational factor any physiological or psy- motor disturbance any disturbance of motor
chological factor that stimulates, maintains, and behavior, such as hyperactivity, retarded activ-
directs behavior. Examples are basic physiolog- ity, automatism, repetitive movements, rigid
ical needs, interests, and extrinsic rewards. posture, grimacing, or tics.
motivational hierarchy see maslow’s moti- motor neuron a neuron whose axon connects
vational hierarchy. directly to muscle fibers. Because motor neurons
M are the final stage of output from the nervous
motivational styles a way of classifying peo-
ple with regard to their learning and perfor- system and are the only means of stimulating
mance, in which categories are based on in- muscle fibers, they are known as the final com-
dividual differences in motivation, including mon path. There are two types: lower motor
but not limited to intrinsic–extrinsic motiva- neurons (or alpha motor neurons), found in the
tion, mastery orientation, and competitiveness. cranial nerves and the anterior horn of the spinal
The notion of motivational styles is particularly cord and which are responsible for muscle con-
used in education, business, and sport to help traction; and upper motor neurons (or gamma
people recognize both strengths and weaknesses motor neurons), found in the corticospinal tract
and develop strategies to improve learning and and which modulate the sensitivity of muscle
performance. spindles, thus influencing activity of the lower
motor neurons. Also called motoneuron.
motive n. 1. a specific physiological or psycho-
logical state of arousal that directs an organism’s motor speech disorder any of several com-
energies toward a goal. See motivation. 2. a rea- munication disorders arising from inaccurate
son offered as an explanation for or cause of an production of speech sounds because of lack of
individual’s behavior. strength or coordination of the muscles in-
volved in speaking, as occurs in cerebellar
motor area an area of the motor cortex that, ataxia or parkinson’s disease.
when stimulated, produces movements of skele-
tal muscles in various parts of the body. It has
motor system the complex of skeletal muscles,
neural connections with muscle tissues, and
somatotopic organization, with individual neu-
structures of the central nervous system associ-
rons controlling a specific movement direction
ated with motor functions. Also called neuro-
of an associated body part that might involve co-
muscular system.
ordinated action of several muscles. Also called
Brodmann’s area 4; primary motor cor- motor tension a state of muscle tension in
tex. which the individual is restless and tires easily.
This symptom is associated with generalized
motor conversion symptoms one of two
anxiety disorder.
types of symptoms of conversion disorder,
the other being sensory conversion symp- motor test any test designed to measure motor
toms. Examples of motor conversion symptoms skills, ranging from gross motor to fine motor
include impaired coordination and balance, pa- manipulation.
ralysis or weakness confined to a specific area of mourning n. the process of feeling or expressing
the body, difficulty in swallowing, aphonia (loss grief following the death of a loved one, or the
of voice), and urinary retention. period during which this occurs. It typically in-
368
multidetermined behavior
volves feelings of apathy and dejection, loss of drate—in the tissues. Certain forms of the dis-
interest in the outside world, and diminution in ease are associated with mental retardation.
activity and initiative. These reactions are simi- See hunter’s syndrome; hurler’s syndrome;
lar to depression, but are less persistent and are maroteaux–lamy syndrome; sanfilippo’s
not considered pathological. See also bereave- syndrome.
ment. mucous colitis see irritable bowel syn-
movement disorder any abnormality in motor drome.
processes, relating primarily to posture, coor- muina n. see bilis.
dination, or locomotion. Medication-induced
movement disorders, such as tardive dyskin- muliebrity n. the state or condition of being a
esia, occur as an adverse effect of medication woman (from Latin mulier, “woman”) or the
and are particularly common with antipsychotic qualities considered to be characteristic of
drugs. women.
movement therapy a therapeutic technique multa loca tenens principle a rule stating
in which individuals use rhythmic exercises and that if a drug can substitute for or mimic one ac-
bodily movements to achieve greater body tion of a natural physiological agent, it may be
awareness and social interaction and enhance able to simulate other natural functions as well.
their psychological and physical functioning. Because of such multiple effects, the adminis-
See also dance therapy. tered drug may compete for receptors, enzymes,
and other physiological targets.
MPI abbreviation for Maudsley Personality In-
ventory. See eysenck personality inventory. multiattribute-utility analysis a method
MPS 1. abbreviation for mucopolysacchari- of using the ratings of judges to quantify the so-
dosis. 2. abbreviation for myofascial pain syn- cial utility or value of a given program. Dimen-
drome (see chronic myofascial pain). sions relevant to program outcomes are ranked
and then weighted in terms of their comparative
MPTP n. 1-methyl-4-phenyl-1,2,3,6-tetrahydro- social importance; each program is scored on all
pyridine: a by-product of heroin synthesis that social-value dimensions. This form of analysis
is used experimentally to induce symptoms of enables comparisons of different social programs
Parkinson’s disease in laboratory animals. It was to be made.
discovered accidentally in 1976 when it was syn-
thesized and injected by a recreational drug multiaxial classification a system of classi- M
user who was attempting to produce an analog fying mental disorders according to several cate-
of meperidine (Demerol). This individual devel- gories of factors, for example, social and cultural
oped acute symptoms of Parkinson’s disease, as influences, as well as clinical symptoms. dsm–
did other users of the drug. Autopsy revealed iv–tr uses multiaxial classification, which takes
massive degeneration of dopamine-containing account of the many factors involved in the eti-
neurons in the nigrostriatal tract. MPTP is ology of these disorders and enables a more com-
not in itself neurotoxic (damaging to nerve tis- prehensive clinical assessment to be made. See
sue), but it is converted to the methylphenyl- axis.
+
pyridinium ion (MPP ), a potent neurotoxin at multicultural therapy 1. any form of psy-
dopaminergic neurons, by the enzyme mono- chotherapy that takes into account not only the
amine oxidase B. increasing racial and ethnic diversity of clients
MR abbreviation for mental retardation. in many countries but also diversity in spiritual-
ity, sexual orientation, ability and disability, and
MRI abbreviation for magnetic resonance im-
social class and economics; the potential cultural
aging.
bias (e.g., racism, sexism) of the practitioner; the
mRNA abbreviation for messenger rna. history of oppressed and marginalized groups;
MS abbreviation for multiple sclerosis. diversity within diversity; acculturation and is-
MSE abbreviation for mental status examina- sues involving living in two worlds; and the poli-
tion. tics of power as they affect clients. 2. any form
of therapy that assesses, understands, and evalu-
MSIS abbreviation for multistate information ates a client’s behavior in the multiplicity of
system. cultural contexts (e.g., ethnic, national, demo-
MSLT abbreviation for multiple sleep latency graphic, social, and economic) in which that be-
test. havior was learned and is displayed.
MSP abbreviation for munchausen syndrome multidetermination n. the interaction of sev-
by proxy. eral different factors in the etiology of a disorder
MSUD abbreviation for maple-sugar urine dis- (e.g., biological, psychological, environmental).
ease. —multidetermined adj.
mucopolysaccharidosis (MPS) n. (pl. muco- multidetermined behavior the concept that
polysaccharidoses) any of various metabolic human behavior is influenced by the interaction
disorders, classified into six groups (I–VI), that of multiple factors, past and present. In general,
are marked by excess mucopolysaccharide— the major influences are genetic, environmental,
glyccosaminoglycan (GAG), a complex carbohy- physiological, and psychological.
369
multidimensional
multidimensional adj. 1. describing any form chotherapy in which the therapist assesses
of analysis in which factors or variables are repre- the client’s significant Behaviors, Affective re-
sented on more than one dimension. 2. of scales sponses, Sensations, Imagery, Cognitions, Inter-
or measures, having a number of different di- personal relationships, and the need for Drugs
mensions. Compare unidimensional. and other biological interventions. The first
Multidimensional Scale for Rating Psy- letters yield the acronym BASIC ID, which sum-
chiatric Patients see inpatient multidi- marizes the seven basic interactive modalities of
mensional psychiatric scale. the approach. MMT posits that these modalities
exist in a state of reciprocal transaction and flux,
multidimensional scaling (MDS) a scaling connected by complex chains of behavior and
method that represents perceived similarities other psychophysiological processes. The thera-
among stimuli by arranging similar stimuli in pist, usually in concert with the client, deter-
spatial proximity to one another, while disparate mines which specific problems across the BASIC
stimuli are represented far apart from one an- ID are most salient. MMT uses an eclectic ap-
other. Multidimensional scaling is an alternative proach drawing mainly from a broad-based so-
to factor analysis for dealing with large multi- cial and cognitive learning theory. Also called
dimensional matrices of data or stimuli. multimodal behavior therapy. [developed
multifactorial adj. consisting or arising out of by South African-born U.S. clinical psychologist
several factors, variables, or causes. Arnold Allan Lazarus (1932– )]
multifactorial inheritance inheritance of a multimodal treatment a manner of treating
trait, such as height or predisposition to a certain a disease, disorder, or syndrome by simulta-
disease, that is determined not by a single gene neously applying several different methods,
but by many different genes acting cumula- often from different disciplines or traditions.
tively. Such traits show continuous, rather than
multinomial distribution a theoretical
discrete, variation among the members of a
probability distribution that describes the distri-
given population and are often significantly
bution of n objects sampled at random from a
influenced by environmental factors, such as nu-
population of k kinds of things with regard to
tritional status. Also called polygenic inheri-
the number of each of the kinds that appears in
tance.
the sample.
multigenerational transmission process multipayer system see all-payer system.
M the passing on of psychological problems, pri-
marily anxiety, over several generations through multiphilia n. interest in multiple, short-term
family relationships. A central concept in fam- sexual relationships only, with no desire for any
ily systems theory, the principal process in- long-term relationship or commitment.
volves the unconscious passing on of a higher multiple delusions concurrent delusions,
level of anxiety, which overrides adaptive think- not necessarily interconnected.
ing and behavior, to members in each succeed- multiple family therapy a form of group
ing generation. Interventions to change this therapy in which a group of two or more family
transmission involve charting family relation- members meets with two or more therapists at
ships and coaching individuals on how to inter- once. See also family therapy; cotherapy.
act with targeted relatives, usually those who are
lowest in anxiety and who function at the most multiple-impact therapy a treatment
adaptive level. [developed by U.S. psychiatrist method in which a group of mental health pro-
Murray Bowen (1913–1990)] fessionals works with a client family during an
intensive, limited period.
Multilingual Aphasia Examination (MAE)
a neuropsychological test battery used to deter- multiple marital therapy a form of therapy
mine the presence, type, and severity of apha- in which each marital partner is treated inde-
sia. The 11 subtests, assessing various aspects of pendently by individual therapists. The two
expressive and receptive language function, therapists may meet privately to discuss their cli-
include Visual Naming, Sentence Repetition, ents, and sessions involving all four parties or a
controlled oral word association, Oral combination of the parties may be held. See also
Spelling, Written Spelling, Block Spelling, a conjoint therapy.
token test, Aural Comprehension of Words multiple monitored electroconvulsive
and Phrases, Reading Comprehension of Words treatment (MMECT) a form of electrocon-
and Phrases, Rating of Articulation, and Rating vulsive therapy in which an attempt is made
of Praxic Features of Writing. The MAE was origi- to shorten the overall period of treatment by in-
nally developed in 1978 and is now in its third ducing several seizures in a single session. Also
edition (published in 2001). Despite the implica- called multimonitored electroconvulsive
tions of its name, the MAE currently is available treatment.
only in English and Spanish versions. [devel- multiple orgasm in women, the occurrence of
oped by U.S. psychologists Arthur Lester Benton more than one orgasm, without a resolution
(1909–2006), Kerry deS. Hamsher (1946– ), and phase (see sexual-response cycle) separating
Abigail B. Sivan (1943– )] the orgasms. Studies have found that as many as
multimodal therapy (MMT) a form of psy- 30% of women experience this. Male multiple
370
murder–suicide
orgasm does not occur, because further arousal hours apart. The object is to assess daytime sleep
and response are not possible during the re- tendency by measuring the number of minutes
fractory phase following male orgasm. How- it takes the individual to fall asleep. The individ-
ever, some men do carefully monitor and ual is monitored by means of electrodes that
control their arousal and may experience the measure brain waves, eye movements, heartbeat,
first elements of an orgasm, without ejaculation, and muscle tone. The test is used in the diagnosis
more than once before having a complete or- of primary hypersomnia and narcolepsy.
gasm, with ejaculation. multiple suicides see cluster suicides; mass
multiple personality disorder see dis- suicide.
sociative identity disorder. multistage sampling a sampling technique in
multiple regression a statistical technique for which samples are drawn first from higher order
examining the linear relationship between a groupings (e.g., states) and in later stages of the
continuous dependent variable and a set of process from successively lower level groupings
two or more independent variables. It is often (e.g., counties within states, towns within coun-
used to predict the score of individuals on a crite- ties) in order to avoid the necessity of having a
rion variable from multiple predictor variables. sampling frame for the entire population.
multiple relationship in a therapeutic con- multistate information system (MSIS) an
text, a situation in which a psychologist has automated record-keeping system designed to
more than one type of relationship with a client. provide comparative statistics for evaluation of
A multiple relationship occurs when a psycholo- programs and treatment procedures in U.S. men-
gist is in a professional role with a person and (a) tal hospitals and community mental health fa-
concurrently is in another role with the same cilities.
person, (b) concurrently is in a relationship with multivariate adj. consisting of or otherwise in-
a person closely associated with or related to the volving two or more variables. Compare uni-
client, or (c) promises to enter into another rela- variate. See also bivariate.
tionship in the future with the client or a person
multivariate analysis any of several types of
closely associated with or related to the client.
statistical analysis that simultaneously model
Psychologists are ethically expected to refrain
multiple dependent variables.
from entering into a multiple relationship
because it might impair their objectivity, compe- multivariate analysis of variance (MAN- M
tence, or effectiveness in performing their func- OVA) an extension of the analysis of variance
tions as a psychologist or exploit or harm the (ANOVA) model that identifies the simultaneous
client with whom the professional relationship effects of the independent variables upon a set of
exists. Also called dual relationship. dependent variables.
multiple sclerosis (MS) a demyelinating dis- Munchausen syndrome a severe and chronic
ease of the central nervous system (brain and spi- form of factitious disorder characterized by
nal cord) characterized by inflammation and repeated and elaborate fabrication of clinically
multifocal scarring of the protective myelin convincing physical symptoms and a false
sheath of nerves, which damages and destroys medical and social history (see pseudologia
the sheath and the underlying nerve, disrupting fantastica). Other features are recurrent hospi-
neural transmission. The initial symptom of MS talization and peregrination, and there may be
is often a visual disturbance, such as blurred or multiple scars from previous (unnecessary) in-
double vision, red–green color distortion, or vestigative surgery. The patient’s motivation is a
blindness in one eye. Later symptoms include fa- psychological need to assume the sick role.
tigue, weakness in the hands and feet, numb- See also pathomimicry. [Baron Karl Friedrich
ness, stiffness or muscular spasms, muscle and Hieronymus von Münchhausen (1720–1797),
back pain, difficulties with coordination and bal- German soldier-adventurer famous for his tall
ance, loss of bladder or bowel control, and de- tales]
pression. Some individuals also experience Munchausen syndrome by proxy (MSP) a
cognitive impairments, such as difficulties with psychological disorder in which caregivers fabri-
concentration, attention, memory, and judg- cate or intentionally cause symptoms in those
ment. The onset is usually between the ages of they are caring for in order to seek and obtain
20 and 40, and, with periods of remission, the medical investigation or treatment. Typically,
disease may continue for 25 years or more. Rapid the caregiver is the mother, who behaves as if
progression to death is rare. The cause of MS, distressed about her child’s illness and denies
which occurs twice as frequently in females as in knowing what caused it: She is believed to be
males, is unknown. However, the destruction of motivated by the hope that she will be seen as an
myelin may be due to an autoimmune response exceptionally attentive parent, and her behavior
(see autoimmunity). may be an attempt to arouse sympathy. In DSM–
Multiple Sleep Latency Test (MSLT) an in- IV–TR this condition is called factitious disorder
patient test performed in a sleep laboratory in by proxy (see factitious disorder not other-
which the individual is monitored during a se- wise specified).
ries of five 20-minute nap periods scheduled 2 murder–suicide the intentional killing of an-
371
mu receptor
other person followed by the suicide of the killer. ioral therapies may be useful in bringing
See also extended suicide. awareness and perspective to such maladaptive
mu receptor see opioid receptor. cognitions. See also rational emotive behav-
ior therapy. [defined by U.S. psychotherapist
muscarine n. a toxic alkaloid, isolated from fly Albert Ellis (1913–2007)]
agaric (Amanita muscaria) and some other fungi,
that stimulates certain types of acetylcholine re- mutation n. a permanent change in the genetic
ceptors (the muscarinic receptors) in smooth material of an organism. It may consist of an al-
muscle, cardiac muscle, endocrine glands, and teration to the number or arrangement of chro-
the central nervous system. See also nicotine. mosomes (a chromosomal mutation) or a change
in the composition of DNA, generally affecting
muscarinic receptor (mAChR) a type of
only one or a few bases in a particular gene (a
acetylcholine receptor that responds to
point mutation). Mutations can occur spontane-
muscarine as well as to acetylcholine. Mus-
ously, but many are due to exposure to agents
carinic receptors mediate chiefly the inhibitory
(mutagens) that significantly increase the rate of
activities of acetylcholine. Compare nicotinic
mutation; these include X-rays and other forms
receptor.
of radiation and certain chemicals. A mutation
muscimol n. see fly agaric; gaba agonists; occurring in a body cell (i.e., a somatic mutation)
ibotenic acid. cannot be inherited, whereas a mutation in a re-
muscle dysmorphia a form of body dys- productive cell producing ova or spermatozoa
morphia characterized by chronic dissatisfac- (i.e., a germ-line mutation) can be transmitted
tion with one’s muscularity and the perception to that individual’s offspring. Most mutations
that one’s body is inadequate and undesirable, either have no discernible effect or have a delete-
although objective observers would disagree rious effect; however, a tiny majority are benefi-
with such an assessment. This condition often cial and thus give that individual and his or her
leads to excessive exercising, steroid abuse, and descendants a selective advantage. Mutations re-
eating disorders. It is typically found in males, sponsible for single-gene disorders are sought
especially bodybuilders. Also called bigorexia. in genetic testing of high-risk families or groups.
See also reverse anorexia. mutilation n. 1. the destruction or removal of a
muscle relaxant any of various drugs used in limb or an essential part of the body. 2. a de-
the management of spasms of skeletal muscle structive act causing a disfiguring injury to the
M generally resulting from mechanical injury, body. See also self-mutilation.
stroke, cerebral palsy, or multiple sclerosis. Most mutism n. lack or absence of speaking due to
act on the central nervous system or its associ- physical or psychogenic factors. The condition
ated structures to reduce muscle tone and spon- may result from neurological damage or disor-
taneous activity. Although the precise mode of der, a structural defect in the organs necessary
action varies with the drug, muscle relaxants for speech, congenital or early deafness in which
generally act by depressing spinal reflexes with- an individual’s failure to hear spoken words in-
out loss of consciousness. Common muscle hibits the development of speech, psychological
relaxants include benzodiazepines, baclofen, disorders (e.g., conversion disorder, cata-
dantrolene, and botulinum toxin. Others used tonic schizophrenia), or severe emotional dis-
for localized muscle spasms include cariso- turbance (e.g., extreme anger). The condition
prodol, cyclobenzaprine, methocarbamol, may also be voluntary, as in monastic vows of si-
and orphenadrine. lence or the decision to speak only to selected in-
muscle spindle a receptor that lies within skele- dividuals. See also akinetic mutism; alalia;
tal muscle and sends impulses to the central ner- selective mutism; stupor.
vous system when the muscle is stretched. muttering delirium a type of delirium in
musculoskeletal disorder any disease, in- which an individual’s speech is marked by low
jury, or significant impairment to tendons, mus- utterances, slurring, iteration, dysarthria, per-
cles, bones, joints, and supporting connective severation, or any combination of these.
(soft) tissues. Typically, the individual’s movements are domi-
musician’s cramp a type of occupational nated by restlessness and trembling.
cramp experienced by musicians, usually in the mutual help a form of self-help that is not
arm or hand, that prevents them from perform- professionally guided and that involves joining
ing. The condition may be due to electrolyte im- with others similar to oneself to explore ways to
balance. See also repetitive strain injury. cope with life situations and problems. Mutual
music therapy the use of music as an adjunct help can occur in person, by telephone, or
to the treatment or rehabilitation of individuals through the Internet.
to enhance their psychological, physical, cogni- mutual masturbation 1. sexual activity in
tive, or social functioning. which two individuals stimulate each other’s
musturbation n. the behavior of individuals genitals at the same time for the purpose of
who believe that they must absolutely meet sexual gratification. This is more properly con-
often perfectionist goals in order to achieve suc- sidered a type of petting behavior, as mastur-
cess, approval, or comfort. Cognitive and behav- bation is defined as self-stimulation. 2. sexual
372
mythomania
activity in which two or more individuals stimu- of choices made. The test has little credibility
late their own genitals while jointly viewing among research psychologists but is widely used
erotic materials. Such activity, especially when in educational counseling and human resource
involving adolescent males, is popularly known management to help improve work and personal
as “a circle jerk.” relationships, increase productivity, and identify
mutual pretense an interaction pattern in interpersonal communication preferences and
which all participants try to act as if they are un- skills. [Isabel Briggs Myers (1897–1980), U.S.
aware of the most crucial facts in a situation personologist, and her mother Katharine Cook
(e.g., a situation in which one of the participants Briggs (1875–1968)]
is terminally ill). This pattern is often regarded myocardial infarction see infarction.
by therapists and researchers as an anxiety- myoclonus n. rapid, involuntary contraction of
driven strategy that inhibits communication, in- a muscle or group of muscles. This may occur
creases tension, and leads to missed opportuni- normally, as when a limb or other part of the
ties for meaningful mutual support. body suddenly jerks while falling asleep (see
mutual support group a group composed of nocturnal myoclonus), or abnormally, as in
individuals who meet on a regular basis to help creutzfeldt–jakob disease and other neuro-
one another cope with a shared life problem. logical disorders.
This term is sometimes used by researchers and myofascial pain syndrome (MPS) see
practitioners instead of the traditional term chronic myofascial pain.
self-help group, as it emphasizes the mutual,
interdependent nature of self-help group pro- myriachit n. a culture-bound syndrome
cesses. found in Siberian populations. Similar to latah,
it is characterized by indiscriminate, apparently
myasthenia gravis an autoimmune disorder uncontrolled imitations of the actions of other
(see autoimmunity) in which the body pro- people encountered by the individual. Also
duces antibodies against acetylcholine recep- called ikota; irkunii; menkeiti; olan. See
tors, causing faulty transmission of nerve also imu; jumping frenchmen of maine syn-
impulses at neuromuscular junctions. Affected drome.
muscles—initially those of the face and neck—
are easily fatigued and may become paralyzed Mysoline n. a trade name for primidone.
temporarily (e.g., muscles involved in eating mysophilia n. a pathological interest in dirt or
may fail to function normally toward the end of filth, often with a desire to be unclean or in con- M
a meal, or speech may become slurred after a pe- tact with dirty objects. Mysophilia may be ex-
riod of talking). The disease is progressive, even- pressed as a paraphilia in which the person is
tually affecting muscles throughout the body. sexually aroused by a dirty partner.
mydriasis n. excessive dilation (widening) of the mystic union the feeling of spiritual identifica-
pupil of the eye caused by anticholinergic drugs tion with God, nature, or the universe as a
(e.g., atropine and scopolamine) acting on whole. See cosmic identification; oceanic
muscarinic receptors. —mydriatic adj., n. feeling; transcendental meditation; yoga;
myelination n. the formation and development zen therapy.
of a myelin sheath around the axon of a neu- Mytelase n. a trade name for ambenomium.
ron, which is effected by neuroglia, such as mythology n. 1. a body of traditional stories
schwann cells. Researchers look to anomalies (myths) associated with the early history of a
in this process to explain some forms of severe particular culture. Such stories generally involve
mental illness (e.g., schizophrenia). Also called supernatural beings and events and often seek to
axonal myelination; medullation; mye- explain particular natural or cultural phenom-
linization. ena (e.g., the cycle of the seasons or a specific
myelin sheath the insulating layer around custom) in terms of their supposed origins.
many axons that increases the speed of conduc- Myths are often distinguished from legends as
tion of nerve impulses. It is laid down by glia, having little or no basis in historical events. 2.
which wrap themselves around adjacent axons. the study of myths. Sigmund freud compared
The myelin sheath is interrupted by small gaps myths to dreams, which contain hidden mean-
(nodes of Ranvier) which are spaced about every ings, and believed they throw unique light on
millimeter along the axon. Also called me- the cultures from which they stem, and in some
dullary sheath. instances, as in the myth of Oedipus, on human
Myers–Briggs Type Indicator (MBTI) a per- nature in general. 3. in Carl jung’s analytic
sonality test designed to classify individuals ac- psychology, primordial images, or arche-
cording to their expressed choices between types, that are stored in the collective uncon-
contrasting alternatives in certain categories of scious. —mythological adj.
traits. The categories, based on jungian ty- mythomania n. 1. a tendency to elaborate,
pology, are (a) Extraversion–Introversion, (b) exaggerate, and tell lies, including reports of
Sensing–Intuition, (c) Thinking–Feeling, and (d) imagined experiences, often involving self-
Judging–Perceiving. The participant is assigned a deception. See also factitious disorder;
type (e.g., INTJ or ESFP) according to the pattern pathological lying. 2. an abnormal interest
373
myxedema
in myths, in which the individual may believe is characterized by subnormal heart rate, circula-
fantasy to be reality, and a tendency to fabricate tion, and body temperature and a decrease in
incredible stories. Also called pseudologia most other metabolic activities. Affected indi-
fantastica. See also fabulation. viduals tend to be fatigued, listless, and over-
myxedema n. a metabolic disorder that devel- weight, but usually respond to administration of
ops in adulthood due to a deficiency of thyroid thyroxine. —myxedemic adj.
hormone (see hypothyroidism). The condition MZ twins abbreviation for monozygotic twins.
374
Nn
n symbol for the number of scores or observations the management of opioid dependence in indi-
obtained from a particular experimental condi- viduals desiring abstinence. Naltrexone is also
tion or subgroup. appropriate as an adjunctive treatment in the
NA abbreviation for narcotics anonymous. management of alcoholism. U.S. trade name:
ReVia.
nabilone n. a synthetic cannabinoid, closely re-
lated to tetrahydrocannabinol, that is used name-of-the-father adj. in the theory of
clinically to manage nausea and vomiting in pa- French psychoanalyst Jacques Lacan (1901–
tients recovering from surgical anesthesia or 1981), denoting the stage at which the infant
undergoing chemotherapy. U.S. and Canadian first enters the realm of the symbolic. The
trade name: Cesamet. child’s ability to “name the father” as a symbol
for the absence of the mother represents his or
n-Ach abbreviation for need for achievement.
her first use of symbolization and the first recog-
n-Aff abbreviation for need for affiliation. nition that the father is a rival at the beginning
naikan n. a Japanese therapy that emphasizes of the oedipus complex. See also mirror
character building through rigorous self- phase.
reflection upon (a) what the client has received NAMI abbreviation for national alliance on
from others, (b) what the client has returned mental illness.
to others, and (c) how the client’s actions may
have hurt others. Through this process of self- naming n. an association disturbance observed
reflection, guided by the therapist, the client ac- in schizophrenia, in which the individual relates
quires a sense of responsibility for his or her to the external world solely by naming objects
actions and an appreciation of the positive influ- and actions (e.g., naming furniture or other ob-
ences in his or her life. [introduced by Japanese jects in an examining room).
Buddhist of the Jodo Shinshu sect Yoshimoto Narcan n. a trade name for naloxone.
Ishin (1916–1988)] narcissism n. 1. excessive self-love or ego-
nail biting the compulsive habit of chewing on centrism. See narcissistic personality disor-
one’s fingernails, usually thought to be a means der. 2. in psychoanalytic theory, the taking of
of releasing tension. Also called onycho- one’s own ego or body as a sexual object or focus
phagia; onychophagy. of the libido or the seeking or choice of another
naive participant a participant who has not for relational purposes on the basis of his or her
previously participated in a particular research similarity to the self. See body narcissism; pri-
study and has not been made aware of the exper- mary narcissism. —narcissist n. —narcissis-
imenter’s hypothesis. Compare confederate. tic adj.
Nalline test a test to determine abstinence from narcissistic character see narcissistic per-
opiates, in which the subject is given an injec- sonality.
tion of the opioid antagonist nalorphine narcissistic object choice in psychoanalytic
(Nalline). This precipitates withdrawal symp- theory, selection of a mate or other love object
toms if opiates have been used recently. similar to oneself. Compare anaclitic object
nalmefene n. see opioid antagonist. choice.
nalorphine n. see opioid antagonist. narcissistic personality a pattern of traits
naloxone n. a morphine-derived opioid antag- and behaviors characterized by excessive self-
onist that prevents the binding of opioids to concern and overvaluation of the self. Also
opioid receptors, having primary activity at called narcissistic character.
the mu receptor. Like other opioid antagonists, it narcissistic personality disorder in DSM–
can quickly reverse the effects of opioid overdose IV–TR, a personality disorder with the following
and is useful in emergency settings to reverse re- characteristics: (a) a long-standing pattern of
spiratory depression. U.S. trade name: Narcan. grandiose self-importance and exaggerated sense
naltrexone n. an opioid antagonist that, like of talent and achievements; (b) fantasies of un-
the shorter acting naloxone, prevents the bind- limited sex, power, brilliance, or beauty; (c) an
ing of opioid agonists to opioid receptors. Ac- exhibitionistic need for attention and admira-
cordingly, both drugs may precipitate a rapid tion; (d) either cool indifference or feelings of
withdrawal syndrome. If naltrexone is taken rage, humiliation, or emptiness as a response to
prior to use of opiate drugs, it will prevent their criticism, indifference, or defeat; and (e) various
reinforcing effects and can therefore be used for interpersonal disturbances, such as feeling enti-
375
narcissistic type
tled to special favors, taking advantage of others, narcotic analgesic see opioid analgesic.
and inability to empathize with the feelings narcotic antagonist see opioid antagonist.
of others. [originally formulated by U.S. psychia-
trists Wilhelm Reich (1897–1957), Otto Kern-
narcotic dependence see opioid depend-
ence.
berg, and Heinz Kohut (1913–1981), and U.S.
psychologist Theodore Millon (1929– )] Narcotics Anonymous (NA) a self-help orga-
nization for those who seek help with a drug ad-
narcissistic type see libidinal types.
diction, based on a twelve-step program and
narcoanalysis n. a form of psychoanalysis in modeled after alcoholics anonymous. The
which injections of drugs (often opioids) are only requirement for membership is the desire
used to induce a semihypnotic state in order to to stop using drugs.
facilitate exploration and ventilation of feelings,
narcotic stupor a state of lethargy or limited
uncover repressed traumatic memories, and,
mobility and decreased responsiveness to stimu-
through the analyst’s review and interpretation
lation due to the effects of an opioid drug. This
with the patient afterward, promote the pa-
state may border on loss of consciousness and be
tient’s insight into the unconscious forces that
followed by coma.
underlie his or her symptoms. The technique
was developed initially to treat combat stress NARHC abbreviation for national association
reactions in the 1940s and is rarely if ever used of rural health clinics.
now. narrative theory any theory of consciousness
narcolepsy n. a disorder consisting of excessive stating that beliefs arise as part of an explanatory
daytime sleepiness accompanied by brief “at- narrative about oneself and society.
tacks” of sleep during waking hours. These sleep narrative therapy treatment for individuals,
attacks may occur at any time or during any ac- couples, or families that helps clients reinterpret
tivity, including in potentially dangerous situa- and rewrite their life events into true but more
tions, such as driving an automobile. The attacks life-enhancing narratives or stories. Narrative
are often associated with hypnagogic hallucina- therapy posits that individuals are primarily
tions (hallucinations occurring just before fall- meaning-making beings who are the linguistic
ing asleep), sleep paralysis, and cataplexy authors of their lives and who can reauthor these
and are marked by immediate entry into REM stories by learning to deconstruct them, by see-
sleep without going through the usual initial ing patterns in their ways of interpreting life
stages of sleep. Also called paroxysmal sleep. events or problems, and by reconstruing prob-
—narcoleptic adj. lems or events in a more helpful light. See also
N narcomania n. 1. a pathological desire for nar- constructivism; constructivist psycho-
cotic drugs to relieve pain or discomfort. 2. an therapy.
obsolete name for psychosis resulting from long- narrotophilia n. sexual interest and arousal ob-
term abuse of narcotic drugs. tained from speaking or hearing sexually explicit
words during sexual activity. It most commonly
narcosynthesis n. a treatment technique that
occurs in telephone sex or online computer sex,
involves the administration of narcotic drugs to
in which partners talk while masturbating.
stimulate recall of emotional traumas, followed
There are commercial services that employ peo-
by “synthesis” of these experiences with the pa-
ple to engage in narratophilia with clients for a
tient’s emotional life through therapeutic dis-
fee. In some cases of narratophilia, however,
cussions in the waking state. [developed during
people prefer to make obscene phone calls to
World War II by U.S. psychiatrists Roy Richard
strangers or randomly selected numbers, as the
Grinker and John P. Spiegel]
involvement of a noncooperating person adds to
narcotherapy n. psychotherapy conducted their pleasure. —narratophile n.
while the patient is in a semiconscious state
National Alliance on Mental Illness
induced by injection of narcotic drugs, such as
(NAMI) a network of self-help groups that
amobarbital (Amytal) or thiopental. Narco-
provides emotional and educational support for
therapy was used, for example, with individuals
relatives and individuals affected by mental ill-
experiencing combat stress reactions during
ness. Formerly called National Alliance for the
and after World War II. See also narcoanalysis;
Mentally Ill.
narcosynthesis.
National Association of Rural Health
narcotic 1. n. originally, any drug that induces Clinics (NARHC) an organization that seeks to
a state of stupor or insensibility (narcosis). More promote, expand, improve, and protect the de-
recently, the term referred to strong opioids livery of quality, cost-effective health care ser-
used clinically for pain relief but this usage is vices in underserved rural areas. NARHC actively
now considered imprecise and pejorative; the engages in the legislative and regulatory process
term is still sometimes used in legal contexts with the U.S. Congress, federal agencies, and
to refer to a wide variety of abused substances. rural health organizations.
2. adj. of or relating to narcotics or narcosis.
National Committee for Quality Assur-
narcotic addiction see opioid dependence. ance (NCQA) a national organization, founded
narcotic agonist see opioid agonist. in 1979, that reviews and accredits managed
376
near-death experience
care plans and measures the quality of care of- ness that is often associated with physical or
fered by them. mental exertion, in contrast to similar mood
National Health Interview Survey (NHIS) states induced by drugs. A natural high is pro-
a questionnaire that provides the principal duced by activities that are part of everyday life
source of information on the health of the civil- as opposed to methods that have a direct effect
ian noninstitutionalized population of the on brain chemistry.
United States and is one of the major data- naturalistic observation data collection in a
collection programs of the National Center for field setting, usually without laboratory controls
Health Statistics (NCHS). The survey includes or manipulation of variables. These procedures
core questions and sometimes questions relating are usually carried out by a trained observer, who
to specific initiatives (e.g., aging, healthy people, watches and records the everyday behavior of
AIDS). participants in their natural environments. Ex-
National Institute of Mental Health amples of naturalistic observation include an
(NIMH) an agency of the federal government es- ethologist’s study of the behavior of chimpan-
tablished in 1949 to understand the mind, the zees and an anthropologist’s observation of play-
brain, and behavior and thereby reduce the bur- ing children.
den of mental illness through research. It is com- nature–nurture the dispute over the relative
mitted to scientific programs to educate and contributions of hereditary and constitutional
train future mental health researchers, including factors (nature) and environmental factors (nur-
scientists trained in molecular science, cognitive ture) to the development of the individual.
and affective neuroscience, and other disciplines Nativists emphasize the role of heredity, whereas
required for the study of mental illness and the environmentalists emphasize sociocultural and
brain. ecological factors, including family attitudes,
National Mental Health Association child-rearing practices, and economic status.
(NMHA) the largest nonprofit organization in Most scientists now accept that there is a close
the United States that addresses all aspects of interaction between hereditary and environ-
mental health and illness. Established in 1909, it mental factors in the ontogeny of behavior
is dedicated to promoting mental health, pre- (see epigenesis). Also called heredity–envi-
venting mental disorders, and achieving victory ronment controversy; nature–nurture
over mental illness through advocacy, educa- issue; nature–nurture problem.
tion, research, and service. naturopathy n. an alternative health care sys-
National Practitioner Data Bank a com- tem that aims to prevent disease and promote
puterized database, established through Title IV physical and mental health by using natural and N
of Public Law 99-660 (the Health Care Quality physiologically based therapies (e.g., dietary
Improvement Act of 1986) and maintained and measures, acupuncture, and massage) to address
operated by the U.S. Department of Health and underlying disease processes. See also comple-
Human Services, that contains information on mentary and alternative medicine.
physicians and other health care professionals nay-saying n. answering questions negatively
against whom malpractice claims have been regardless of their content, which can distort the
paid or certain disciplinary actions taken. The results of surveys, questionnaires, and similar in-
database is primarily an alert or flagging system struments. Compare yea-saying.
intended to facilitate a comprehensive review of NBAS abbreviation for Neonatal Behavioral As-
health care practitioners’ professional creden- sessment Scale (see brazelton neonatal beha-
tials. vioral assessment scale).
National Register of Health Service Pro- NCQA abbreviation for national committee
viders in Psychology a national, nonprofit for quality assurance.
credentialing organization for professional
NE abbreviation for norepinephrine.
psychologists, founded in 1974 to advance psy-
chology as a profession and improve the delivery near-death experience (NDE) an image, per-
of health services to the public. ception, event, interaction, or feeling (or a com-
bination of any of these) reported by some
natural child 1. one of the child ego states in
people after a life-threatening episode. Typical
transactional analysis, characterized as care-
features include a sense of separation from
free, fun-loving, creative, impulsive, and impa-
the body, often accompanied by the ability to
tient. Compare adapted child. 2. a biological
look down on the situation; a peaceful and pleas-
offspring of a parent, in contrast to an adopted
ant state of mind; and an entering into the light,
child.
sometimes following an interaction with a spiri-
natural family planning controlling the tual being. There is continuing controversy re-
number of children in a family by the use of garding the existence, cause, and nature of
natural techniques of birth control, such as NDEs. Spiritual, biomedical, and contextual
the rhythm method, as opposed to the use of lines of explanation are still in play, and there
oral contraceptives, intrauterine devices, dia- is no solid evidence to support the proposition
phragms, and similar methods. that NDEs prove survival of death. [term
natural high a state of well-being and happi- coined in 1975 by U.S. parapsychologist Ray-
377
necromania
mond A. Moody (1944– ) in his book Life After sion to external control or influence. In marked
Life] form, it is a characteristic condition in schizo-
necromania n. a morbid preoccupation with phrenia, particularly in terms of both greatly
corpses, usually including sexual desire for dead needing and greatly fearing other people.
bodies, and a morbid interest in funerals, need for achievement (n-Ach) a strong de-
morgues, autopsies, and cemeteries. See necro- sire to accomplish goals and attain a high stan-
philia. dard of performance and personal fulfillment.
necrophilia n. 1. sexual interest in or sexual People with a high need for achievement often
contact with dead bodies. It is a rare paraphilia undertake tasks in which there is a reasonable
seen almost exclusively in men. In some cases probability of success and avoid tasks that are ei-
they kill the victim themselves, but most fre- ther too easy (because of lack of challenge) or too
quently they gain access to corpses from funeral difficult (because of fear of failure). The need for
parlors, mortuaries, morgues, or graves. Numer- achievement was proposed by U.S. psychologist
ous explanations have been offered for the be- Henry Alexander Murray (1893–1988) and in-
havior since it was first described by German vestigated extensively by David mcclelland.
psychiatrist Richard von Krafft-Ebing (1840–1902) need for affection the degree to which a per-
in his 1886 book Psychopathia Sexualis, many son wants to be close or distant in a relationship
of which were psychoanalytically oriented and with another. In intimate relationships, need for
have now generally been abandoned. More re- affection is often expressed concretely as a desire
cent explanations of necrophilia, however, have to be touched or held or to be commended ver-
received some empirical support and include de- bally. An exaggerated need for affection and ap-
sire for a partner who is incapable of resistance or proval is considered by many to be a neurosis
rejection, desire to exercise power over others as and is often seen as resulting from early depriva-
a means of enhancing self-esteem, and desire to tion, especially of physical affection.
counteract feelings of isolation. See katasex-
uality. 2. as described in 1964 by Erich fromm,
need for affiliation (n-Aff) a strong desire to
socialize and be part of a group. People with a
an attraction to death, decay, and sickness. He
high need for affiliation often seek the approval
considered this passion for the lifeless to be a
and acceptance of others. See affiliation. [pro-
fundamental yet pathological orientation within
posed by David mcclelland]
certain individuals’ characters that revealed it-
self through increasing tendencies toward greed, need for closure 1. the motivation to achieve
narcissism, destruction, cruelty, and murder and finality and absoluteness in decisions, judg-
N a growing attachment to mechanical (i.e., non- ments, and choices. A person with a high need
living) artifacts at the expense of interest in liv- for closure will often have a low tolerance of am-
ing beings and the natural world. According biguity and uncertainty and may be attracted to
to Fromm, necrophilia stems from a person’s dogmatic political or religious views. 2. the need
desire to compensate for a lack of authenticity to achieve a sense of finality at the close of a
and self-identity. —necrophile n. —necro- painful or difficult episode in one’s life. Some es-
philic adj. tranged couples, for example, feel a need to ob-
necrophilic fantasies male (and, occasion- tain a formal divorce for emotional as well as
ally, female) fantasies about viewing or having practical reasons. See closure.
heterosexual or same-sex intercourse with a corpse need for cognition a personality trait reflect-
as a means of achieving sexual excitement. Such ing a person’s tendency to enjoy engaging in ex-
fantasies are sometimes acted out with the aid of tensive cognitive activity. This trait primarily
prostitutes who satisfy necrophilic clients by reflects a person’s motivation to engage in cogni-
simulating a lifeless appearance. tive activity rather than his or her actual ability
necrophobia n. a persistent and irrational fear to do so. Individuals high in need for cognition
of corpses. See also thanatophobia. tend to develop attitudes or take action based on
thoughtful evaluation of information. [origi-
necrosis n. the death of cells (e.g., neurons, nally investigated in 1994 by U.S. psychologists
muscle cells) from any of a variety of causes, in-
John T. Cacioppo (1951– ) and Richard E. Petty
cluding obstruction of blood supply to the
(1951– )]
affected part, disease, injury, or toxins. —nec-
rotic adj. need for power the dispositional tendency to
seek control over other people and over one’s en-
need n. 1. a condition of tension in an organism
vironment. See power.
resulting from deprivation of something re-
quired for survival, well-being, or personal ful- need-hierarchy theory see maslow’s moti-
fillment. 2. a substance, state, or any other thing vational hierarchy.
(e.g., food, water, security) whose absence gener- need–press method in the thematic apper-
ates this condition. ception test, a system of analyzing and scoring
need–fear dilemma 1. a simultaneous need each sentence of the stories told by a participant
for and fear of close relationships with others. as a means of evaluating his or her needs and the
2. a conflicting set of conditions facing those press of environmental factors to which he or
who need structured control but have an aver- she is exposed.
378
negative reinforcement
need–press theory in the personology of negative correlation a relationship between

U.S. psychologist Henry Alexander Murray two variables in which the value of one variable
(1893–1988), an explanation of behavior in increases while the value of the other variable
terms of the influence, or press, of both the pres- decreases. For example, in a study about babies
ent environment and past experiences upon the crying and being held, the discovery that those
expression and activation of a need. who are held more tend to cry less is a negative
needs assessment 1. the identification of cur- correlation. See also correlation coefficient.
rently unmet service needs in a community or negative emotion an unpleasant, often disrup-
other group, done prior to implementing a new tive, emotional reaction designed to express a
service program or modifying an existing service negative affect. Negative emotion is not con-
program. The perceived needs are generally as- ducive to progress toward obtaining one’s goals.
sessed from multiple perspectives, including Examples are anger, envy, sadness, and fear.
those of community or group leaders and those Compare positive emotion.
of each individual in the community or group.
2. the identification of those areas that should negative exercise addiction an inordinate
be the focus of a personnel training program. attraction to habitual participation in physical
Needs assessment involves analyses in three exercise activities that has a negative effect on
key areas: (a) the knowledge, skills, abilities, physical, psychological, or social well-being.
and other characteristics of employees; (b) the Also called exercise compulsion; exercise
requirements of the tasks performed by em- obsession. Compare positive exercise addic-
ployees; and (c) the requirements of the organi- tion.
zation. negative feedback in social psychology, non-
need to belong the motivation to be a part of constructive criticism, disapproval, and other
relationships, belong to groups, and be viewed negative information received by a person in re-
positively by others. See affiliation. sponse to his or her performance.
need to evaluate a personality trait reflecting a negative hallucination a false perceptual ex-
person’s tendency to engage in extensive perience characterized by failure to see a person
evaluative thinking when encountering people, or object while looking directly at it, as in failing
issues, or objects. People who are high in need to to perceive a certain person in a group in re-
evaluate tend to form attitudes and categorize sponse to hypnotic suggestion. Compare posi-
objects spontaneously along a positive–negative tive hallucination.
scale. People who are low in need to evaluate negative imagery mental images that incorpo-
tend to think of objects in evaluative terms only rate sensations of performance errors, unwanted N
when the context encourages such categoriza- outcomes, demotivation, or self-degradation.
tion. [originally investigated in 1996 by U.S. psy-
chologists William Blair Gage Jarvis and Richard negative incentive an object or condition that
E. Petty (1951– )] constitutes an aversive stimulus and therefore
facilitates avoidance behavior. Compare posi-
nefazodone n. a mixed-function antidepres-
tive incentive.
sant chemically related to trazodone but with
some important pharmacological distinctions. It negative Oedipus complex in psychoana-
is an antagonist at 5-HT2 serotonin receptors lytic theory, the opposite or reverse aspect of the
and an inhibitor of both serotonin and oedipus complex, in which the son desires the
norepinephrine reuptake. This combination of father and regards the mother as rival, or the
actions is thought to be related to the lack of daughter is attached to the mother and regards
ssri-like side effects associated with its antide- the father as rival. The more familiar attachment
pressant properties. Its sedative effects may be is the heterosexual form (the positive Oedipus
useful in the treatment of depression-related complex). Sigmund freud held that both as-
anxiety and insomnia. pects are part of the normal Oedipus complex in
negative adaptation a gradual loss of sensitiv- boys and girls. Also called inverted Oedipus
ity or weakening of response due to prolonged complex.
stimulation. negative punishment punishment that re-
negative affect the internal feeling state (af- sults because some stimulus or circumstance is
fect) that occurs when one has failed to achieve removed as a consequence of a response. For ex-
a goal or to avoid a threat or when one is not sat- ample, if a response results in a subtraction of
isfied with the current state of affairs. The ten- money from an accumulating account, and the
dency to experience such states is known as response becomes less likely as a result of this ex-
negative affectivity. perience, then negative punishment has oc-
curred. Compare positive punishment.
negative attitude in psychotherapy and coun-
seling, the client’s feeling of rejection or disap- negative reinforcement the removal, pre-
proval of the therapist or counselor or of the vention, or postponement of an aversive stim-
therapeutic or counseling process, of another ulus as a consequence of a response, which, in
person, or of himself or herself. Compare posi- turn, increases the probability of that response.
tive attitude. Compare positive reinforcement.
379
negative response
negative response a response that results in neglect n. 1. failure to provide for the basic needs
avoidance of or withdrawal from a stimulus. of a person in one’s care. The neglect may be
negative schizophrenia a form of schizo- emotional (e.g., rejection or apathy), material
phrenia characterized by a predomination of (e.g., withholding food or clothing), or service-
negative symptoms, suggesting deficiency or oriented (e.g., depriving of education or medical
absence of behavior normally present in a per- attention). See child neglect; elder neglect.
son’s repertoire, as shown in apathy, blunted af- See also maltreatment. 2. a syndrome charac-
fect, emotional withdrawal, poor rapport, and terized by lack of awareness of a specific area or
lack of spontaneity. Compare positive schizo- side of the body caused by a brain injury. It may
phrenia. [defined in 1982 by U.S. psychiatrist involve failure to recognize the area as belonging
Nancy C. Andreasen and Scott A. Olsen] to oneself or ignoring the existence of one side
of the body or one side of the visual field (see
negative self-verification theory the the- unilateral neglect; visual neglect). This is
ory that a depressed mood is exacerbated or
most often associated with an injury to the right
maintained because depressed individuals solicit
cerebral hemisphere with corresponding left-
or inspire feedback or treatment from others that
sided neglect. Neglect has also been found in
confirms or reinforces their negative beliefs
auditory, tactile, and proprioceptive tasks. Also
about themselves.
called perceptual neglect. See also sensory
negative-state-relief model the hypothesis neglect; spatial neglect.
that helping behavior is used by some people in
neglect dyslexia a form of acquired dyslexia
stress situations and periods of boredom and in-
(see alexia) associated with visual neglect, a
activity to avoid or escape negative moods.
condition in which a person is unaware of half of
negative suggestion a statement intended to the visual field as a result of neurological dam-
deter or suppress a feeling, thought, or action on age. Either the initial parts of words are misread
the part of another person. (left neglect) or the terminal parts of words are
negative symptom a deficit in the ability to misread (right neglect), and the errors are not
perform the normal functions of living—logical simple deletions but typically guesses of real
thinking; self-care; social interaction; planning; though incorrect words with approximately the
initiating; and carrying through constructive ac- right number of letters.
tions; and so forth—as shown in apathy, blunted negligence n. failure to fulfill a duty or to pro-
affect, emotional withdrawal, poor rapport, and vide some response, action, or level of care that
lack of spontaneity. In schizophrenia, a predom- is appropriate or reasonable to expect. In ergo-
N inance of negative symptoms is often associated nomics, for example, negligence involves failure
with a poor prognosis. Compare positive symp- to take reasonable care to protect human safety
tom. See negative schizophrenia. or equipment in the design, development, or
negative transference in psychoanalysis, evaluation of a system. A variety of different
transfer of anger or hostility felt toward the par- types of negligence exist in law. See also mal-
ents, or other individuals significant during practice. —negligent adj.
childhood, onto the therapist. Compare posi- Nembutal n. a trade name for pentobarbital.
tive transference.
neobehaviorism n. an approach to psychol-
negative triad see cognitive triad.
ogy, influenced by logical positivism, that
negativism n. 1. an attitude characterized by emphasized the development of comprehensive
persistent resistance to the suggestions of others theories and frameworks of behavior, such as
(passive negativism) or the tendency to act in those of Clark Leonard hull and Edward C.
ways that are contrary to the expectations, re- tolman, through empirical observation of be-
quests, or commands of others (active negativ- havior and the use of consciousness and mental
ism), typically without any identifiable reason events as explanatory devices. It thus contrasts
for opposition. In young children and adoles- with classical behaviorism, which was con-
cents, such reactions may be considered a cerned with freeing psychology of mentalistic
healthy expression of self-assertion. Negativism concepts and explanations. According to U.S.
may also be associated with a number of dis- psychologist and philosopher Sigmund Koch
orders (extreme negativism is a feature of ca- (1917–1996), neobehaviorism replaced classical
tatonic schizophrenia) and it can be an ex- behaviorism as the dominant 20th-century pro-
pression of opposition, withdrawal, or anger or gram for experimental psychology around 1930;
a method of gaining attention. Also called ne- its influence began to wane in the 1950s. See
gativistic response. See also oppositional also radical behaviorism. —neobehaviorist
defiant disorder; passive-aggressive per- adj., n.
sonality disorder. 2. any philosophy or doc-
trine based on negation, such as nihilism or neocortex n. regions of the cerebral cortex
skepticism. —negativistic adj. that are the most recently evolved and contain
six main layers of cells. Neocortex, which com-
negativistic personality disorder see pas- prises the majority of human cerebral cortex, in-
sive-aggressive personality disorder. cludes the primary sensory and motor cortex
negativistic response see negativism. and association cortex. Also called neopal-
380
nerve impulse
lium. Compare allocortex. —neocortical prising 240 statements to which participants

adj. respond using a 5-point likert scale for-
neodissociative theory a theory that explains mat, ranging from “strongly disagree” to
the paradoxical phenomena of hypnosis as a re- “strongly agree.” [developed by U.S. psycholo-
sult of divided consciousness. For example, gists Paul T. Costa, Jr. (1942– ) and Robert R.
hypnotic analgesia can produce subjectively re- McCrae (1949– )]
ported relief from pain while physiological mea- neophasia n. a complex language system cre-
sures indicate that pain is still being registered. ated by and idiosyncratic to a person, with its
neo-Freudian 1. adj. denoting an approach that own vocabulary and rules of grammar.
derives from the classical psychoanalysis of neophilia n. a strong desire for anything new or
Sigmund freud but with modifications and re- different, such as new foods.
visions that typically emphasize social and inter- neophobia n. 1. a persistent and irrational fear
personal elements over biological instincts. The of change or of anything new, unfamiliar, or
term is not usually applied to the approaches of strange. 2. the avoidance of new stimuli, espe-
Freud’s contemporaries, such as Alfred adler cially foods. —neophobic adj.
and Carl jung, who broke away from his school
neoplasm n. a new, abnormal growth, that is, a
quite early. Erik erikson, Erich fromm, Ger-
benign or malignant tumor. The term is gen-
man-born U.S. psychoanalyst Karen Horney
erally used to specify a malignant tumor (see
(1885–1952), and U.S. psychiatrist Harry Stack
cancer). A neoplasm usually grows rapidly by
Sullivan (1892–1949) are considered to be
cellular proliferation but generally lacks struc-
among the most influential neo-Freudian theo-
tural organization. A malignant neoplasm is us-
rists and practitioners. 2. n. an analyst or theore-
ually invasive, destroying or damaging neigh-
tician who adopts such an approach.
boring normal tissues, and can spread to distant
neolalia n. the abnormal tendency to use neol- sites by the process of metastasis; benign
ogisms when speaking. Also called neolallism. neoplasms are usually encapsulated and do not
neologism n. a recently coined word or expres- spread, but they may damage neighboring tis-
sion. In a neurological or psychopathological sues by compression. —neoplastic adj.
context neologisms, whose origins and mean- neostigmine n. an anticholinesterase (see
ings are usually nonsensical and unrecognizable cholinergic drug) used in the diagnosis and
(e.g., “klipno” for watch), are typically associ- treatment of myasthenia gravis and glaucoma.
ated with aphasia or schizophrenia. —neo- U.S. trade name: Prostigmin.
logistic adj.
nephrogenic diabetes insipidus a form of N
neologistic jargon unintelligible speech con- diabetes in which the kidneys are unable to pro-
taining a mixture of inappropriately combined duce a normal concentration of urine because
words and bizarre expressions coined by the the kidney tubules do not respond to
speaker. Also called neologistic paraphasia. vasopressin produced by the pituitary gland.
See word salad. The patient drinks enormous amounts of water
neonatal drug dependency syndrome a and excretes large volumes of dilute urine. The
syndrome in which a baby is born with drug de- disorder can be critical for infants, who cannot
pendence due to the mother’s drug abuse (most communicate their thirst and therefore suffer
often opioid abuse) during the latter part of preg- water depletion, which may lead to brain dam-
nancy. Such babies are often of low birth weight. age and mental retardation before the cause can
Other severe problems that accompany drug be diagnosed.
abuse by pregnant women include increased risk nepiophilia n. sexual interest in and arousal by
of intrauterine death, premature delivery, and infants: a type of pedophilia. The person gener-
increased neonatal mortality. ally does not find adults, or sometimes even
neonatal period in human development, the older children, sexually arousing. Nepiophilia is
period from birth to approximately 1 month of rarely seen in females.
age for infants born after a full-term pregnancy nerve n. a bundle of axons outside the central
(for infants born prematurely, the period is lon- nervous system (CNS), enclosed in a sheath of
ger). See also developmental levels. connective tissue to form a cordlike structure.
neonaticide n. the killing of an infant who is Nerves serve to connect the CNS with the tissues
less than 24 hours old. and organs of the body. They may be motor, sen-
sory, or mixed (containing axons of both motor
NEO Personality Inventory (NEO-PI) a per- and sensory neurons). See cranial nerve; spi-
sonality questionnaire designed to assess the fac- nal nerve. Compare tract.
tors of the five-factor personality model.
First published in 1985 and revised in 1992 nerve block the blocking of nerve impulses by
(NEO-PI-R), the inventory takes its name from drugs (e.g., anesthetics) or by mechanical means.
three factors of the model: neuroticism, ex- nerve impulse a wave of depolarization, in the
traversion, and openness to experience. It is form of an action potential, that is propa-
available in two versions (Form S for self-reports gated along a neuron or chain of neurons as the
and Form R for observer ratings), each com- means of transmitting signals in the nervous sys-
381
nervios
tem. Also called nervous impulse; neural im- lic opinion, either spontaneously or through
pulse. See also synapse. propaganda.
nervios n. a wide range of symptoms affecting network effect see network.
Latino groups in the United States and Latin network therapy individual psychotherapy
America (the word literally means “nerves”) and or family therapy in which an attempt is
attributed to stressful and difficult life experi- made to involve not only family members but
ences and circumstances. Symptoms include also other relatives, friends, and neighbors as
headache, dizziness, concentration difficulties, sources of emotional support and possible voca-
sleep disturbance, stomach upsets, and tingling tional opportunity. See also social-network
sensations; mental disorder may or may not be therapy.
present. See also ataque de nervios.
neural circuit an arrangement of neurons and
nervous adj. 1. in a transient emotional state of their interconnections. Neural circuits often per-
anxious apprehension. 2. of an excitable, highly form particular limited functions, such as nega-
strung, or easily agitated disposition. 3. referring tive feedback circuits, positive feedback circuits,
to the structures or functions of the nervous sys- or oscillator circuits. In a local circuit the neu-
tem. rons are all contained within a level of brain or-
nervous breakdown a lay term for an emo- ganization of a particular region.
tional illness or other mental disorder that has a neural pathway any route followed by a nerve
sudden onset, produces acute distress, and sig- impulse through central or peripheral nerve fi-
nificantly interferes with one’s functioning. Also bers of the nervous system. A neural pathway
called nervous prostration. may consist of a simple reflex arc or a complex
nervous exhaustion a lay term for a state of se- but specific routing, such as that followed by im-
vere fatigue due to emotional strain. See also pulses transmitting a specific wavelength of
neurasthenia. sound from the cochlea to the auditory cortex.
nervous habit stereotyped behavior, such as Also called nerve pathway.
nail biting or tics, presumed to be based on anxi- neural plasticity the ability of the nervous sys-
ety and performed to reduce tension. tem to change in response to experience or envi-
nervousness n. a state of restless tension and ronmental stimulation. For example, following
emotionality in which people tend to tremble, an injury remaining neurons may adopt certain
feel apprehensive, or show other signs of anxiety functions previously performed by those that
or fear. were damaged, or a change in reactivity of the
nervous system and its components may result
N nervous prostration see nervous break- from constant, successive activations. Also
down. called neuroplasticity.
nervous system the system of neurons, neural tube a structure formed during early de-
nerves, tracts, and associated tissues that, to- velopment of an embryo, when folds of the neu-
gether with the endocrine system, coordinates ral plate curl over and fuse. Cells of the neural
activities of the organism in response to signals tube differentiate along its length on the ante-
received from the internal and external environ- rior–posterior axis to form swellings that corre-
ments. The nervous system of higher vertebrates spond to the future forebrain, midbrain, and
is often considered in terms of its divisions, hindbrain; the posterior part of the tube devel-
principally the central nervous system, the ops into the spinal cord. The cavity of the tube
peripheral nervous system, and the auto- ultimately becomes the interconnected cerebral
nomic nervous system. ventricles and the central canal of the spinal
NES 1. abbreviation for neurological evalua- cord. Many congenital defects of the nervous
tion scale. 2. abbreviation for nonepileptic system originate at this stage of development
seizure. (see neural tube defect).
nesting n. in an experimental design, the appear- neural tube defect any of a group of congeni-
ance of the levels of one factor (the nested fac- tal defects caused by faulty development of the
tor) only within a single level of another factor. neural tube. As a result, portions of the brain or
For example, classrooms are nested within a spinal cord or their covering membranes (the
school because each specific classroom is found meninges) protrude through a gap in the skull or
only within a single school; similarly, schools spinal column, giving rise to neurological disor-
are nested within school districts. ders, mental retardation, or physical disability of
network n. 1. the system of interpersonal inter- varying severity. Anencephaly and spina bifida
actions and relationships in an individual’s envi- are examples of such defects.
ronment that play an important part in the neurasthenia n. a condition marked by fatigue,
production of mental health or psychological weakness, insomnia, aches, and pains. The name
disorder. The specific impact that these interac- (from Greek neurastheneia, “nerve weakness”)
tions and relationships have on the develop- originated in the 19th century, when the symp-
ment of psychopathology is called the network toms were believed to be due to exhaustion, pri-
effect. 2. in sociometry, a complex chain of in- marily from overwork, and is rarely used today.
terrelations that shape social tradition and pub- The condition is now attributed primarily to
382
neurolinguistic programming
emotional conflicts, tensions, frustrations, and neurofibroma n. a tumor of peripheral nerves

other psychological factors, and in DSM–IV–TR it caused by abnormal proliferation of schwann
is classified as undifferentiated somatoform cells. A neurofibroma is very similar to a
disorder. [coined in 1869 by U.S. neurologist schwannoma but is distinguished by its lack of
George Miller Beard (1839–1883)] —neuras- a capsule.
thenic adj. neurofibromatosis n. see von reckling-
neuritic plaque see senile plaque. hausen’s disease.
neurobiofeedback n. see neurofeedback. neurogenic adj. pertaining to a condition or
neurobiotaxis n. the growth of a nerve fiber to- event caused or produced by a component of the
ward the tissue it will innervate, which occurs nervous system.
during embryological development. Those fac- neurogenic communication disorder any
tors that influence neurobiotaxis are currently speech or language problem due to nervous sys-
the subject of research on nerve growth in adult tem impairment that causes some level of diffi-
organisms, suggesting the possibility of nerve re- culty or inability in exchanging information
generation or replacement after injury or dis- with others.
ease. neurohormone n. a hormone produced by
neurodermatitis n. an eczematous skin lesion neural tissue and released into the general circu-
that may be associated with psychological stress lation. See neuroendocrinology.
and is exacerbated by rubbing or scratching the neuroleptic n. see antipsychotic.
skin.
neuroleptic malignant syndrome a rare
neurodevelopmental hypothesis a promi- complication of therapy with conventional (typ-
nent theory stating schizophrenia results from ical or first-generation) antipsychotics, char-
an early brain lesion, either fetal or neonatal, acterized by fever, inability to regulate blood
that disrupts normal neurological development pressure, difficulty in breathing, and changes in
and leads to abnormalities and later psychotic consciousness (including coma); mortality rates
symptoms. Consequences of this early disrup- approaching 25% have been observed. It occurs
tion appear in childhood and adolescence, prior primarily at the start of treatment or with a sud-
to the actual onset of schizophrenic symptoms, den increase in dose. The incidence of the syn-
as subtle differences in motor coordination, cog- drome, never high, has declined further with the
nitive and social functioning, and temperament. abandonment of megadose pharmacotherapy
Much evidence supports this hypothesis and risk with conventional antipsychotics and the ad-
factors operating in early life (e.g., obstetric com- vent of second-generation atypical antipsy-
plications) have been shown to be associated N
chotics.
with the later development of schizophrenia.
neuroleptic syndrome the series of effects
neuroendocrinology n. the study of the observed in individuals who have taken
relationships between the nervous system, espe- antipsychotics. It is characterized by reduced
cially the brain, and the endocrine system. Some motor activity and emotionality, an indifference
cells within the nervous system release hormones to external stimuli, and a decreased ability to
into the local or systemic circulation; these are perform tasks that require good motor coordina-
called neuroendocrine (or neurosecretory) cells. tion. With high doses, patients may become cat-
The hypothalamus, for example, produces re- aleptic.
leasing hormones that regulate secretion of pi-
neurolinguistic programming (NLP) a set
tuitary hormones. Certain substances, such
of techniques and strategies designed to improve
as norepinephrine, act both as hormones and
interpersonal communications and relations by
as neurotransmitters. —neuroendocrinologi-
modifying the “mental programs,” or mental
cal adj. —neuroendocrinologist n.
models of the world, that individuals develop
neurofeedback n. a learning strategy that en- and use to respond to and interact with the envi-
ables people to alter their own brain waves using ronment and other people. This approach pre-
information about their brain-wave characteris- sumes that these programs, as well as the
tics that is made available through electroen- behaviors they influence, result from the inter-
cephalograph recordings that may be presented action among the brain, language, and the body.
to them as a video display or an auditory signal. In order to achieve desired change, one must
Also called neurobiofeedback. See biofeed- first understand subjective experience and the
back. structures of thought (i.e., mental programs) un-
neurofibrillary tangles twisted strands of ab- derlying that experience, and then learn to mod-
normal filaments within neurons that are associ- ify these programs as needed, for example, to
ated with Alzheimer’s disease. The filaments enhance adaptive behavior across a variety of sit-
form microscopically visible knots or tangles uations or to attain excellence in personal
consisting of tau protein, which normally is as- performance. Although originally applied to
sociated with microtubules. If the structure of psychotherapy and counseling, neurolinguistic
tau is rendered abnormal, the microtubule struc- programming has developed applications in
ture collapses, and the tau protein collects in other fields, such as business management, arti-
neurofibrillary tangles. ficial intelligence, and education. [developed in
383
neurological amnesia
the United States in 1976 by U.S. mathematician or neurohormones. They include the endoge-
and therapist Richard Bandler (1950– ) and nous opioids (e.g., enkephalin and endorphin);
U.S. linguist John Grinder (1940– )] peptides found in both the brain and the pe-
neurological amnesia a loss or impairment of ripheral nervous system (e.g., substance p); hy-
memory due to disease or injury that affects the pothalamic releasing hormones (e.g., thyro-
nervous system. tropin-releasing hormone); pituitary hor-
mones (e.g., prolactin); and other circulating
neurological evaluation analysis of the data peptides (e.g., atrial natriuretic peptide and
gathered by an examining physician of an indi- bradykinin).
vidual’s mental status and sensory and motor
functioning. The examination typically includes neuropharmacology n. the scientific study
assessment of cognition, speech and behavior, of the effects of drugs on the nervous system.
orientation and level of alertness, muscular —neuropharmacological adj. —neurophar-
strength and tone, muscle coordination and macologist n.
movement, tendon reflexes, cranial nerves, pain neuroplasticity n. see neural plasticity.
and temperature sensitivity, and discriminative
neuropsychological assessment an evalua-
senses.
tion of the presence, nature, and extent of brain
Neurological Evaluation Scale (NES) an as- damage or dysfunction derived from the results
sessment instrument originally developed in of various neuropsychological tests.
1989 to provide a standardized tool for the eval-
neuropsychological rehabilitation the
uation of neurological abnormalities and
use of psychological techniques to treat and
impairments associated with schizophrenia.
manage cognitive, emotional, and behavioral
Currently, it is often used in researching other
problems that arise from brain damage or dys-
severe mental illnesses, such as bipolar disorders,
function.
as well. [developed by U.S. psychiatrists Robert
W. Buchanan and Douglas W. Heinrichs] neuropsychological test any of various clini-
cal instruments for assessing cognitive impair-
neurological examination see neurologi-
ment, including those measuring memory,
cal evaluation.
language, learning, attention, and visuospatial
neurology n. a branch of medicine that deals and visuoconstructive functioning. Examples of
with the nervous system in both healthy and dis- batteries of such tests are the halstead–reitan
eased states. The diagnosis and treatment of dis- neuropsychological battery and the luria–
eases of the nervous system is called clinical nebraska neuropsychological battery.
N neurology; neurologists diagnose and treat pa-
neuropsychology n. the branch of science that
tients with stroke, dementia, headaches, and
studies the physiological processes of the ner-
back pain, among other disorders. —neurolog-
vous system and relates them to behavior and
ical adj.
cognition. See also clinical neuropsychol-
neuron (neurone) n. the basic cellular unit of ogy. —neuropsychological adj. —neuro-
the nervous system. Each neuron is composed psychologist n.
of a cell body; fine, branching extensions (den-
drites) that receive incoming nerve signals; and
neuroreceptor n. a receptor molecule located
in a neuron cell membrane that binds molecules
a single, long extension (axon) that conducts
of a particular neurotransmitter, hormone, drug,
nerve impulses to its branching terminal. The
or the like and initiates a particular response
axon terminal transmits impulses to other neu-
within the neuron. Also called neurotrans-
rons, or to effector organs (e.g., muscles and
mitter receptor.
glands), via junctions called synapses or
neuromuscular junctions. Neurons can be classi- neuroscience n. the scientific study of the
fied according to their function as motor neu- nervous system, including neuroanatomy,
rons, sensory neurons, or interneurons. neurochemistry, neurology, neurophysiology,
There are various structural types, including uni- and neuropharmacology, and its applica-
polar neurons, bipolar neurons, and multipolar tions in psychology and psychiatry. See also
neurons. The axons of vertebrate neurons are behavioral neuroscience; cognitive neuro-
often surrounded by a myelin sheath. Also science.
called nerve cell. [term coined by German phy- neurosis n. any one of a variety of mental disor-
sician Heinrich Wilhelm von Waldeyer-Hartz ders characterized by significant anxiety or other
(1836–1921)] —neuronal adj. distressing emotional symptoms, such as persis-
Neurontin n. a trade name for gabapentin. tent and irrational fears, obsessive thoughts,
neuropathic pain pain caused by damage to compulsive acts, dissociative states, and somatic
peripheral nerves. It is often difficult to treat. and depressive reactions. The symptoms do not
involve gross personality disorganization, total
neuropathology n. the study of diseases of lack of insight, or loss of contact with reality
the nervous system. —neuropathological adj. (compare psychosis). In psychoanalysis, neuro-
—neuropathologist n. ses are generally viewed as exaggerated, uncon-
neuropeptide n. any of several peptides that scious methods of coping with internal conflicts
are released by neurons as neurotransmitters and the anxiety they produce. In dsm–iv–tr,
384
neurotransmitter
most of what used to be called neuroses are now others being introversion versus extraversion
classified as anxiety disorders. Also called and psychoticism versus impulse control. See
psychoneurosis. —neurotic adj., n. also factor theory of personality.
neurosurgery n. surgical procedures performed neurotic need in psychoanalytic theory, an ex-
on the brain, spinal cord, or peripheral nerves cessive drive or demand that may arise out of the
for the purpose of restoring functioning or pre- strategies individuals use to defend themselves
venting further impairment. See also psycho- against basic anxiety. German-born U.S. psy-
surgery. —neurosurgeon n. —neurosurgi- choanalyst Karen D. Horney (1885–1952) enu-
cal adj. merated ten neurotic needs: for affection and
neurotic anxiety in psychoanalytic theory, approval, for a partner to take over one’s life, for
anxiety that originates in unconscious conflict restriction of one’s life, for power, for exploita-
and is maladaptive in nature: It has a disturbing tion of others, for prestige, for admiration, for
effect on emotion and behavior and also intensi- achievement, for self-sufficiency and independ-
fies resistance to treatment. Neurotic anxiety ence, and for perfection. When an individual’s
contrasts with realistic anxiety, about an ex- personality is dominated by a few neurotic needs
ternal danger or threat, and with moral anxiety, he or she may exhibit a neurotic trend.
which is guilt posited to originate in the super- neurotic resignation the avoidance of any as-
ego. pect of reality that may bring inner conflicts into
neurotic character see character neurosis. one’s awareness, involving withdrawal that may
neurotic conflict 1. in psychoanalytic theory, take the form of total inactivity or overactivity
an intrapsychic conflict that leads to persis- in other areas. Neurotic resignation is distin-
tent maladjustment and emotional disturbance. guished from dynamic resignation, which is
2. in the approach of German-born U.S. psycho- viewed as a temporary decision to postpone ac-
analyst Karen D. Horney (1885–1952), the clash tion until more favorable circumstances emerge.
that occurs between opposing neurotic needs, See also escape from reality; flight from re-
such as an excessive need for power and inde- ality; flight into reality. [first described by
pendence and the need for love and depend- German-born U.S. psychoanalyst Karen D.
ence. See also neurotic trend. Horney (1885–1952)]
neurotic depression 1. see reactive depres- neurotic solution a method of resolving a
sion. 2. any major depressive episode that neurotic conflict by removing it from aware-
does not include psychotic features. ness.
neurotic disorder any mental disorder charac- neurotic trend in the theory of German-born
U.S. psychoanalyst Karen D. Horney (1885–
N
terized by distressing symptoms that are recog-
nized by the individual as being unacceptable 1952), one of three basic tendencies stemming
and alien. reality testing is largely intact, and from an individual’s choice of strategies to coun-
behavior does not actively violate social norms teract basic anxiety. These strategies generate
(although functioning may be markedly im- insatiable neurotic needs, which group them-
paired). The disturbance is relatively enduring or selves into three trends: (a) moving toward peo-
recurrent without treatment, is not limited to a ple, or clinging to others (see compliant
transitory reaction to stressors, and has no de- character); (b) moving away from people, or
monstrable organic cause. In DSM–IV–TR, neu- insisting on independence and self-dependence
rotic disorders are not recognized as a valid (see detached character); and (c) moving
diagnostic entity, and the individual disorders against people, or seeking power, prestige, and
that were included under that heading in earlier possessions (see aggressive character).
editions of the DSM have been subsumed under neurotransmission n. the process by which a
various other categories. signal or other activity in a neuron is transferred
neurotic inventory a questionnaire designed to an adjacent neuron or other cell. Synaptic
to reveal an individual’s tendency toward transmission, which occurs between two neu-
neuroticism. Statements are taken from case rons via a synapse, is largely chemical, by the re-
histories and related material, and the partici- lease and binding of neurotransmitter, but it
pant indicates agreement or disagreement with may also be electrical. Neurotransmission also
each statement. Theoretically, the more state- occurs between a neuron and an effector organ
ments with which participants agree, the greater or gland and between a neuron and a skeletal
their tendency toward neuroticism. muscle cell. Also called neural transmission;
neuroticism n. 1. the state of being neurotic or neuronal transmission.
a proneness to neurosis. 2. a mild condition of neurotransmitter n. any of a large number of
neurosis. 3. one of the dimensions of the five- chemicals that can be released by neurons to me-
factor personality model and the big five diate transmission or inhibition of nerve signals
personality model, characterized by a chronic across the junctions (synapses) between neu-
level of emotional instability and proneness rons. When triggered by a nerve impulse, the
to psychological distress. 4. in eysenck’s neurotransmitter is released from the terminal
typology, one of three major dimensions button (see axon), travels across the synaptic
whose polar opposite is emotional stability, the cleft, and binds to and reacts with receptor
385
neurotrophin
molecules in the postsynaptic membrane. Neu- (see nicotine dependence; nicotine with-
rotransmitters include amines, such as acetyl- drawal). The behavioral effects of the drug in-
choline, norepinephrine, dopamine, and clude enhanced alertness and feelings of calm.
serotonin; and amino acids, such as gamma- Nicotine produces multiple pharmacological
aminobutyric acid, glutamate, and glycine. effects on the central nervous system by activat-
Also called chemical transmitter; synaptic ing nicotinic receptors, facilitating the re-
transmitter. lease of several neurotransmitters, particu-
neurotrophin n. any of various proteins that larly dopamine (a reaction similar to that seen
promote the development and survival of spe- with such drugs as cocaine and heroin), along
cific populations of neurons. Neurotrophins in- with other actions in the periphery. In large
clude nerve growth factor, deficits in the axonal doses it is highly poisonous, producing such
transport of which have been linked to Alzhei- symptoms as dizziness, diarrhea, vomiting,
mer’s disease, and brain-derived neurotrophic tremors, spasms, unconsciousness, heart attack,
factor, which plays a crucial role in cognition, and potentially death via paralysis of the mus-
learning, and memory formation by modulating cles of respiration. Nicotine was isolated from
synaptic plasticity. Also called neurotrophic the tobacco plant in 1828 and was named for
factor. the French diplomat Jean Nicot, who intro-
duced tobacco into France in 1560. —nicotinic
neutrality n. a role or a manner of behavior adj.
adopted by the therapist, who not only remains
passive and permissive but also does not express nicotine dependence in DSM–IV–TR, a cluster
judgments of right and wrong or suggest what is of cognitive, behavioral, and physiological
proper behavior on the part of the client. symptoms indicating continued use of nicotine
despite significant nicotine-related problems.
neutralization n. in psychoanalytic theory, There is a pattern of repeated nicotine ingestion
the use of sexual or aggressive energy in the ser- resulting in tolerance, characteristic withdrawal
vice of the ego rather than for gratification of symptoms if use is suspended (see nicotine
the instincts, that is, in functions such as prob- withdrawal), and an uncontrollable drive to
lem solving, creative imagination, scientific in- continue use. There is no DSM–IV–TR diagnosis
quiry, and decision making. sublimation uses of nicotine abuse. See also substance depend-
neutralized energy. Also called taming of the ence.
instinct. See also desexualization. —neu-
tralize vb. nicotine withdrawal a characteristic with-
drawal syndrome that develops after cessation of
neutralizer n. a member of a therapy group
N who plays a role of modifying and controlling
(or reduction in) prolonged, heavy nicotine con-
sumption. Two or more of the following are re-
impulsive, aggressive, or destructive behaviors of
quired for a DSM–IV–TR diagnosis of nicotine
other members of the group. [first described by
withdrawal: dysphoria or depressed mood; in-
Russian-born U.S. psychotherapist Samuel Rich-
somnia; irritability, frustration, or anger; anxi-
ard Slavson (1890–1981)]
ety; difficulty in concentrating; restlessness;
Nevo syndrome see sotos syndrome. decreased heart rate; and increased appetite or
new-age therapy any of a number of popular weight gain.
treatments that lack a sound scientific basis and nicotinic receptor (nAchR) a type of acetyl-
are generally not accepted by mental health pro- choline receptor that responds to nicotine
fessionals as valid, effective therapeutic practice. as well as to acetylcholine. Nicotinic receptors
Support for such therapies does not come from mediate chiefly the excitatory activities of ace-
independent scientific studies but rather is de- tylcholine, including those at neuromuscular
rived primarily from the “insights” and observa- junctions. Compare muscarinic receptor.
tions of their founders or the analysis and
evaluation of participant feedback. An example Niemann–Pick disease an inherited lipid-
of a new-age therapy is rebirthing. storage disorder generally marked by a defi-
ciency of the enzyme sphingomyelinase and ac-
NHIS abbreviation for national health inter- cumulation of lipids in brain tissue and visceral
view survey. organs. Massive liver and spleen enlargement
NHST abbreviation for null hypothesis signifi- (hepatomegaly and splenomegaly) may occur.
cance testing. Mental retardation, blindness, and death before
nicotine n. an alkaloid obtained primarily from adulthood are common. About 95% of individu-
the tobacco plant (Nicotiana tabacum). Today als with this disorder have a defective NPC1 gene
nicotine is one of the most widely used psycho- (chromosomal locus 18q11–12). Also called
active drugs; it is the primary active ingredient in sphingomyelin lipidosis. See also lipid-
tobacco and accounts for both the acute phar- metabolism disorders. [Albert Niemann
macological effects of smoking or chewing to- (1880–1921) and Ludwig Pick (1868–1944), Ger-
bacco (e.g., a discharge of epinephrine; a sudden man physicians]
release of glucose; an increase in blood pressure, night-eating syndrome an eating disorder
respiration, heart rate, and cutaneous vaso- characterized by insomnia, nocturnal hyper-
constriction) and the dependence that develops phagia, and morning anorexia that persist for
386
N-methyl-D-aspartate
at least 3 months. Recent research suggests Nitoman n. a Canadian trade name for tetra-
night-eating syndrome is related to hormonal ir- benazine.
regularities and a disturbed circadian rhythm nitrazepam n. a long-acting benzodiazepine
of food intake, although chronic stress may also with a half-life of more than 24 hours, used as a
be a contributing factor. This type of eating dis- hypnotic. Though nitrazepam has no active
order is estimated to affect 1.5% of the global metabolic products, its lengthy half-life may
population and is thought to occur in 10–25% of cause unwanted accumulation with daily dos-
obese individuals. [first described in 1955 by U.S. ing. It is not currently marketed in the United
psychiatrist Albert J. Stunkard] States. Canadian trade name: Mogadon.
night hospital a unit within a hospital in nitric oxide a compound present in numerous
which patients receive psychiatric care at night, body tissues, where it has a variety of functions.
having spent the day in the community. See also In the body it is synthesized by the enzyme nitric
partial hospitalization. oxide synthase from arginine, NADPH, and
nightmare n. a frightening or otherwise disturb- oxygen. Nitric oxide functions as a neurotrans-
ing dream, in which fear, sadness, despair, dis- mitter, or an agent that influences neurotrans-
gust, or some combination of these forms the mitters, in the brain and other parts of the
emotional content. Nightmares contain visual central nervous system. In peripheral tissues it is
imagery and some degree of narrative structure involved in the relaxation of smooth muscle,
and typically occur during rem sleep. The and thus acts as a vasodilator, a bronchodilator,
dreamer tends to waken suddenly from a night- and a relaxant of smooth muscle in the penis
mare and is immediately alert and aware of his or and clitoris, being involved in erection and
her surroundings. In DSM–IV–TR, the occur- other components of the sexual response.
rence of frequent nightmares is classified as
nitrous oxide an analgesic gas that is com-
nightmare disorder. Nightmares are also a
monly used in outpatient dental procedures and
symptom of posttraumatic stress disorder.
as an adjunct in surgical anesthesia. It is also
—nightmarish adj.
used as a propellant in aerosolized foods (e.g.,
nightmare-death syndrome the unexpected whipping cream). In low doses nitrous oxide
and mysterious nocturnal death of a healthy in- produces sensations of giddiness, elation, and
dividual that occurs among southeast Asian refu- euphoria. This property was apparent when it
gees, especially Hmong, arriving in the United was initially synthesized in 1772 by British
States. It is attributed by Hmong informants to chemist Joseph Priestley (1733–1804), and ni-
a nocturnal spirit encounter and is similar to trous oxide has long been known colloquially as
the Filipino concept of bangungut. Also called laughing gas. Its euphoriant effects make ni- N
sudden unexpected nocturnal-death syn- trous oxide a popular inhalant in social settings.
drome. Also called dinitrogen monoxide.
nightmare disorder in DSM–IV–TR, a sleep Nizoral n. a trade name for ketoconazole.
disorder characterized by the repeated occur-
NLD abbreviation for nonverbal learning dis-
rence of frightening dreams that lead to awaken-
order.
ings from sleep. It was formerly known as dream
anxiety disorder. See parasomnia. NLP abbreviation for neurolinguistic pro-
gramming.
night terror see sleep terror disorder.
nigrostriatal tract the neural pathway that NMDA N-methyl-D-aspartate: an agonist that
binds to a class of glutamate receptors that
extends from the substantia nigra to the
are both ligand-gated and voltage-sensitive (see
striatum of the basal ganglia. It contains
nmda receptor).
dopaminergic neurons and is associated with
the production of voluntary movement. NMDA receptor a type of glutamate recep-
nihilism n. 1. the delusion of nonexistence: a tor that binds nmda as well as glutamate.
fixed belief that the mind, body, or the world at NMDA receptors are ligand-gated and voltage-
large—or parts thereof—no longer exists. Also sensitive, which enables them to participate in a
called delusion of negation; nihilistic delu- variety of information-processing operations at
sion. 2. the belief that existence is without synapses where glutamate is the neurotransmit-
meaning. —nihilistic adj. ter. The drugs of abuse ketamine and pcp are an-
tagonists at NMDA receptors, preventing the
nilutamide n. see antiandrogen. influx of calcium ions, which may cause the hal-
NIMH abbreviation for national institute of lucinogenic effects of these drugs. Excessive flow
mental health. of calcium ions into the presynaptic neuron via
nirvana principle in psychoanalytic theory, the NMDA receptor is thought to contribute to
the tendency of all instincts and life processes glutamate toxicity. A recently emerging hypoth-
to remove tension and seek the stability and esis on the etiology of schizophrenia involves
equilibrium of the inorganic state, that is, death. dysfunction of the NMDA glutamate receptor
This is the trend of the death instinct, which (see glutamate hypothesis). Compare ampa
Sigmund freud believed to be universal. See also receptor.
principle of inertia. N-methyl-D-aspartate n. see nmda.
387
NMHA
NMHA abbreviation for national mental change one’s residence and occupation, often
health association. giving rise to instability and social maladjust-
nocebo n. an adverse or otherwise unwanted ment. In milder form this tendency may be an
physical or emotional symptom caused by the attempt to escape from a distressing situation or
administration of a placebo. from responsibility, but in extreme form it may
be associated with brain damage, epilepsy, men-
noctambulation n. see sleepwalking disor- tal retardation, or psychosis. See also dromo-
der.
mania; poriomania. 2. the lifestyle of a group
noctiphilia (noctophilia) n. see nyctophilia. of people with no fixed residence, characterized
nocturnal emission an involuntary ejacula- by frequent movement from place to place,
tion that occurs during a nocturnal dream, often in search of resources or in accordance
known popularly as a wet dream. Studies show with seasonal changes.
that the majority of males experience a noctur- nomifensine n. an antidepressant that is struc-
nal emission before the age of 21. A small per- turally different from any in current use. It
centage of total sexual release in a young adult blocks the synaptic reuptake of norepinephine
male is through nocturnal emissions. Orgasm as and dopamine but not of serotonin. Due to se-
part of nocturnal dreams is rare among adoles- vere, sometimes fatal, drug reactions, including
cent females but increases among mature fe- acute hemolytic anemia, it was withdrawn
males. worldwide in 1986. Former U.S. trade name:
nocturnal enuresis see enuresis. Merital.
nodal behavior in group psychotherapy, a pe- nominal data numerical values that represent
riod of increased activity, which may be inter- membership in specific categories. For example,
personally challenging, aggressive, or disorderly, the category male could be labeled 0 and the cat-
followed by a relatively quiet period of antinodal egory female labeled 1, and each person within
behavior. the population of interest (e.g., a particular
noetic adj. describing a level of knowledge or town) assigned the number corresponding to
memory in which there is awareness of the their sex. Nominal data are similar to categori-
known or remembered thing but not of one’s cal data, and the two terms are often used in-
personal experience in relation to that thing. terchangeably.
Noetic consciousness is a state of consciousness nominal fallacy the false belief that a phe-
in which one is aware of facts, concepts, words, nomenon is understood if it is merely named or
and meanings but not of any connection to labeled.
N one’s own experience. Compare anoetic; nominal scale a sequence of numbers that do
autonoetic. [defined by Estonian-born Cana- not indicate order, magnitude, or a true zero
dian psychologist Endel Tulving (1927– )] point but rather identify items as belonging to
no excuse in reality therapy, the concept that mutually exclusive categories. For example, a
there are no acceptable reasons to condone irre- nominal scale for the performance of a specific
sponsible behavior or attribute it to another group of people on a particular test might use the
source. According to this concept, all behavior number 1 to denote pass and the number 2 to de-
stems directly from the client and the client is note fail. Also called categorical scale.
therefore completely and solely responsible for nomothetic adj. relating to the formulation of
his or her behavior. [devised by U.S. psychiatrist general laws as opposed to the study of the indi-
William Glasser (1925– )] vidual case. A nomothetic approach involves the
N-of-1 experimental design see single-case study of groups of people or cases for the purpose
experimental design. of discovering those general and universally
noise n. 1. a random or aperiodic waveform valid laws or principles that characterize the av-
whose properties are described statistically. erage person or case. Compare idiographic.
There are many types of noise, which are distin- nonadherence n. failure of an individual to fol-
guished by their spectral or statistical properties. low a prescribed therapeutic regimen. Although
White noise (or background noise) has equal en- nonadherence has traditionally been ascribed to
ergy at all frequencies; broadband noise has en- oppositional behavior, it is more likely due to
ergy over a relatively wide frequency range (e.g., inadequate communication between the practi-
50 Hz to 10 kHz for audition); pink noise has en- tioner and the individual, physical or cognitive
ergy that is inversely proportional to frequency; limitations that prevent the patient from
and Gaussian noise has instantaneous values that following therapeutic recommendations (e.g.,
are determined according to a normal probabil- language differences between patient and prac-
ity density function. 2. anything that interferes titioner, physical disabilities), or adverse effects
with, obscures, reduces, or otherwise adversely that are not being adequately addressed. A pri-
affects the clarity or precision of an ongoing pro- mary aspect of health psychology involves
cess, such as the communication of a message or methods of reducing nonadherence and increas-
signal. ing adherence. Also called noncompliance.
nomadism n. 1. a pathological tendency to nonaffective hallucination a hallucination
wander from place to place and repeatedly whose content is not thematically related to de-
388
nonregulatory drive
pressed or manic affect. See mood-incongru- nondirective play therapy a form of play
ent psychotic features. therapy based on the principle that a child has
nonaggressive erotica sexually explicit litera- the capacity to revise his or her own attitudes
ture, pictures, or other artistic material that does and behavior. The therapist provides a variety of
not contain any violence, coercion, or exploita- play materials and either assumes a friendly, in-
tion but instead presents a caring, consensual, terested role without giving direct suggestions or
mutually gratifying view of sexuality. interpretations or engages the child in conversa-
tion that focuses on the child’s present feelings
noncardiac chest pain recurrent chest pain
and present life situations. The therapist’s ac-
that cannot be attributed to heart disease. It is
cepting attitude encourages the child to try new
commonly caused by problems with the esopha-
and more appropriate ways of dealing with prob-
gus (gullet), such as gastroesophageal reflux dis-
lems.
ease or esophageal spasm, or by musculoskeletal
disorders, especially fibromyositis (muscle in- nondirective therapy see client-centered
flammation). Anxiety and panic attacks can also therapy.
produce pain that resembles cardiac chest pain. nondisjunction n. the failure of pairs of chro-
See also pseudoangina. mosomes to separate during cell division with
noncompliance n. see nonadherence. the result that both chromosomes move to the
nucleus of one daughter cell, while the other
non compos mentis in law, mentally deficient
daughter cell fails to receive its normal comple-
or legally insane and therefore not responsible
ment.
for one’s conduct. See incompetence; insan-
ity. Compare compos mentis. nonepileptic seizure (NES) an episode that
resembles an epileptic seizure but is not pro-
nonconscious adj. describing anything that is
duced by an abnormal electrical discharge in the
not available to conscious report. See uncon-
brain. According to the Epilepsy Foundation,
scious.
such seizures may be classified as physiologic
nonconscious processes processes that do not nonepileptic seizures, which are associated with
themselves reach consciousness, although their metabolic disturbances (e.g., changes in heart
eventual outcomes or consequences may have rhythm or sudden drops in blood pressure) and
conscious impact. include syncope and transient ischemic at-
nondeclarative memory a collection of vari- tacks, or as psychogenic nonepileptic sei-
ous forms of memory that operate automatically zures. Nonepileptic seizures are also called
and accumulate information that is not accessi- nonepileptic events (or attacks), pseudo-
ble to conscious recollection. For instance, one seizures, or pseudoepilepsy, although use of the N
can do something faster if one has done it be- latter two terms is now discouraged.
fore, even if one cannot recall the earlier per- nonjudgmental approach in psychother-
formance. Nondeclarative memory includes apy, the presentation or display of a neutral,
priming. Nondeclarative memory does not de- noncritical attitude on the part of the therapist
pend on the medial temporal lobes and is pre- in order to encourage the client to give free ex-
served in individuals with amnestic disorder. pression to ideas and feelings. See also neutral-
Compare declarative memory. ity.
nondemand pleasuring caressing of a part- nonnormative influences influences on life-
ner’s body for the sensual pleasure involved, span development that are irregular, in that they
with no expectation of sexual arousal. In sex happen to just one or a few individuals and do
therapy this practice, which excludes any touch- not follow a predictable timetable.
ing of breasts or genitals, is often prescribed to
nonorganic hearing loss hearing loss that
eliminate performance anxiety: It allows a cou-
cannot be accounted for by a known biological
ple with a sexual dysfunction to begin to enjoy
cause.
physical relations with each other without the
risk of experiencing another failure. Also called nonparametric statistics statistical tests that
nondemanding pleasuring. do not make assumptions about the distribution
of the attribute (or attributes) in the population
nondirectional test see two-tailed test. being tested, such as normality and homogene-
nondirective approach an approach to psy- ity of variance. Compare parametric statis-
chotherapy and counseling in which the client tics.
leads the way by expressing his or her own feel-
nonperson n. see personality deterioration.
ings, defining his or her own problems, and in-
terpreting his or her own behavior, while the nonprescription drugs see over-the-
therapist or counselor establishes an encourag- counter.
ing atmosphere and clarifies the client’s ideas nonrapid-eye-movement sleep see nrem
rather than directing the process. This approach sleep.
is a cornerstone of client-centered therapy. nonregulatory drive a drive that serves func-
[originally advocated by Carl rogers] tions that are unrelated to preserving physiologi-
nondirective counseling see client- cal homeostasis and thus not necessary for the
centered therapy. physical survival of the individual organism, for
389
non-REM sleep
example, sex or achievement. Also called gen- cessing nonverbal information. This affects
eral drive. Compare regulatory drive. a child’s academic progress as well as other areas
non-REM sleep see nrem sleep. of functioning, which may include social
competencies, visual-spatial abilities, motor coor-
nonsedating antihistamines see antihis-
dination, and emotional functioning.
tamine.
nonverbal reinforcement any form of non-
nonshared environment in behavior genetic
verbal communication, such as a gesture, fa-
analyses, those aspects of an environment that
cial expression, or body movement, that
individuals living together (e.g., in a family
increases the frequency of the behavior that im-
household) do not share and that therefore
mediately precedes it. For example, a parent’s
cause them to become dissimilar to each other.
smile following a desired response from a child,
Examples of nonshared environmental factors
such as saying “thank you,” reinforces the
include the different friends or teachers that sib-
child’s behavior. See also reinforcement; so-
lings in the same household might have outside
cial reinforcement.
of the home. Also called unshared environ-
ment. Compare shared environment. non-Western therapies alternatives or com-
plements to traditional Western forms of and ap-
nonsteroidal anti-inflammatory drugs
proaches to psychotherapy and counseling that
see nsaids.
emphasize the body (e.g., acupuncture, yoga)
nontraditional marriage a marriage that de- and the interdependency of all beings and de-
viates from the traditional patterns of marriage emphasize individualism and rigid autonomy.
in a society. In the United States and western Eu- These therapies have typically developed outside
rope, such marriages may include marriages of Europe and North America. See also comple-
without the intent of having children or that mentary and alternative medicine.
permit the partners to have sexual relations
with other people. Compare traditional mar- Noonan’s syndrome a genetic disorder that in-
riage. volves the skin, heart, gonads, and skeleton and
is transmitted as an autosomal dominant trait.
nonulcer dyspepsia see dyspepsia. Affected individuals often have short stature,
nonverbal behavior actions that can indicate cardiovascular defects, and deafness. Intellectual
an individual’s attitudes or feelings without the development varies: Some have above average
need for speech. Nonverbal behavior can be ap- intelligence, most have mild to moderate mental
parent in facial expression, gaze direction, in- retardation, and a few have profound retar-
terpersonal distance, posture and postural dation. Male patients are seldom fertile. Also
N changes, and gestures. It serves a number of called familial Turner syndrome; Ullrich–
functions, including providing information to Noonan syndrome. [reported in 1963 by Jac-
other people (if they can detect and understand queline Noonan (1921– ), U.S. pediatrician]
the signals), regulating interactions among peo- nootropic n. any of various drugs that are used
ple, and revealing the degree of intimacy be- to enhance cognitive function, usually in the
tween those present. Nonverbal behavior is treatment of progressive dementias, such as Alz-
often used synonymously with nonverbal heimer’s disease, but also of cognitive dysfunc-
communication, despite the fact that nonver- tion due to traumatic brain injury. They do not
bal actions are not always intended for, or under- reverse the course of the dementia, but are re-
stood by, other people. ported to slow its progress in mild to moderate
nonverbal communication (NVC) the act forms of the disease. Many of these drugs work
of conveying information without the use of by inhibiting the activity of acetylcholinesterase
words. Nonverbal communication occurs through in the central nervous system, thereby counter-
facial expressions, gestures, body language, tone acting the disruption of cholinergic neurotrans-
of voice, and other physical indications of mission observed in patients with Alzheimer’s
mood, attitude, approbation, and so forth, some disease. Other drugs use different mechanisms
of which may require knowledge of the culture for improving cognitive performance in patients
or subculture to understand. In psychotherapy, with Alzheimer’s disease, including nmda re-
clients’ nonverbal communication can be as im- ceptor antagonism and potentially the preven-
portant to note as their verbal communication. tion of beta-amyloid plaque formation in the
See also nonverbal behavior. brain. Current nootropics include tacrine,
nonverbal intelligence an expression of in- donepezil, rivastigmine, and galantamine.
telligence that does not require language. Non- Also called cognitive enhancer; memory-
verbal intelligence can be measured with enhancing drug.
performance tests. norepinephrine (NE) n. a catecholamine neu-
nonverbal language see nonverbal behav- rotransmitter and hormone produced mainly
ior; nonverbal communication. by brainstem nuclei and in the adrenal medulla
nonverbal leakage see verbal leakage. (the central portion of the adrenal gland). Also
called noradrenaline.
nonverbal learning disorder (NLD) a
learning disorder that is characterized by lim- Norflex n. a trade name for orphenadrine.
ited skills in critical thinking and deficits in pro- norm n. 1. a standard or range of values that rep-
390
nosomania
resents the typical performance of a group or of that approximately follow the normal distri-
an individual (of a certain age, for example) bution.
against which comparisons can be made. 2. a norm group a group whose performance serves
conversion of a raw score into a scaled score that as the basis for establishing norms.
is more easily interpretable, such as percentiles
or IQ scores. —normative adj. norm-referenced testing an approach to
testing based on a comparison of one person’s
normal adj. relating to what is considered stan- performance with that of a norm group on the
dard, average, typical, or healthy. This general same test. Norm-referenced testing differentiates
meaning is applied in a variety of different con- among individuals and ranks them on the basis
texts, including statistics (referring to scores that of their performance. For example, a nationally
are within the usual or expected range), biology standardized norm-referenced test will indicate
(referring to the absence of malformation or how a given person performs compared to
other pathology), and development (referring to the performance of a national sample. See cri-
progression and growth that is comparable to terion-referenced testing.
those of similar age). The term, however, is most
often applied to behavior that conforms to a cul- Norpramin n. a trade name for desipramine.
turally accepted norm, especially as an indica- Norrie’s disease a type of congenital blindness
tion that a person is mentally healthy and does that is transmitted as an X-linked genetic defect
not have a psychological disorder. affecting only males. Progressive loss of hearing
often accompanies the blindness. About two
normal distribution a theoretical continuous thirds of affected individuals show mental retar-
probability distribution that is a function of
dation, and some experience hallucinations or
two parameters: the expected value, μ, and the
other psychological difficulties. [reported in
variance, σ2. It is given by
1927 by Gordon Norrie (1855–1941), Danish
P(x) = [exp(–(x – μ)2/2σ2)]/σ√(2π) ophthalmologist]
The normal distribution is the type of distri- nortriptyline n. a tricyclic antidepressant,

a so-called secondary tricyclic, that is the princi-
bution expected when the same measurement
pal metabolic product of amitriptyline. Al-
is taken several times and the variation about
though its clinical efficacy is the same as other
the mean value is random. It has certain con-
tricyclics, nortriptyline and the other secondary
venient properties in statistics, and unknown
tricyclic agent, desipramine, were often pre-
distributions are often assumed to be normal ferred because they were less sedating and had
distributions. Also called Gaussian distribu- fewer anticholinergic effects. A therapeu- N
tion. tic window is thought to exist for nortrip-
normality n. a broad concept that is roughly the tyline: Although plasma levels do not always
equivalent of mental health. Although there correlate with clinical effectiveness, optimum re-
are no absolutes and there is considerable cul- sponses are thought to occur when serum levels
tural variation, some flexible psychological and of the drug are between 50 and 150 ng/ml.
behavioral criteria can be suggested: (a) freedom Plasma levels over 500 ng/ml are toxic. The avail-
from incapacitating internal conflicts; (b) the ca- ability of newer antidepressants that do not
pacity to think and act in an organized and rea- require therapeutic monitoring has led to a de-
sonably effective manner; (c) the ability to cope cline in its use. U.S. trade names: Aventyl;
with the ordinary demands and problems of life; Pamelor.
(d) freedom from extreme emotional distress, NOS abbreviation for not otherwise specified.
such as anxiety, despondency, and persistent
upset; and (e) the absence of clear-cut symptoms
nosocomial adj. denoting or relating to a hospi-
tal-acquired infection that is unrelated to the pa-
of mental disorder, such as obsessions, phobias,
tient’s primary illness.
confusion, and disorientation.
nosogenesis n. see pathogenesis.
normalization principle the concept that
people with mental or physical disability should nosological approach a method or procedure
not be denied social and sexual relationships that focuses on the naming and classifying of
and participation in community life merely be- disorders together with the identification of
cause of their disability. Social and sexual rela- pathognomonic signs and symptoms and
tionships can include a wide range of emotional their grouping into syndromes for diagnostic
and physical contacts, from simple friendship purposes. The nosological approach contrasts
to sexual stimulation and satisfaction. Participa- with the psychodynamic approach, which
tion in community life includes engaging in typ- emphasizes causal factors.
ical life activities, such as work and recreation. nosology n. the scientific study and classifica-
See also social role valorization. [intro- tion of diseases and disorders, both mental and
duced in 1969 by Swedish psychologist Bengt physical. See also psychiatric classification.
Nirje] —nosological adj.
normalize vb. to apply a transformation to a nosomania n. a rarely used term for an un-
batch of data that produces a new set of scores founded, abnormal belief that one is suffering
391
nostalgia
from a particular disease. See hypochon- frequently in the first hours of sleep, the electro-
driasis. encephalogram shows only minimal activity,
nostalgia n. 1. a longing to return to an earlier and there is little or no change in pulse, respira-
period or condition of life recalled as being tion, and blood pressure. Also called non-REM
better than the present in some way. 2. a longing sleep. Compare rem sleep.
to return to a place to which one feels emotion- n=1 research see single-case experimental
ally bound (e.g., home or a native land). —nos- design.
talgic adj. NSAIDs nonsteroidal anti-inflammatory drugs: a
no-suicide contract a specific agreement, used large class of analgesic and anti-inflammatory
when the potential for suicide is at issue, made agents that includes aspirin, ibuprofen, na-
between the client and the therapist that the cli- proxen, and many others. They achieve their
ent will not take his or her own life. It is often effects by blocking the synthesis of prosta-
used as an intermediary measure for an agreed- glandins involved in inflammation and the
upon period of time (e.g., until the next therapy pain response. Concurrent administration of
session). See also contract. NSAIDs and lithium may cause increased serum
not guilty by reason of insanity (NGRI) a levels of lithium.
final judgment made in a court of law if the de- nubile adj. 1. describing a girl or young woman
fendant has been found to lack the mental ca- who is of marriageable age, ready for marriage, or
pacity to be held criminally responsible for his or going through puberty. 2. describing a sexually
her actions. See criminal responsibility; in- attractive young woman. —nubility n.
sanity.
nuclear complex a central conflict or problem
nothingness n. in existentialism, the belief that is rooted in infancy, for example, feelings of
that nothing is seen to structure existence. The inferiority (according to Alfred adler) or the
nothingness or meaninglessness of human exis- oedipus complex (according to Sigmund freud).
tence is thought to be the primary cause of anxi-
ety or anguish. nuclear family a family unit consisting of two
parents and their dependent children (whether
not me in the self-system theory of U.S. psychobiological or adopted). With various modifica-
analyst Harry Stack Sullivan (1892–1949), the tions, the nuclear family has been and remains
part of the personified self that is based on inter- the norm in developed Western societies. Com-
personal experiences that have evoked over- pare extended family; permeable family.
whelming anxiety, dread, and horror, and which
may lead to nightmares, emotional crises, and nuclear imaging imaging that involves scan-
N schizophrenic reactions. Compare bad me; ning for emissions from radioactive isotopes
good me. injected into the body. Techniques include posi-
tron emission tomography (PET) and single
not otherwise specified (NOS) in dsm–iv– photon emission computed tomography
tr, denoting a broad-based diagnostic category, (SPECT). These forms of scanning yield informa-
for example, depressive disorder not other- tion not only about the anatomy of an organ but
wise specified. The NOS diagnosis is chosen also about its functions; they are therefore valu-
when the patient’s problems seem to fall into able for medical diagnosis and research. See also
a particular family of disorders (e.g., depres- brain imaging.
sive disorders, anxiety disorders), but the syn-
drome is not typical or there is not enough infor- nuclear schizophrenia a type of schizophre-
mation available at the time of diagnosis to nia whose defining features, which include so-
specify more accurately the type of disorder that cial inadequacy and withdrawal, blunted affect,
is present. and feelings of depersonalization and de-
realization, are highly similar to those de-
novel antipsychotics see atypical anti- scribed by German psychiatrist Emil Kraepelin
psychotic. (1856–1926) for dementia praecox. It is of
novelty fear see neophobia. early, insidious onset and is associated with a de-
novelty hypothesis the claim that the con- generative, irreversible course and poor progno-
tents of consciousness can be predicted by sis. This term is often used interchangeably with
their novelty, based on the observation that process schizophrenia. Also called authen-
novel or unexpected events frequently intrude tic schizophrenia; true schizophrenia;
in ongoing conscious functioning. typical schizophrenia. Compare schizo-
noxious stimulus an aversive stimulus that phreniform psychosis. [proposed in the late
can serve as a negative reinforcer of behavior, in 1930s by Norwegian psychiatrist Gabriel Lang-
severe cases because it causes pain or damage to feldt (1895–1983)]
the experiencing organism and in lesser cases be- null finding the result of an experiment indi-
cause it is unpleasant. cating that there is no relationship, or no signifi-
NREM sleep nonrapid-eye-movement sleep: pe- cant relationship, between variables. Also called
riods of sleep in which dreaming, as indicated by null result.
rapid eye movements (REM), usually does not null hypothesis (symbol: H0) the statement
occur. During these periods, which occur most that an experiment will find no difference be-
392
nympholepsy
tween the experimental and control conditions, known as mammary pheromones that enable
that is, no relationship between variables. Statis- the young to locate the nipple and initiate suck-
tical tests are applied to experimental results in ling.
an attempt to disprove or reject the null hypoth- nursing home a long-term care facility
esis at a predetermined significance level. See that provides 24-hour nursing care in addition to
also alternative hypothesis. supportive services for people with chronic dis-
null hypothesis significance testing ability or illness, particularly older people who
(NHST) computation of a test of significance to have mobility, eating, and other self-care prob-
evaluate the tenability of the null hypothesis. lems.
See significance testing. nurturance n. 1. the provision of affectionate
null result see null finding. attention, protection, and encouragement to
number-completion test an intelligence test, others. 2. the need or tendency to provide such
or a component of one, in which the subject is nurturance.
required to supply a missing item in a series of nutmeg n. the seed of the trees Myristica
numbers or to continue the series. A component acuminata and M. fragrans, which are indigenous
of such a test might be: 6, 9, 13, 18,—(the next to the Moluccas (Indonesia) and cultivated in
number is 24). South America, the Philippines, and the West In-
numerical scale any scale or measurement indies. It has a history of folk use as a remedy for
strument that yields a quantitative (numerical) stomach and gastrointestinal complaints. Nut-
representation of an attribute. meg has volatile oils containing elemecin,
myristicin, and other active ingredients that in
nurse practitioner a registered nurse who
sufficient doses produce intoxicating effects,
has undergone extensive postgraduate training
some of which have been compared to those
(often in a specialty area, such as internal medi-
produced by cannabis. In larger doses, however,
cine or pediatrics) and is licensed to perform
nutmeg is poisonous; signs of toxicity include
some of the activities of a physician, including
abnormally dilated or contracted pupils, halluci-
the prescription of medicine. Nurse practitioners
nations, severe nausea and vomiting, and rapid
generally function under the supervision of phy-
heartbeat. See also mace.
sicians, but not in their presence.
nutrient n. any substance required as part of the
nurse’s aide a person who works in a hospital or
diet for growth, maintenance, and repair of the
nursing home, has completed at least a brief
body’s tissues or as a source of energy. Nutrients
course of health care training, and assists nurs-
include carbohydrates, fats, proteins (see also
ing staff in providing care for patients. Also
amino acid), vitamins, and some minerals N
called nurse’s assistant.
(e.g., calcium, sodium, potassium).
nursing n. 1. the health care profession that fo-
nutritional disorder any medical or psycho-
cuses on the protection and promotion of health
logical condition that results from malnutri-
through the alleviation and treatment of illness,
tion. Such disorders include obesity and
injury, disease, and physical suffering. Nurses
vitamin deficiency disorders. See also eating
practice in a variety of contexts, including hospi-
disorder.
tals, nursing and independent-living homes,
schools, workplaces, and community centers, nux vomica the seed of a plant, Strychnos nux
among others. In the United States, nurses must vomica, that grows in tropical Asia and has been
graduate from a state-approved school of nurs- used as an emetic (the name means literally “a
ing (either a four-year university program, a two- nut that causes vomiting”). Nux vomica con-
year associate degree program, or a three-year tains two substances, strychnine and brucine,
diploma program) and pass a state licensing ex- which are cns stimulants and highly poison-
amination. 2. the provision by a female of nour- ous, causing powerful, painful convulsions and
ishment for her young offspring until they are eventually death from paralysis of respiratory
capable of obtaining their own food. Nursing in muscles. In low doses, nux vomica increases
mammals (including humans, in whom it typi- glandular secretion in the gastrointestinal tract
cally is called breast-feeding) primarily involves and has been used as a homeopathic remedy to
the secretion of milk from the mammary glands, stimulate digestion and treat a variety of gastro-
as stimulated by the hormones prolactin and intestinal conditions.
oxytocin. Other vertebrates exhibit different NVC abbreviation for nonverbal communica-
forms of nursing behavior. For example, some tion.
birds produce a milklike substance within their nyakwana n. see epena.
digestive system called crop milk that is regur-
gitated to feed young chicks. The length of nyctophilia n. a strong preference for darkness
the nursing period varies across animals, rang- or night. Also called noctiphilia; nocto-
ing from mere days (e.g., Sprague–Dawley rats) philia; scotophilia.
to several years (e.g., bottlenose dolphins). Re- nympholepsy n. 1. a type of pedophilia in
gardless of its form or duration, however, suc- which the individual has a strong preference or
cessful nursing is critical to survival and often obsessive desire for young girls who are sexually
depends upon maternally emitted odorants precocious (nymphets: a word coined by Vladi-
393
nymphomania
mir Nabokov in his 1955 novel Lolita). Also note a high degree of sexuality in a woman, re-
called Lolita complex. 2. a mania or frenzy, es- flecting negative cultural attitudes toward
pecially of an erotic nature, characterized by female sexuality and male fears of being unable
a desire for some unattainable ideal. The name is to meet the sexual needs of women. —nym-
derived from myths in which an individual phomaniac n., adj.
glimpses a nymph and becomes possessed by a nystagmus n. involuntary, rapid movement of
demonic frenzy in pursuit of her. the eyeballs. The eyeball motion may be rota-
nymphomania n. excessive or uncontrollable tory, horizontal, vertical, or a mixture. See also
desire for sexual stimulation and gratification in physiological nystagmus; vestibular nys-
a woman. The word is often used loosely to de- tagmus.
394
Oo
OA abbreviation for overeaters anonymous. capacity to conceive of a mother who exists
when she is out of sight and who has positive at-
obesity n. the condition of having excess body
tributes when she is unsatisfying. Thus an infant
fat resulting in overweight, variously defined in
becomes attached to the mother herself rather
terms of absolute weight, weight–height ratio
than to her tension-reducing ministrations; she
(see body mass index), distribution of subcuta-
comes to exist continuously for the infant and
neous fat, and societal and aesthetic norms. The
not only during instances of need satisfaction.
basic causes are genetic, environmental, behav-
This investment by an infant in a specific
ioral, or some interaction of these. Overeating
libidinal object indicates that he or she no longer
may have a psychological cause (see binge-
finds people to be interchangeable.
eating disorder; food addiction; night-
eating syndrome) but in some cases it may be object fetish sexual interest and arousal focused
due to an organic disorder (see hyperphagia). on a particular item. Common targets of such in-
The consequences of obesity are a matter for terest are feet, shoes, and undergarments, but al-
concern: It predisposes to heart disease, diabetes, most anything can be the focus of an object
and other serious medical conditions (see mor- fetish. See also retifism.
bid obesity), and obese individuals may de- objectification n. see reification.
velop emotional and psychological problems objectifying attitude a tendency to react to
relating to body image. —obese adj. an object, person, or event while disregarding
obesity treatments therapeutic efforts used to personal feelings about it.
produce substantial weight reduction in an indi- objective 1. adj. having actual existence in real-
vidual. Treatments include long-term diets, ity, based on observable phenomena. 2. adj. im-
crash diets, group support, hypnotherapy, ex- partial or uninfluenced by personal feelings,
ercise programs, nutritional education, drug interpretations, or prejudices. Compare subjec-
therapy, behavior modification of eating pat- tive. 3. n. something that is to be obtained or
terns, hormonal treatment when indicated, and worked toward. See aim.
psychodynamic psychotherapy focused on
objective anxiety see realistic anxiety.
insight into the unconscious purposes served by
the individual’s excessive food intake. objective indicator a marker or other measure
of an entity, condition, emotion, or behavior
object n. 1. the “other,” that is, any person or that is free of subjective bias, that is, it is not an
symbolic representation of a person that is not
opinion or rating but an independent measure
the self and toward whom behavior, cognitions,
of the condition. An objective indicator is gener-
or affects are directed. The term is sometimes
ally viewed as more reliable than a subjective as-
used to refer to nonpersonal phenomena (e.g.,
sessment.
an interest might be considered to be an “ob-
ject”) but the other-person connotation is far objective psychotherapy a treatment proce-
more typical and central. 2. in psychoanalytic dure developed primarily for use with institu-
theory, the person, thing, or part of the body tionalized patients and patients with mild-to-
through which an instinct can achieve its aim moderate emotional disturbances. To reduce the
of gratification. See object cathexis; object subjectivity resulting from a personal relation-
relations. 3. the person who is loved by an in- ship with the therapist, all therapeutic commu-
dividual’s ego: his or her love object. nication is carried out in writing. The patient
answers written autobiographical questions, re-
object cathexis in psychoanalytic theory, the lates and comments on dreams, and reacts to
investment of libido or psychic energy in ob- assigned readings. In return, the therapist gives
jects outside the self, such as a person, goal, idea, interpretations and points out underlying mo-
or activity. Also called object libido. Compare tivations in written memoranda, including a
ego cathexis. See cathexis. memorandum as a whole, which summarizes all
object choice in psychoanalytic theory, the se- the insights reached in the process. [developed
lection of a person toward whom libido or psy- by U.S. psychoanalyist Benjamin Karpman
chic energy is directed. See anaclitic object (1886–1962)]
choice; narcissistic object choice. objective self-awareness a reflective state of
object constancy in object relations the- self-focused attention in which a person eval-
ory, the ability of an infant to maintain an at- uates him- or herself and attempts to attain
tachment that is relatively independent of correctness and consistency in beliefs and be-
gratification or frustration, based on a cognitive haviors. This involves the viewing of oneself as a
395
objective sociogram
separate object, acknowledging limitations and called vicarious learning. 2. the conditioning
the existing disparity between the ideal self and of an animal to perform an act observed in a
the actual self. Objective self-awareness is often a member of the same or a different species. For
necessary part of self-regulation. example, the mockingbird can learn to imitate
objective sociogram see sociogram. the song patterns of other kinds of birds. Also
called vicarious conditioning. See also mod-
object libido see object cathexis. eling theory.
object loss in psychoanalytic theory, the actual observation commitment the confinement
loss of a person who has served as a good ob- of a person in a hospital by a court order for a
ject, which precedes introjection and is in- limited period of observation, usually to deter-
volved in separation anxiety. Anxiety about mine competency to stand trial or overall
the possible loss of a good object begins with the legal competence.
infant’s panic when separated from its mother.
In this perspective, adult grief and mourning observation delusion see delusion of ob-
are related to object loss and separation anxiety servation.
in infancy and childhood, which often intensi- observer’s sociogram see sociogram.
fies and complicates the grief reaction. obsession n. a persistent thought, idea, image,
object love in psychoanalytic theory, love of or impulse that is experienced as intrusive and
a person other than the self. It is a function of inappropriate and results in marked anxiety,
the ego and not the instincts as in object distress, or discomfort. Obsessions are often de-
cathexis. See love object. scribed as ego-dystonic in that they are experi-
object of consciousness in conscious percep- enced as alien or inconsistent with one’s self and
tion, the perceived object as distinct from the outside one’s control. Common obsessions in-
perceiver. In Buddhism and Hinduism, there is a clude repeated thoughts about contamination, a
related notion that the real self is “overshad- need to have things in a particular order or se-
owed” by the object of perception. The separa- quence, repeated doubts, aggressive or horrific
tion of observer and observed is criticized as impulses, and sexual imagery. Obsessions can be
artificial in phenomenological philosophies (see distinguished from excessive worries about ev-
phenomenology). Compare subject of con- eryday occurrences in that they are not con-
sciousness. cerned with real-life problems. The response to
an obsession is often an effort to ignore or sup-
object of instinct in psychoanalytic theory, press the thought or impulse or to neutralize it
that which is sought (the external aim, e.g., a by a compulsion. See obsessive-compulsive
person, object, or behavior) in order to achieve disorder. —obsessional adj. —obsessive adj.
satisfaction (the internal aim). See aim of the in-
stinct. obsessional type see libidinal types.
O obsessive behavior behavior characteristic of
object relations 1. an individual’s relationship
to his or her entire external world. 2. in psycho- obsessive-compulsive personality disorder or ob-
analysis, an individual’s relationships to his or sessive-compulsive disorder, such as persistent
her objects (real and imagined), that is, the per- brooding, doubting, ruminating, worrying over
sons, activities, or things that function as sources trifles, cleaning up and keeping things in perfect
of libidinal or aggressive gratification. order, or performing rituals.
object relations theory any psychoanalyti- obsessive-compulsive disorder (OCD) an
cally based theory that views the need to relate anxiety disorder characterized by recurrent
to objects as more central to personality organi- intrusive thoughts (obsessions) that prompt
zation and motivation than the vicissitudes of the performance of neutralizing rituals (com-
the instincts. These theories developed from pulsions). Typical obsessions involve themes of
and in reaction to classic Freudian theories of contamination, dirt, or illness (fearing that one
psychodynamics. Some theories view the per- will contract or transmit a disease) and doubts
sonality as organized in terms of a complex about the performance of certain actions (e.g.,
world of internal object representations and an excessive preoccupation that one has ne-
their relationships with each other, for example, glected to turn off a home appliance). Common
fairbairnian theory and the approach of compulsive behaviors include repetitive clean-
Melanie klein. ing or washing, checking, ordering, repeating,
and hoarding. The obsessions and compul-
obnubilation n. clouding of consciousness sions—which are recognized by the individual as
or stupor. excessive or unreasonable—are time consuming
obscenity n. verbal expressions, drawings, ges- (more than one hour per day), cause significant
tures, and written material that grossly violate distress, or interfere with the individual’s func-
the norms of good taste and decency in a given tioning.
society. See pornography. —obscene adj. obsessive-compulsive personality disor-
observational learning 1. the acquisition of der in DSM–IV–TR, a personality disorder char-
information, skills, or behavior through watch- acterized by an extreme need for perfection, an
ing the performance of others, either directly or excessive orderliness, an inability to compro-
via such media as films and videotapes. Also mise, and an exaggerated sense of responsibility.
396
O’Connor v. Donaldson
Also called compulsive personality disor- originally believed to be conversion symptoms

der. reflecting inner conflicts but have increasingly
obsessive personality an obsolete DSM–I per- been found to have a medical explanation. Also
sonality trait disturbance characterized by exces- called occupational inhibition.
sive orderliness, perfectionism, indecisiveness, occupational stress a state of physiological
constant worry over trivia, and the imposition and psychological response to events or condi-
of rigid standards on others. See compulsive tions in the workplace that is detrimental to
character. health and well-being. It is influenced by such
obtrusive idea an obsessive, unwanted, and factors as autonomy and independence, deci-
alien idea that intrudes on a person’s normal sion latitude, workload, level of responsibility,
flow of thought. See also obsession. job security, physical environment and safety,
the nature and pace of work, and relationships
obtrusive measure any method of obtaining
with coworkers and supervisors.
measurements or observations in which the par-
ticipants are aware that a measurement is being occupational therapy (OT) a therapeutic, re-
made. Compare unobtrusive measure. habilitative process that uses purposeful tasks
occasional inversion a form of same-gender and activities to improve health; prevent injury
sexual behavior that may occur when a person is or disability; enhance quality of life; and de-
deprived of the presence of individuals of the op- velop, sustain, or restore the highest possible
posite sex, for example, in prison or in military level of independence of individuals who have
service. See also situational homosexuality. been injured or who have an illness, impair-
ment, or other mental or physical disability
occipital lobe the most posterior (rearward) or disorder. It typically includes assessment of
subdivision of each cerebral hemisphere, roughly an individual’s functional status, the devel-
shaped like a pyramid and lying under the skull’s opment and implementation of a customized
occipital bone. It is associated with vision, con- treatment program, and recommendations for
taining the several visual areas that receive and adaptive modifications in home and work envi-
process information regarding visual stimuli, ronments as well as training in the use of appro-
being involved in the basic functions (e.g., visual priate assistive technology devices. The term
acuity, contrast sensitivity, and perception of occupation is used by practitioners of the ther-
color, form, and motion) as well as the higher apy to denote three broad categories of human
level ones (e.g., figure-ground segregation based activity: (a) activities of daily living, (b) work
on textural cues). and productive activities, and (c) play or leisure
occupational counseling an early 20th- activities.
century approach to vocational guidance. Three
OCD abbreviation for obsessive-compulsive
steps were identified in the process: (a) relevant O
disorder.
knowledge of self, (b) realistic knowledge of oc-
cupations, and (c) true reasoning in making sen- oceanic feeling an expansion of consciousness
sible choices. [proposed by U.S. educator Frank beyond one’s body (limitless extension) and a
Parsons (1854–1908)] sense of unlimited power associated with iden-
occupational cramp painful spasm of the tification with the universe as a whole (see
muscles, usually in the hand or arm, that pre- cosmic identification). According to psycho-
vents the individual from engaging in his or her analytic theory, this feeling originates in the ear-
occupation, such as writing, driving, sewing, liest period of life, before the infant is aware of
playing a musical instrument, or firing a gun. See the outside world or the distinction between the
musician’s cramp; writer’s cramp. See also ego and nonego. Oceanic feelings may be re-
repetitive strain injury. vived later in life as a delusion or as part of a reli-
gious or spiritual experience.
occupational health psychology a spe-
cialty within psychology devoted to understand- oceanic state a condition of perceived bound-
ing workplace sources of health, illness, and lessness of the self, sometimes involving the per-
injury and the application of this knowledge to ception of omnipotence. It may be an ecstatic
improve the physical and mental well-being of state, a state of altered awareness, a state of inter-
employees. personal connection or union or of spiritual
union, or a dissociative experience. See also al-
occupational neurosis a psychogenic inhi-
tered state of consciousness.
bition associated with employment in which the
individual experiences distress and increasing O’Connor v. Donaldson a 1975 lawsuit in the
aversion to work, which may be expressed as U.S. Supreme Court in which it was determined
poor work performance or reactive symptoms of that people cannot be involuntarily committed
illness (e.g., fatigue, vertigo) that increase in se- to a facility on the basis of mental illness alone if
verity as the individual continues to work. In they are not dangerous to themselves or others
some cases, there is a specific inhibition that in- and are able to survive safely outside the facility.
terferes with the ability to work, often affecting A lower court ruling in this case assisted the
an essential function necessary for that work, court in its final ruling in Wyatt v. Stickney (1972)
such as writer’s cramp. These inhibitions were regarding right to treatment with involuntary
397
ocular hypertelorism
commitment (see forced treatment; wyatt v. the daughter and father is referred to as the fe-
stickney decision). male Oedipus complex. The complete Oedipus
ocular hypertelorism see hypertelorism. complex includes both this heterosexual form,
called the positive Oedipus complex, and its ho-
oculocerebral-hypopigmentation syn-
mosexual counterpart, the negative oedipus
drome a hereditary disorder marked by eye
complex. Sigmund freud derived the name
anomalies, absence of hair and skin pigmenta-
from the Greek myth in which Oedipus un-
tion, mental retardation, and spasticity. The
knowingly killed his father and married his
cases studied have involved children of Old
mother. Although Freud held the complex to be
Order Amish families. The syndrome is believed
universal, most anthropologists question this
to be due to an autosomal recessive trait that be-
universality because there are many cultures in
comes manifested through consanguinity (rela-
which it does not appear. Freud saw the Oedipus
tionship by blood).
complex as the basis for neurosis when it is not
oculocerebrorenal syndrome an X-linked adequately resolved by the boy’s fear of castra-
recessive genetic disorder affecting male chil- tion and gradual identification with the fa-
dren and marked by renal-tubule dysfunction, ther. The female Oedipus complex is posited to
mental retardation, and eye disorders, including be resolved by the threat of losing the mother’s
congenital glaucoma, cataracts, and distension love and by finding fulfillment in the feminine
of the eyeball because of fluid accumulation. role. Contemporary psychoanalytic thought has
The renal disorders include acidosis, hypo- decentralized the importance of the Oedipus
phosphatemia, and excess amino acids in the complex and has largely modified the classical
urine. Neurological deficits vary from absence of theory by emphasizing the earlier, primal rela-
brain abnormalities to hydrocephalus and cere- tionship between child and mother. Also called
bral atrophy. Also called Lowe’s disease; oedipal conflict; oedipal situation. See also
Lowe’s syndrome; oculocerebrorenal syn- castration complex; nuclear complex.
drome of Lowe.
off-label adj. denoting or relating to the clinical
oculogyric crisis prolonged fixation of the use of a drug for a purpose that has not been ap-
eyeballs in a single position for minutes to proved by the U.S. Food and Drug Administra-
hours. It may result from encephalitis or be pro- tion. Manufacturers generally do not promote
duced by certain antipsychotic drugs. Also called drugs for off-label uses, although medical litera-
oculogyric spasm. ture may support such uses.
OD 1. n. a colloquial name (an abbreviation) for ‘ohana n. the family unit in the Hawaiian cul-
an overdose, most often of an opioid or a seda- ture, characterized by a value system that em-
tive. 2. vb. to take an overdose. phasizes multigenerational kinship, including
O data other data: information about an individ- the prescription of age-appropriate roles, con-
O ual gathered from the observations, judgments, nection to one’s ancestors, respect for the wis-
and evaluations of third parties who know him dom of elders, promotion of the welfare of
or her personally, such as family and friends. See children, and the overall sustenance of the fam-
also l data; q data; t data. ily system. Similar ways of conceptualizing fam-
odd–even reliability a method of assessing ily are found in other Polynesian cultures.
the reliability of a test by correlating scores 6-OHDA abbreviation for 6-hydroxydopamine.
on the odd-numbered items with scores on the
even-numbered items. It is a special case of oikofugic adj. having or relating to an urge to
split-half reliability. travel or wander from home. See dromomania;
nomadism.
odds n. the ratio of the probability of an event oc-
curring to the probability of the event not occur- oikomania n. see ecomania.
ring, usually expressed as the ratio of integers oikotropic adj. affected with homesickness or
(e.g., 3:2). nostalgia for home.
odds ratio the ratio of two odds. For example, olan n. see myriachit.
in a study on a drug, the odds ratio is calculated olanzapine n. an atypical antipsychotic
as the odds of an effect in a treated group divided used for the treatment of acute mania, schizo-
by the odds of the same effect in a control group. phrenia, and other psychotic disorders in adults.
oedipal conflict see oedipus complex. It is closely related to clozapine, but lacks the
oedipal phase in psychoanalytic theory, the latter drug’s association with agranulocytosis.
later portion of the phallic stage of psy- Common side effects are sedation, lethargy,
chosexual development, usually between ages 3 weight gain, and orthostatic hypotension.
and 5, during which the oedipus complex Rarely, like all antipsychotics, it may be associ-
manifests itself. Also called oedipal stage. ated with tardive dyskinesia or neuroleptic
Oedipus complex in psychoanalytic theory, malignant syndrome. U.S. trade names: Zydis;
the erotic feelings of the son toward the mother, Zyprexa.
accompanied by rivalry and hostility toward the Older Adult Resources and Services a
father, during the phallic stage of develop- questionnaire used as a community assessment
ment. The corresponding relationship between tool to determine the level of functioning of
398
onset of action
older adults in five areas: mental health, physical forms, and psychosis, when the delusion is ex-
health, social resources, economic resources, pressed as alienation from or outright denial of
and activities of daily living. It must be ad- reality. See also megalomania. —omnipotent
ministered by a trained individual and can be ad- adj.
ministered in separate segments if assessment of omnipotent therapist see prestige sugges-
only one area is desired. The responses to the tion.
questionnaire can be used to determine choices
onanism n. coitus interruptus or masturba-
of supportive services for the geriatric popula-
tion. Onanism is named for the biblical charac-
tion.
ter Onan, who “went to his brother’s wife and
olfactophilia n. sexual interest in and arousal spilled it [his seed] on the ground” (Genesis
by body odors, especially those from the genital 38:9).
areas. ondansetron n. a serotonin antagonist at
olfactory eroticism pleasurable sensations, the 5-HT3 serotonin receptor that is used for
particularly of an erotic nature, associated with the prevention and treatment of nausea result-
the sense of smell. ing from chemotherapy or anesthesia. Recent
olfactory hallucination a false perception of studies have also demonstrated that, when com-
odors, which are usually unpleasant or repulsive, bined with appropriate behavior therapy, it may
such as poison gas or decaying flesh. be an effective adjunctive agent in managing
oligocephaly n. see oligoencephaly. certain types of alcoholism, although it is not of-
ficially approved by the U.S. Food and Drug
oligoencephaly n. a form of mental retardation Administration for such treatment. U.S. trade
associated with asymmetrical physical develop- name: Zofran.
ment and often marked by an abnormally small
brain, nervous-system irregularities, and low re-
oneirism n. a dreamlike state in a condition of
wakefulness. —oneiric adj.
sistance to disease. Also called oligocephaly.
oneirodynia n. a form of dreaming character-
olisbos n. see dildo.
ized by nightmares or unpleasant dreams.
olivopontocerebellar atrophy a slowly pro-
oneirophrenia n. a dreamlike, hallucinatory
gressive neurological disorder characterized by
state resembling schizophrenia in certain symp-
degeneration of neurons in the pons, cerebel-
toms, such as disturbances of emotion and asso-
lum, and olivary nucleus, an olive-shaped mass
ciations, but distinguished from schizophrenia
of gray matter in the medulla oblongata. Symp-
by disturbances of the senses and clouding of
toms are highly variable across individuals but
consciousness. It is associated with prolonged
typically include ataxia, difficulties with bal-
sleep deprivation, sensory deprivation, or drug
ance and walking, tremors, and dysarthria. In
use, but currently is not widely considered a dis-
many cases onset is in middle adulthood and
death occurs within 10–20 years.
tinct clinical entity. [first described in the 1950s O
by Hungarian-born U.S. psychiatrist Ladislas
ololiuqui n. the seed of a Latin American vine, von Meduna (1896–1964)]
Rivea corymbosa, which contains substances one-tailed test a statistical test of an experi-
chemically related to lsd but less potent. mental hypothesis in which the expected direc-
Ololiuqui was first described in the reports of tion of an effect or relationship is specified. Also
the 16th-century Spanish physician Francisco called directional test. Compare two-tailed
Hernández while studying the indigenous peo- test.
ples of Mexico, who used it for both medicinal
and religious purposes. one-way analysis of variance a statistical
test of the probability that the means of three or
ombudsman n. a person or program responsible more samples have been drawn from the same
for investigating consumer complaints and population; that is, an analysis of variance
grievances and acting as a consumer advocate in with a single independent variable.
resolving problems, for example in a health-care
facility. oniomania n. compulsive shopping, or an un-
controllable impulse to spend money and to buy
omission training see differential rein- without regard to need or use.
forcement of other behavior.
online self-help group a self-help group com-
omnipotence n. in psychology, the delusion posed of individuals who communicate via per-
that one can personally direct, or control, reality sonal computer over the Internet on a regular
outside of the self by thought or wish alone. In basis to help one another cope with a shared life
psychoanalytic theory, the main emphasis is on problem. Online groups overcome some of the
the infant’s feeling that he or she is all-powerful, traditional barriers to self-help participation, in-
which is thought to arise (a) out of the fact that cluding lack of local group availability, rarity of
the child’s slightest gesture leads to satisfaction problem, and time or transportation constraints.
of the need for food; (b) out of increasing abili-
online therapy see e-therapy.
ties; and (c) as a reaction formation to feel-
ings of helplessness and anxiety. Psychology onset insomnia see sleep-onset insomnia.
generally considers feelings of omnipotence to onset of action the point at which the activity
fall anywhere between neurosis, in its milder of a drug is apparent, generally measured in
399
ontoanalysis
terms of the time elapsed between administra- vidual differences in the tendency to be open
tion and the appearance of its pharmacological to new aesthetic, cultural, or intellectual experi-
effects. ences.
ontoanalysis n. a form of existential analysis open ward a hospital ward or unit in which the
that probes the ultimate nature of being. doors are not locked.
ontogeny n. the biological origin and develop- operant behavior behavior that produces an
ment of an individual organism from fertiliza- effect on the environment and whose likelihood
tion of the egg cell until death. Also called of recurrence is influenced by consequences. Op-
ontogenesis. Compare phylogeny. —onto- erant behavior is nearly synonymous with vol-
genetic adj. untary behavior.
ontogeny of conscious experience the de- operant conditioning the process in which
velopmental origins of conscious sensory experi- behavioral change (i.e., learning) occurs as a
ence in an organism. In humans, conscious function of the consequences of behavior. Ex-
experience can be demonstrated from the 5th or amples are teaching a dog to do tricks and re-
6th month of gestation. warding behavioral change in a misbehaving
OPD syndrome otopalatodigital syndrome: a child (see behavior therapy). The term is es-
congenital disorder affecting males or females, sentially equivalent to instrumental condi-
believed to be X-linked, and marked by short tioning. Also called operant learning. See
stature, mild mental retardation, bone behavior modification; shaping. [first de-
anomalies, and a variety of other possible described by B. F. skinner]
fects, including hearing impairment, cleft pal-
operant conditioning therapy a therapeu-
ate, and abnormalities of the digits.
tic approach that relies on the use of anteced-
open-door hospital see open hospital. ents, behaviors, and consequences. For example,
open-door policy the policy of maintaining an reinforcement through rewards may be used
open hospital or open ward (without locked to improve behaviors in everyday situations.
doors or physical restraints). Such a policy is as- operationalism n. the position that the mean-
sociated with the concept of a therapeutic ing of a scientific concept depends upon the pro-
community. cedures used to establish it, so that each concept
open-ended question a question that respon- can be defined by a single observable and mea-
dents answer in their own words (e.g., an essay surable operation. An example is defining an
question). Compare closed-ended question. emotional disorder as a particular score on a di-
open group a psychotherapy or counseling agnostic test. This approach was mainly associ-
group to which new members may be admitted ated with radical behaviorism. Also called
operationism.
O during the course of therapy. Also called con-
tinuous group. Compare closed group. ophidiophilia n. an abnormal fascination with
open head injury a head injury, such as a snakes.
gunshot wound, in which the skull is penetrated opiate n. any of a variety of natural and
or broken open. Compare closed head injury. semisynthetic compounds derived from opium.
open hospital a psychiatric hospital without They include the alkaloids morphine and co-
locked doors or physical restraints. Also called deine and their derivatives (e.g., heroin [di-
open-door hospital. acetylmorphine]). Opiates, together with syn-
opening moves see opening technique. thetic compounds having the pharmacological
properties of opiates, are known as opioids.
opening technique the means by which a
therapist establishes initial rapport and trust at opioid n. any of a group of compounds that in-
the beginning of a professional relationship with clude the naturally occurring opiates (e.g.,
a client in therapy or at the beginning of each morphine, codeine) and their semisynthetic de-
session in individual or family therapy. Also rivatives (e.g., heroin); synthetic compounds
called opening moves. with morphinelike effects (opioid agonists,
e.g., meperidine, methadone); opioid antago-
open marriage 1. a marriage in which both
nists (e.g., naloxone, naltrexone) and mixed ag-
partners allow and encourage each other to grow
onist–antagonists (e.g., buprenorphine); and
and change over the years. Compare closed
endogenous opioids. The effects of opioids in-
marriage. 2. a marital arrangement (formal or
clude analgesia, drowsiness, euphoria or other
common-law) in which the partners permit each
mood changes, respiratory depression, and
other to have sexual relations with other people.
reduced gastrointestinal motility. Many natural
See also nontraditional marriage.
opioids are subject to abuse and dependence (see
openmindedness n. a personality trait reflect- opioid abuse; opioid dependence; opioid in-
ing a relative lack of dogmatism. —open- toxication; opioid withdrawal). Opioids are
minded adj. used clinically as pain relievers (see opioid an-
openness to experience a dimension of the algesic), anesthetics (e.g., fentanyl), cough
big five personality model and the five- suppressants (e.g., dextromethorphan), and
factor personality model that refers to indi- antidiarrheal drugs (e.g., loperamide). Opioid
400
opioid withdrawal
agonists are used for (among other things) the the abuse potential of opioid agonists. Also
management of opioid addiction. called narcotic antagonist.
opioid abuse in DSM–IV–TR, a pattern of opioid opioid blockade the inhibition of the euphoric
use manifested by recurrent significant adverse effects of such opioids as heroin by administra-
consequences related to the repeated ingestion tion of a blocking agent, especially methadone,
of an opioid. This diagnosis is preempted by the as maintenance treatment for drug abuse. See
diagnosis of opioid dependence: If the criteria methadone maintenance therapy; opioid
for opioid abuse and opioid dependence are antagonist.
both met, only the latter diagnosis is given. opioid dependence in DSM–IV–TR, a cluster of
See also substance abuse; substance depend- cognitive, behavioral, and physiological symp-
ence. toms indicating continued use of opioids despite
opioid agonist any drug with enhancing ef- significant opioid-related problems. There is a
fects at opioid receptors in the central nervous pattern of repeated opioid ingestion resulting in
system. Opioid agonists may be complete (pure) tolerance, characteristic withdrawal symptoms if
or partial agonists. morphine is a pure opioid ag- use is suspended (see opioid withdrawal), and
onist; other examples include codeine, heroin, an uncontrollable drive to continue use. Also
methadone, meperidine, and laam. Partial called narcotic addiction; narcotic de-
opioid agonists (e.g., buprenorphine, tra- pendence. See also opioid abuse.
madol) have lower levels of activity than com- opioid intoxication a reversible syndrome
plete opioid agonists at the same receptors and due to the recent ingestion of an opioid. It
consequently have less analgesic activity. Also includes clinically significant behavioral or
called narcotic agonist. psychological changes (e.g., initial euphoria fol-
opioid analgesic any opioid used clinically to lowed by apathy, dysphoria, psychomotor
reduce both the sensation of pain and the emo- agitation or psychomotor retardation, im-
tional response to pain. This analgesia results paired judgment, and impaired social or occupa-
from agonist activity at the mu opioid recep- tional functioning), as well as one or more signs
tor. codeine, dihydrocodeine, propoxy- of physiological involvement (e.g., pupillary
phene, and hydrocodone are among opioids constriction, drowsiness or unconsciousness,
used for the relief of mild to moderate pain; se- slurred speech, respiratory depression).
vere pain is managed with more potent agents, opioid neurotransmitter see endogenous
such as morphine, meperidine, oxycodone opioid.
(U.S. trade name: OxyContin), and levor-
opioid receptor a receptor that binds
phanol. methadone, fentanyl, and bupren-
opioids (including endogenous opioids) and
orphine are potent analgesics that have
mediates their effects via g proteins. It is gener-
additional uses. Side effects associated with opioid
ally agreed that there are at least three classes: O
analgesics include nausea and vomiting, consti-
delta (δ), kappa (κ), and mu (μ) receptors. Opioid
pation, sedation, and respiratory depression;
receptors are widely distributed in the brain, spi-
many also have the potential for abuse and phys-
nal cord, and periphery and each type of recep-
ical dependence. Also called narcotic analge-
tor is differentially distributed. Mu receptors are
sic. See also opioid antagonist.
largely responsible for the analgesic and eu-
opioid analgesic addiction psychological phoric effects associated with opioid use. Most
and physical dependence on an opioid drug, exogenously administered opioids bind to mu
such as morphine, that is administered to relieve receptors, which also mediate the respiratory de-
pain. A sign is the need to increase the dosage in pression, sedation, and reduced gastrointestinal
order to obtain the same degree of relief. See motility associated with opioids. Kappa recep-
opioid dependence; opioid withdrawal. tors are localized primarily in the dorsal root
opioid antagonist an agent that acts as an an- ganglia of the spinal cord. Stimulation of these
tagonist at opioid receptors. Generally, opioid receptors produces more modest analgesia and
antagonists are synthetic derivatives of mor- dysphoric responses and may also be responsible
phine that, as a result of structural changes in for some of the perceptual and cognitive effects
the molecule, bind to opioid receptors but do of opioids. Delta receptors may potentiate activ-
not produce the effects of euphoria, respiratory ity of opioids at the mu receptor site and have a
depression, or analgesia that are observed with less direct involvement in the production of an-
opioid agonists. Opioid antagonists may be com- algesia. The more recently discovered N/OFQ re-
plete (pure) or mixed. Complete antagonists, ceptor has not been completely characterized.
such as naloxone, naltrexone, nalmefene opioid withdrawal a characteristic with-
(U.S. trade name: Revex), and nalorphine, are drawal syndrome that develops after cessation of
generally used to reverse the effects of opiate (or reduction in) prolonged, heavy opioid con-
overdose (notably respiratory depression). sumption. Features may include dysphoria or
Mixed agonist–antagonist opioids, such as anxiety, nausea or vomiting, muscle aches, dila-
butorphanol and pentazocine (U.S. trade tion of the pupils, piloerection (goose flesh) or
name: Talwin), were developed in attempts to sweating, diarrhea, fever, and insomnia. See also
produce opioid analgesics that did not possess substance withdrawal.
401
Opitz–Frias syndrome
Opitz–Frias syndrome see telecanthus- optimal adjustment the ideal degree and
hypospadias syndrome. [reported in 1969 by quality of coping with life or with a specific
John M. Opitz (1935– ) and Jaime L. Frias, U.S. stressful event.
geneticists] optimal functioning the highest possible
opium n. the dried resin of the unripe seed pods level of functioning, especially in the areas of
of the opium poppy, Papaver somniferum. Opium meaningful relationships, work life, education,
contains more than 20 alkaloids (see opium al- and subjective well-being.
kaloids), the principal one being morphine, optimism n. hopefulness: the attitude that good
which accounts for most of its pharmacological things will happen and that people’s wishes
(including addictive) properties. Natural and or aims will ultimately be fulfilled. Optimists
synthetic derivatives (see opiate; opioid) are are people who anticipate positive outcomes,
eaten, smoked, injected, sniffed, and drunk. whether serendipitously or through persever-
Their action, due mainly to their morphine con- ance and effort, and who are confident of attain-
tent, is to induce analgesia and euphoria and ing desired goals (compare pessimism). Most
produce a deep, dreamless sleep from which the individuals lie somewhere on the spectrum be-
user can be easily aroused. tween the two polar opposites of pure optimism
opium alkaloids alkaloids derived from and pure pessimism but tend to demonstrate
opium, of which there are more than 20. The sometimes strong, relatively stable or situational
principal alkaloid is morphine; others include tendencies in one direction or the other. —opti-
codeine, thebaine, and papaverine. See also mistic adj.
opiate. oral administration see administration.
opponent process theory of acquired oral-aggressive personality in psychoana-
motivation a theory that a stimulus or event lytic theory, a personality type resulting from
simultaneously arouses a primary affective state, fixation at the oral-biting phase of the oral
which may be pleasurable or aversive, and an op- stage and marked by aggressiveness, envy, and
ponent (opposite) affective state, which serves to exploitation. Compare oral-receptive person-
reduce the intensity of the primary state: These ality. See oral personality.
two states together constitute emotional experi-
oral behavior activities involving the mouth,
ence. According to this theory, the opponent
such as thumb sucking, smoking, eating, kissing,
state has a long latency, a sluggish course of in-
nail biting, talking, and oral sex.
crease, and a sluggish course of decay after the
initiating stimulus is removed, all of which lead oral-biting phase in psychoanalytic theory,
to its domination for a period following removal the second phase of the oral stage of
of the stimulus. In contrast to the primary state, psychosexual development, from about the
it is also strengthened through use and weak- 8th to the 18th month of life. During this phase
O the child begins to feel that he or she is an inde-
ened through disuse. This theory sought to ac-
count for such diverse acquired motives as drug pendent person, develops ambivalent attitudes
addiction, love, affection and social attachment, toward the mother, and expresses hostility by
and cravings for sensory and aesthetic experi- biting her breast or the nipple of the bottle. In
ences. Also called opponent process theory later life the urge to bite may take the form of
of emotion; opponent process theory of nail-biting, spitting, sticking out the tongue,
motivation. [originated by U.S. psychologist or chewing on a pencil or gum. Also called oral-
Richard Lester Solomon (1918–1995)] sadistic phase. Compare oral-sucking
phase. See oral-aggressive personality;
opportunistic sampling the selection of par-
oral sadism. [identified by German psychoana-
ticipants or other sampling units for an experi-
lyst Karl Abraham (1877–1925)]
ment or survey simply because they are readily
available. oral character see oral personality.
opposites test see antonym test. oral coitus see fellatio.
oppositional defiant disorder in DSM–IV– oral contraceptives tablets (“pills”) taken reg-
TR, a behavior disorder of childhood character- ularly by women to prevent pregnancy. Most are
ized by recurrent disobedient, negativistic, or combined formulations of a synthetic estrogen
hostile behavior toward authority figures that is and a progestin; some are progestin-only formu-
more pronounced than usually seen in children lations. The synthetic hormones in these pills
of similar age and lasts for at least 6 months. It is alter the normal menstrual activities so that ovu-
manifest as temper tantrums, active defiance of lation and related functions are prevented. In-
rules, dawdling, argumentativeness, stubborn- troduced in 1960, this type of contraceptive
ness, or being easily annoyed. The defiant be- became known popularly as simply “the Pill.”
haviors typically do not involve aggression, oral eroticism in psychoanalytic theory, the
destruction, theft, or deceit, which distinguishes pleasure derived from oral activities such as
this disorder from conduct disorder. Op- smoking, chewing, biting, talking, kissing, and
positional defiant disorder should be distin- oral-genital contact. Also called oral erotism;
guished from attention-deficit/hyperactiv- oral gratification. See also orality; oral-
ity disorder, with which it often co-occurs. sucking phase.
402
ordinal data
oral-eroticism phase see oral-sucking cation is achieved by sucking the nipple during
phase. feeding, and the later oral-biting phase, when
Oralet n. a trade name for fentanyl. gratification is also achieved by biting. fixation
during the oral stage is posited to cause an oral
oral–genital contact see orogenital activ-
personality. Also called oral phase. See also
ity.
oral-aggressive personality; oral eroti-
oral gratification see oral eroticism. cism.
orality n. in psychoanalytic theory, the oral fac- oral-sucking phase in psychoanalytic theory,
tor in eroticism or neurosis, ranging from plea- the earliest part of the oral stage of psy-
sure in biting, sucking, smoking, or oral sex to chosexual development, in which the infant
such habits as speech-making, overeating, alco- is posited to feel that he or she is ingesting the
holism, and excessive generosity. See oral per- mother’s being along with the milk swallowed
sonality. (see incorporation). This phase is believed to
oral–lingual dyskinesia see buccolingual lay the foundation for feelings of closeness and
masticatory syndrome. dependence, as well as for possessiveness, greed,
oral-passive type see oral-receptive person- and voraciousness. Also called oral-eroticism
ality. phase. Compare oral-biting phase. See oral-
oral personality in psychoanalytic theory, a receptive personality. [identified by German
pattern of personality traits derived from fix- psychoanalyst Karl Abraham (1877–1925)]
ation at the oral stage of psychosexual de- Orap n. a trade name for pimozide.
velopment. If the individual has experienced orchidectomy n. the surgical removal of a tes-
sufficient sucking satisfaction and adequate at- tis. An orchidectomy may be performed when a
tention from the mother during the oral-sucking testis is injured or diseased, as when the male re-
phase, he or she is posited to develop an oral- productive system has been affected by cancer. It
receptive personality marked by friendliness, op- does not necessarily cause impotence but may
timism, generosity, and dependence on others. reduce the desire for coitus. Orchidectomy per-
If the individual does not get enough satisfac- formed before puberty can affect the develop-
tion during the sucking and biting phases, he or ment of secondary male sex characteristics. Also
she is posited to develop an oral-aggressive called orchiectomy. See also castration.
personality marked by tendencies to be hos-
order effect in within-subjects designs, the
tile, critical, envious, exploitative, and over-
effect of the order in which treatments are ad-
competitive. Also called oral character.
ministered, that is, the effect of being the first
oral phase see oral stage. administered treatment (rather than the second,
oral-receptive personality in psychoana- third, and so forth). This is often confused with
lytic theory, a personality pattern characterized the sequence effect. O
by dependence, optimism, and expectation of orderliness n. the tendency to be neat and tidy
nourishment and care from external sources and to keep everything in place. Excessive order-
(just as the mother provided these satisfactions liness may be a symptom of obsessive-com-
in infancy), which is believed to be caused by fix- pulsive disorder or obsessive-compulsive
ation at the oral-sucking phase. Also called oral- personality disorder.
passive type. Compare oral-aggressive per-
sonality. See also oral personality; recep- order of magnitude the approximate magni-
tive character. tude of a number or value within a range, usually
to the nearest power of 10. For example, 2,500
oral sadism in psychoanalytic theory, the prim- (2.5 × 103) and 4,300 (4.3 × 103) are of the same
itive urge to use the mouth, lips, and teeth as in- order of magnitude, but both are one order of
struments of aggression, mastery, or sadistic magnitude greater than 240 (2.4 × 102).
sexual gratification. This impulse is believed to
originate in the oral-biting phase of infancy. ordinal data numerical values that represent
See also oral-aggressive personality. rankings along a continuum of lowest and high-
est, as in a judge’s assignment of a 1 to denote
oral-sadistic phase see oral-biting phase.
that a particular athlete’s performance was fair
oral sex stimulation of the external genitals by and a 2 to denote that a subsequent athlete’s per-
the partner’s mouth (see orogenital activity). formance was better. Ordinal data may be
Oral sex may be carried to the point of orgasm or counted (i.e., how many athletes obtained a 1,
done as part of foreplay. Research has shown how many a 2, etc.) and arranged in descending
that some adolescents who wish to remain vir- or ascending sequence but may not be manipu-
gins will have oral sex to orgasm, as this is not lated; it is meaningless to add, subtract, divide,
considered to constitute a loss of virginity. or multiply any rank by any other because the
oral stage in psychoanalytic theory, the first actual differential in performance between adja-
stage of psychosexual development, occupy- cent values is unspecified and may vary. In other
ing the first year of life, in which the libido is words, one does not know how much better a 2
concentrated on the mouth, which is the princi- is than a 1, and the difference between a 1 and a
pal erotic zone. The stage is divided into the 2 may not be the same as the difference between
early oral-sucking phase, during which gratifi- a 2 and a 3.
403
ordinal position
ordinal position a place or rank, such as a can result from maternal disorders or other con-
child’s position or birth order in a family, indi- ditions in pregnancy, including preeclampsia,
cated by an ordinal number (e.g., first, second, viral infections (e.g., rubella), sexually transmit-
etc.). ted infections, protozoan infections (e.g., toxo-
ordinal scale a sequence of numbers that do plasmosis), dietary deficiencies, or drug abuse
not indicate magnitude or a true zero point but (e.g., alcoholism).
rather reflect a rank ordering of the attribute organic delusional syndrome in DSM–III, a
being measured. For example, an ordinal scale condition characterized by the occurrence of
for the performance of a specific group of people prominent delusions, usually persecutory in na-
on a particular test might use the number 1 to in- ture, that are produced most often by such sub-
dicate the person who obtained the highest stances as amphetamines, cannabis (marijuana),
score, the number 2 to indicate the person who and hallucinogens but may also be associated
obtained the next highest score, and so on. It is with brain damage or dysfunction. This diagnos-
important to note, however, that an ordinal tic category was removed from DSM–IV–TR.
scale does not provide any information about organic dementia in DSM–III, dementia due
the degree of difference between adjacent ranks to any condition that causes injury to the brain.
(e.g., it is not clear what the actual point differ-
ence is between the rank 1 and 2 scores). organic hallucinations hallucinations asso-
ciated with a specific brain-based factor. Stimula-
Orestes complex in classical Freudian psycho- tion or irritation of part of the brain or a sensory
analysis, a son’s repressed impulse to kill his pathway may be a factor, and precipitating
mother. The name is derived from the ancient causes include aneurysm, tumor, epilepsy, drug
Greek story of Orestes, who killed his mother, use (including some prescribed drugs), and abuse
Clytemnestra, and her lover, Agamemnon. of alcohol, cocaine, amphetamines, or similar
orexis n. the affective, appetitive character of an substances.
activity or behavior, as opposed to the cognitive organic hallucinosis in DSM–III, a condition
aspects. Also called orexia. —orectic adj. characterized by persistent or recurrent halluci-
organ eroticism sexual arousal or sexual at- nations produced by hallucinogens (which usu-
tachment associated with a particular organ of ally cause visual hallucinations), alcohol (which
the body. usually causes auditory hallucinations), brain
organic adj. denoting a condition or disorder damage or dysfunction, or, in some cases, sen-
that results from structural alterations of an sory deprivation (blindness, deafness). This diag-
organ or tissue. In psychology and psychiatry, nostic category was removed from DSM–IV–TR.
the term is equivalent to somatic or physical, as organicism n. see organic approach.
contrasted with functional or psychogenic. organic mental disorders in DSM–III, a het-
O organic-affective syndrome in DSM–III–R, erogeneous group of mental disturbances re-
any disturbance of mood with symptoms that sulting from transient or permanent brain
meet the criteria for a mood disorder but that re- dysfunction due to specific organic factors. Spec-
sult from a specific identifiable organic disorder. ification of cause is what distinguished these dis-
This diagnostic category was removed from turbances from organic brain syndromes.
DSM–IV–TR. Also called organic mood syn- This diagnostic category was removed from
drome. DSM–IV–TR.
organic amnesia see amnestic disorder. organic mood syndrome see organic-
organic approach the theory that all mental affective syndrome.
disorders have a physiological basis, resulting organic personality syndrome in DSM–III,
from structural brain changes or alterations in a disorder characterized by a marked change in
other bodily organs. Also called organicism. personality or behavior due to a factor that dam-
organic brain syndromes in DSM–III, a ages the brain, for example, a tumor, head in-
group of disorders, including delirium, demen- jury, or vascular disease. The personality change
tia, amnestic disorder, organic delusional involves at least one of the following: emotional
syndrome, and organic personality syn- lability (temper outbursts, unprovoked crying),
drome, each characterized by a pattern of psy- impulse dyscontrol (shoplifting, sexual indiscre-
chological and behavioral symptoms (e.g., tions), marked apathy and lack of interest, and
memory loss, impaired intellectual functioning, suspiciousness or paranoid ideation. This diag-
disorientation, poor judgment) associated with nostic category was removed from DSM–IV–TR.
transient or permanent brain dysfunction, but organic repression a retroactive form of am-
without reference to cause. This diagnostic cate- nesia in which the patient may be unable to re-
gory was removed from DSM–IV–TR. Also called call events prior to the injury although
organic mental syndromes. See also or- examiners are unable to find a personal motive
ganic mental disorders. for the amnesia, such as the kind of repression
organic defect a congenital disorder that is not observed in dissociative amnesia.
the result of a genetic anomaly. For example, a organic retardation failure of an organ or
mental or physical disability in an individual organ system to develop normally because of a
404
orgone
genetic defect, dietary deficiency, or hormonal volved in evaluating the structure, process, cli-
disorder. A failure of one or more parts of the mate, and environmental factors that influence
skeletal system to grow normally could be the effectiveness of an organization and the mo-
caused by pituitary, hereditary, or dietary fac- rale and productivity of employees. General or
tors, or a combination of these. specific evaluations (e.g., readiness to change,
organic therapies somatic treatments for seri- job satisfaction, turnover) may be performed by
ous or recalcitrant mental disorder and disease, practitioners from a variety of disciplines, in-
among which are electroconvulsive ther- cluding consulting psychology and indus-
apy, psychopharmacology, and psycho- trial and organizational psychology.
surgery. organizational behavior modification
organic variable a process or state within an the application of the principles of learning the-
organism that combines with a stimulus to pro- ory to effect changes within an organization.
duce a particular response. For example, a head- organ language in the context of classical psy-
ache may be an organic variable, and the choanalytic explanations of psychosomatic ill-
response may be an irritable reaction to a stimu- ness, the bodily expression of emotional conflict
lus (e.g., noise in the neighborhood). Also called or disturbance. Some believe that knowledge of
O variable. the significance to the patient of the organ af-
organ inferiority the sense of being deficient fected by the illness is essential for accurate diag-
or somehow less than others as a result of nega- nosis and treatment. For example, chronic
tive feelings about any type of real or imagined lumbago (lower backache) with no identifiable
abnormal organ function or structure. [defined organic cause may mean that the patient is feel-
by Alfred adler] ing put upon, is being a martyr, or is aiming too
low in life. Also called organ speech.
organismic personality theory an ap-
proach to personality theory in which personal
organ speech see organ language.
functioning is understood in terms of the action orgasm n. the climax of sexual stimulation or ac-
of the whole, coherent, integrated organism, tivity, when the peak of pleasure is achieved,
rather than in terms of psychological variables marked by the release of tension and rhythmic
representing one versus another isolated aspect contractions of the perineal muscles, anal
of body or mind. [developed by German-born sphincter, and pelvic reproductive organs. In
U.S. physician and psychiatrist Kurt Goldstein men, orgasm is also accompanied by the emis-
(1878–1965) and Hungarian psychologist sion of semen (ejaculation); in women, it is
Andras Angyal (1902–1960)] accompanied by contractions of the wall of
the outer third of the vagina. See also sexual-
organismic psychology an approach to psy-
response cycle. —orgasmic or orgastic adj.
chology that emphasizes the total organism, re-
jecting distinctions between mind and body. It orgasmic dysfunction inability of a woman O
embraces a molar approach that takes account to reach orgasm in general or with certain forms
of the interaction between the organism and its of sexual stimulation. It may be primary, in
environment. See holistic psychology. which the woman has never been able to achieve
an orgasm with any type of stimulation, with or
organismic valuing process in client-
without a partner; secondary, in which the
centered theory, the presumed healthy and in-
woman had previously been but is currently un-
nate internal guidance system that a person can
able to attain orgasm through physical contact;
use to “stay on the track” toward self-
or situational, in which the woman is unable to
actualization. One goal of treatment within the
experience orgasm with a particular partner or in
client-centered framework is to help the client
a particular situation. Orgasmic dysfunction is a
listen to this inner guide. See client-centered
gender-specific term, whereas orgasmic disorder
therapy.
is gender neutral and includes female orgas-
organismic variable one of the four factors mic disorder, male orgasmic disorder, and
considered in behavioral assessment using the premature ejaculation.
sorc system, referring to the physiological and
orgasmic phase see sexual-response cycle.
psychological features of the organism that in-
fluence behavior. orgastic impotence inability of a male to
achieve orgasm in spite of normal erection and
organizational approach in the study of ejaculation. See male orgasmic disorder.
emotion, a conceptual framework, based on
general systems theory, emphasizing the role orgastic potency the ability of a man or
of emotions as regulators and determinants of woman to achieve full orgasm during the sex act.
both intrapersonal and interpersonal behaviors, See potency.
as well as stressing the adaptive role of emotions. orgiastic adj. relating to a situation character-
The organizational approach also emphasizes ized by indulgence, revelry, frenzy, and indis-
how perception, motivation, cognition, and ac- criminate sexual behavior.
tion come together to produce important emo- orgone n. the “life energy” and creative force in
tional changes. nature that was believed by Austrian psychoana-
organizational assessment activities in- lyst Wilhelm Reich (1897–1957) to pervade the
405
orgone accumulator
universe. According to Reich, orgone was emit- blood, possibly due to an inborn error of amino
ted by energy vesicles called bions, which he acid metabolism or to liver disease. The condi-
claimed to find in organic material. He also pos- tion sometimes occurs in siblings, who manifest
ited that it related to cosmic radiation and specu- mental retardation and severe speech distur-
lated that it might be responsible for the origin bance.
of life from earth and water (biogenesis), as well
orofacial dyskinesia behavior characterized
as the formation of weather patterns and the sex-
by abnormal chewing, mouthing, and tongue
ual potency of human beings. See also orgone
movements that resemble symptoms of tardive
therapy.
dyskinesia.
orgone accumulator in the orgone therapy
of Austrian psychoanalyst Wilhelm Reich (1897–
orogenital activity the application of the
mouth to the genitalia. The activity may be per-
1957), an enclosure in which the patient sat for
formed by couples of opposite sexes or the same
the purpose of capturing vital orgone energy,
sex, either as a precoital form of stimulation or
which Reich supposed to have the effect of im-
carried to orgasm. Application of the mouth to
proving the flow of life energy and releasing en-
the male genitalia is called fellatio; application
ergy blocks. Also called orgone box.
of the mouth to the female genitalia is known as
orgone therapy the therapeutic approach of cunnilingus. Also called buccal intercourse;
Austrian psychoanalyst Wilhelm Reich (1897– oral–genital contact. See also oral sex.
1957), based on the concept that the achieve-
ment of “full orgastic potency” is the key to psy- orphenadrine n. an anticholinergic drug
chological well-being. Reich believed the orgasm used in the treatment of drug-induced par-
to be the emotional-energy regulator of the kinsonian symptoms, such as those produced by
body, the purpose of which is to dissipate sexual conventional antipsychotics. It is also used for
tensions that would otherwise be transformed the relief of localized muscle spasms (see muscle
into neuroses. He further held that the orgasm relaxant). Orphenadrine is also sold in combi-
derives its power from a hypothetical cosmic nation with analgesics (e.g., with aspirin and
force, orgone energy, which accounts not only caffeine as Norgesic in the United States). U.S.
for sexual capacity but also for all functions of trade name: Norflex.
life and for the prevention of disease. The psy- orthergasia n. see euergasia.
choanalytic community largely rejected and dis-
approved of Reich’s highly unorthodox theories orthodox psychoanalysis see classical psy-
and approaches. Also called vegetotherapy. choanalysis.
orgy n. a type of social gathering at which a num- orthodox sleep a less common name for nrem
ber of people engage in unrestrained sexual ac- sleep.
O tivity, often with other forms of revelry, orthonasia n. a program in which children are
including singing, dancing, and drinking. taught about death as a part of life, to enable
oriental nightmare-death syndrome see them to incorporate healthy attitudes toward
bangungut. death in their coping repertoire. [introduced by
Austrian-born U.S. psychologist Kurt R. Eissler
orientation n. 1. awareness of the self and of (1908–1999)]
outer reality, that is, the ability to identify one’s
self and to know the time, the place, and the per- orthopsychiatry n. an interdisciplinary ap-
son one is talking to. See also reality orienta- proach to mental health in which psychiatrists,
tion. 2. the process of familiarizing oneself with psychologists, social workers, pediatricians, soci-
a new setting (e.g., a new home, neighborhood, ologists, nurses, and educators collaborate on
or city) so that movement and use do not de- the early treatment of mental disorders, with an
pend upon memory cues, such as maps, and emphasis on their prevention. —ortho-
eventually become habitual. —orient vb. psychiatric adj. —orthopsychiatrist n.
orientation illusion see illusion of orien- orthostatic hypotension a drop in blood
tation. pressure when moving from a lying or sitting po-
orienting response 1. a behavioral response to sition to a standing position. Blood pressure is
an altered, novel, or sudden stimulus, for exam- normally maintained in the face of changes in
ple, turning one’s head toward an unexpected position by activation of baroreceptors in the
noise. Various physiological components of the walls of the heart and the major arteries. Activa-
orienting response have subsequently been tion of these receptors in turn activates alpha-
identified as well, including dilation of pupils adrenergic receptors in peripheral blood
and blood vessels and changes in heart rate and vessels, leading to arterial constriction and
electrical resistance of the skin. [described in maintenance of blood pressure. Numerous psy-
1927 by Ivan pavlov] 2. any response of an or- chotropic drugs (e.g., antidepressants, antipsy-
ganism in relation to the direction of a specific chotics) block the activity of peripheral alpha
stimulus. Also called orienting reflex. adrenoreceptors, leading to orthostatic hypo-
tension and an increased risk of falls, particularly
originality n. see creativity. in older adults. Orthostatic hypotension can also
ornithinemia n. excessive ornithine in the be caused by such disorders as diabetes mellitus,
406
out-of-body experience
amyloidosis, and Parkinson’s disease. Also called tion-directed. [introduced by U.S. sociologist
postural hypotension. David Riesman (1909–2002)]
Osgood, Charles Egerton (1916–1991) U.S. other psychosexual disorders the DSM–III
psychologist. Osgood received his PhD in psy- designation for what DSM–IV–TR terms sexual
chology at Yale University in 1946. He joined disorder not otherwise specified.
the faculty at the University of Illinois in 1950, otopalatodigital syndrome see opd syn-
remaining there throughout his career. His most drome.
important general contribution is the text
Method and Theory in Experimental Psychology ought self in analyses of self-concept, a mental
(1953). Osgood’s research has been particularly representation of a set of attributes that one is
relevant to the fields of psycholinguistics and obligated to possess according to social norms or
cross-cultural psychology. Influenced by Clark one’s personal responsibilities.
hull’s neobehaviorism, Osgood developed a outcome n. the result of an experiment, treat-
theory that explicitly named mental representa- ment, interaction, or any other event, for exam-
tions as intervening variables between stimu- ple, a client’s condition after psychotherapy.
lus and response in the behaviorist’s model. outcome evaluation a process used to decide
Along with colleagues, he developed the seman- whether a program has achieved its stated goals
tic differential method of determining the and had the desired impact on the participants.
meaning of words. Although this method was Also called payoff evaluation. See also im-
criticized by other linguists, such as Noam pact analysis; summative evaluation.
Chomsky (1928– ) and Roger brown, it was
nonetheless very influential, inspiring a great outcome expectancies cognitive, emotional,
deal of research. Osgood’s views are summarized and behavioral outcomes that individuals be-
in The Measurement of Meaning (1957), co- lieve are associated with future, or intended, be-
authored with George J. Suci and Percy H. haviors (e.g., alcohol consumption, exercise)
Tannenbaum. His later research focused on and that are believed to either promote or in-
cross-cultural studies of meaning as well as lan- hibit these behaviors.
guage pathology. Among other honors, Osgood outcome measures assessments of the effec-
received the American Psychological Associa- tiveness of an intervention on the basis of mea-
tion’s Distinguished Contributions Award and surements taken before, during, and after the
was elected to fellowships of the American Acad- intervention.
emy of Arts and Sciences and the National Acad- outcome research a systematic investigation
emy of Sciences. of the effectiveness of a single type or technique
osmolagnia n. sexual interest in and pleasure of psychotherapy, or of the comparative effec-
derived from smells emanating from the body, tiveness of different types or techniques, when
especially from the genitals. applied to one or more disorders. See also psy- O
osphresiolagnia n. sexual arousal or erotic ex- chotherapy research.
perience produced by odors. outercourse n. noncoital sexual activity, which
osphresiophilia n. an abnormal attraction to may include achieving orgasm by manual stimu-
odors. lation of the genitals or by oral sex.
osteoarthritis n. see arthritis. outer-directed adj. see other-directed.
osteoporosis n. see calcium-deficiency dis- outing n. revealing one’s own or another per-
orders. son’s same-sex sexual orientation to others. The
OT abbreviation for occupational therapy. term refers to coming out of the closet (see
closet homosexual). —out vb.
OTC abbreviation for over-the-counter.
outlier n. an extreme observation or measure-
Othello syndrome see delusional jealousy. ment, that is, one that significantly differs from
[derived from the name of the protagonist of
all others obtained. Outliers can have a high de-
William Shakespeare’s tragedy Othello]
gree of influence on summary statistics and esti-
other conditions that may be a focus of mates of parametric values and their precision
clinical attention in DSM–IV–TR, a category and may distort research findings if they are the
that includes various conditions or problems result of error.
that warrant psychiatric attention or treatment
out-of-body experience a dissociative experi-
even though they do not meet the criteria of
ence in which the individual imagines that his
mental disorder.
or her mind, soul, or spirit has left the body and
other-conscious emotion see self-con- is acting or perceiving independently. Such ex-
scious emotion. periences are sometimes reported by those who
other-directed adj. describing or relating to have recovered from the point of death (see
people whose values, goals, and behavior stem near-death experience); they have also been
primarily from identification with group or reported by those using hallucinogens or under
collective standards rather than with individu- hypnosis. Certain occult or spiritualistic prac-
ally defined standards. Also called outer- tices may also attempt to induce such experi-
directed. Compare inner-directed; tradi- ences.
407
outpatient
outpatient n. a person who obtains diagnosis, pose or fulfill more than one unconscious wish.
treatment, or other service at a hospital, clinic, —overdetermined adj.
physician’s office, or other health care facility overdose 1. n. the ingestion of an excessive
without overnight admission. See also ambula- amount of a drug, with resulting adverse and po-
tory care. Compare inpatient. tentially lethal effects. The precise toxic effects
outpatient commitment a form of court- differ according to many factors, including the
ordered psychiatric or psychological treatment properties and dosage of the drug, the body
in which individuals are allowed to remain in weight and health of the individual, and the in-
the community so long as they are closely moni- dividual’s tolerance for the drug. 2. vb. to take an
tored and continue to receive treatment. excessive amount of a drug.
outpatient services health care services per- Overeaters Anonymous (OA) a voluntary or-
formed for registered ambulatory patients in ganization of men and women who seek to help
hospital units, clinics, doctors’ offices, and men- each other understand and overcome compul-
tal health centers. sive eating disorders through a twelve-step
program. See also self-help group.
O variable see organic variable.
overgeneralization n. a cognitive distortion
ovariectomy n. the surgical removal of an in which an individual views a single event as an
ovary. This procedure may be performed when
invariable rule, so that, for example, failure at ac-
the ovaries are diseased or injured. Under some
complishing one task will predict an endless pat-
circumstances, as when a woman is at very high
tern of defeat in all tasks.
risk for ovarian cancer, it may be carried out
for prevention or prophylaxis (see prophylac- overinclusion n. failure of an individual to
tic surgery). Removal of ovaries in premeno- eliminate ineffective or inappropriate responses
pausal women will induce menopause. Also associated with a particular stimulus.
called oophorectomy. overload n. a psychological condition in which
overactivity n. excessive, restless activity that is situations and experiences are so cognitively,
usually less extreme than hyperactivity. perceptually, and emotionally stimulating that
they tax or even exceed the individual’s capacity
overanxious disorder disproportionate and to process incoming information. See cogni-
persistent anxiety or worry occurring in child- tive overload; information overload; sen-
hood or adolescence across a variety of different sory overload; stimulus overload.
situations and objects. In some current diagnos-
tic classifications, notably the dsm–iv–tr, over- overmedication n. see medication.
anxious disorder has been subsumed under overproductive ideas racing thoughts or
generalized anxiety disorder. flight of ideas often present in a manic epi-
O overcompensation n. see compensation. sode.
—overcompensate vb. overprotection n. the process of sheltering a
child to such an extent that he or she fails to be-
overconfidence n. an unsupported belief or
come independent and may experience later
unrealistically positive expectation that a de-
adjustment and other difficulties, including de-
sired outcome will occur. In a sports setting, for
velopment of a dependent personality disor-
example, overconfidence might involve overes-
der.
timating one’s ability to perform or underesti-
mating the ability of a competitor to perform. overreaction n. a reaction, particularly an emo-
—overconfident adj. tional response, that exceeds an appropriate
level.
overcontrolled adj. denoting behavior that is
inhibited and often driven by shyness or fear of overt behavior behavior that is explicit, that is,
rejection. The word is typically used to describe observable without instruments or expertise.
the behavior of children thought to be at risk for over-the-counter (OTC) adj. able to be pur-
depression, but may also refer to similar behav- chased without a doctor’s prescription. A variety
ior in adults. of OTC drugs, including acetaminophen and as-
overcorrection n. in therapy, a technique used pirin, are available.
when a client exhibits inappropriate behavior, overt homosexuality gay or lesbian tenden-
in which the therapist asks the client to repeat cies that are consciously recognized and ex-
the behavior in an appropriate but exaggerated pressed in sexual contact, in contrast to latent
way. homosexuality.
overdetermination n. in psychoanalytic the- overtraining syndrome the unwanted physi-
ory, the concept that several unconscious factors cal and mental effects, collectively, of training
may combine to produce one symptom, dream, beyond the individual’s capacities. Characteris-
disorder, or aspect of behavior. Because drives tic symptoms include decreased performance,
and defenses operate simultaneously and derive easily tiring, loss of motivation, emotional insta-
from different layers of the personality, a dream bility, inability to concentrate, and increased
may express more than one meaning, and a susceptibility to injury and infection. See burn-
single symptom may serve more than one pur- out.
408
oxytocin
overt response any observable or external reac- ergonovine) and some prostaglandins. See
tion, such as pointing to indicate one’s prefer- also oxytocin.
ence from among a set of objects or verbally oxytocin n. a peptide produced in the hypo-
answering “yes” to a question. Compare covert thalamus and released by the posterior pitu-
response. itary gland into the blood, where it acts as a
overvalued idea a false or exaggerated belief hormone, or into the central nervous system,
that is maintained by an individual, but less rig- where it acts as a neurotransmitter and binds to
idly and persistently than a delusion (e.g., the oxytocin receptors to influence behavior and
idea that one is indispensable in an organiza- physiology. Although perhaps best known for
tion). The presence of an overvalued idea implies its role in stimulating contractions of smooth
an unconscious motivation that, if made con- muscle in the wall of the uterus to facilitate
scious, would reduce its importance and corre- labor and in the mammary glands to facilitate
sponding dysfunctions. expression of milk—the so-called milk letdown
oxazepam n. a short-acting benzodiazepine reflex—oxytocin is present and serves impor-
that is the final active product of the metabolism tant functions in both sexes. Indeed, it has
of diazepam. Oxazepam possesses the advan- earned a reputation as a facilitator of social af-
tage of having no metabolic products; it there- filiation and the tend-and-befriend response
fore has a predictable half-life and elimination in particular, and also has been shown to be
time and requires minimal processing in the involved in stressful experiences (e.g., social
liver. Because of this, some consider it to be the isolation, unhappy relationships) and to influ-
preferred agent in the management of alcohol ence sexual pleasure, reproductive functions,
withdrawal. However, the need for close moni- parental behavior (especially maternal behav-
toring of dosing schedules leads others to pre- ior), and emotional behavior such as anxiety
fer longer-acting agents for this condition. U.S. and depression. Additionally, research with non-
trade name: Serax. human animals suggests oxytocin—and the
oxidation n. a chemical reaction in which a sub- structurally similar compound vasopressin—
stance combines with oxygen or in which elec- is important for a variety of other activities, in-
trons are lost. In drug metabolism, oxidation is cluding pair-bond formation, mate guarding,
a common mechanism of Phase I metabolism, in and recognition of social stimuli. A possible
which drugs are made more polar (i.e., more reason for the varied roles that oxytocin ap-
water soluble) by the addition of an oxygen pears to play is that it has dual pathways and
atom, often via the action of cytochrome p450 purposes. It has been theorized that when op-
enzymes. erating during times of low stress, oxytocin
oxycodone n. see opioid analgesic. physiologically rewards those who maintain
oxytocics pl. n. drugs that are capable of stimu- good social bonds with feelings of well-being. O
lating contractions of the uterine muscles and When operating during times of high social
are used clinically to induce labor and elective or stress or pain, however, it may produce physio-
therapeutic abortion and to control postpartum logical changes that then encourage people to
bleeding. They include ergot derivatives (e.g., seek contact with others.
409
Pp
PA abbreviation for physician assistant. or discomfort, which may be achieved by
pharmacotherapy (e.g., administration of opi-
padded cell a room in a psychiatric hospital or
oids or other analgesics), behavioral therapies,
ward that is lined with mattresses or other heavy
neurological and anesthesiologic methods (e.g.,
padding on the floor and walls to protect a vio-
nerve blocks, self-administered pumps), comple-
lent or self-destructive patient from self-injury
mentary or alternative methods (e.g., acupunc-
or from injuring others. In most institutions
ture or acupressure), or a combination of
padded cells have been replaced by some combi-
these. A wide range of psychological interven-
nation of physical restraints, psychological in-
tions have been used successfully in treatment to
terventions, and tranquilizing medications.
help people deal with or control their pain. For
pain n. an unpleasant sensation due to damage example, biofeedback and relaxation have
to nerve tissue, stimulation of free nerve end- been used alone and in conjunction with other
ings, or excessive stimulation (e.g., extremely cognitive techniques to treat chronic headaches
loud sounds). Physical pain is elicited by stimu- and facial pain. hypnotherapy has also been
lation of pain receptors, which occur in groups used successfully to treat acute pain and pain as-
of myelinated or unmyelinated fibers through- sociated with burns and metastatic disease. Cog-
out the body, but particularly in surface tissues. nitive and behavioral coping-skills training,
Pain that is initiated in surface receptors gener- along with external attentional focus, neutral or
ally is perceived as sharp, sudden, and localized; positive imagery, problem solving, communi-
pain experienced in internal organs tends to be cation skills, and psychotherapeutic approaches,
dull, longer lasting, and less localized. Because of have been combined with physical modalities in
psychological factors, as well as previous experi- the treatment of chronic pain syndromes.
ence and training in pain response, individual
reactions vary widely. Although pain is generally pain mechanisms neural mechanisms that
considered a physical phenomenon, it involves mediate pain. These extend from peripheral
various cognitive, affective, and behavioral fac- nerve endings to the cerebral cortex, especially
tors: It is an unpleasant emotional as well as sen- the cingulate gyrus. Some investigators pro-
sory experience. Pain may also be a feeling of pose that sharp pain sensations are transmitted
severe distress and suffering resulting from acute by rapidly conducting A fibers (myelinated
anxiety, loss of a loved one, or other psycholo- nerve fibers or axons of the somatosensory sys-
gical factors (see psychic pain). Psychologists tem) and dull pain sensations are transmitted by
have made important contributions to under- slowly conducting C fibers (unmyelinated pe-
standing pain by demonstrating the psycho- ripheral nerve fibers or axons). See also gate-
social and behavioral factors in the etiology, control theory.
severity, exacerbation, maintenance, and treat-
pain pathway any neural pathway that medi-
ment of both physical and mental pain. See also
ates sensations of pain. Afferent pain pathways
chronic pain; gate-control theory.
include rapidly conducting myelinated A fibers
pain disorder in DSM–IV–TR, a somatoform and slowly conducting unmyelinated C fibers,
disorder characterized by severe, prolonged ascending tracts in the anterolateral system, the
pain that significantly interferes with a person’s periaqueductal gray matter, the reticular
ability to function. The pain cannot be accounted formation, and many thalamic and cerebral
for solely by a medical condition, and there is ev- cortical areas, especially the cingulate gyrus.
idence of psychological involvement in its onset, There are also efferent pathways that inhibit
severity, exacerbation, or maintenance. Although pain signals at various levels down to spinal
not feigned or produced intentionally (compare synapses, including release of endogenous
factitious disorder; malingering), the pain opioids that inhibit pain.
may serve such psychological ends as avoidance
of distasteful activity or gaining extra attention pain perception the perception of physiologi-
or support from others. Pain disorder was for- cal pain, usually evoked by stimuli that cause or
merly referred to as psychogenic pain disorder or threaten to cause tissue damage. In some cases,
somatoform pain disorder. such as phantom limb pain, the persistence of
pain cannot be explained by stimulation of neu-
painful bruising syndrome see gardner– ral pathways. Pain perception can be measured
diamond syndrome. in terms of its intensity and can be classified
pain management the prevention, reduction, according to several categories: These include
or elimination of physical or mental suffering sharp or dull; focal or general; and chronic or
410
panic disorder
intermittent or transitory. Also called nocicep- the globus pallidus. Pallidotomy is used for
tion. the management of disorders involving damage
pain scale a standardized rating scale for judg- to the extrapyramidal tract, such as Parkin-
ing the experience of pain. It may take the form son’s disease.
of verbal self-description, numerical rating, or palpitation n. a rapid heartbeat associated with
graphical depictions of faces. an anxiety attack, excessive tension, or physical
paint sniffing a type of substance abuse in- exertion.
volving the inhalation of the fumes of paint Pamelor n. a trade name for nortriptyline.
thinners and other volatile solvents. See inhal- panarteritis n. a diffuse inflammation of the
ant abuse. walls of the small and medium arteries. Arteries
pair bond a relationship between two individu- of the skeletal muscles, kidneys, heart, and gas-
als characterized by close affiliative behavior be- trointestinal tract may be involved.
tween partners, emotional reaction to separation pancreatitis n. an inflammation of the pan-
or loss, and increased social responsiveness on creas, marked by severe abdominal pain and
reunion. caused by biliary tract disorders (e.g., gallstones),
paired comparison a systematic procedure for alcoholism, viral infection, or reactions to cer-
comparing a set of stimuli or other items. A pair tain drugs (e.g., some antipsychotic agents).
of stimuli is presented to the participant, who is pandemic adj. widespread or universal: affecting
asked to compare them on a particular dimen- significant proportions of many populations
sion, such as size, loudness, or brightness; the over a large area (e.g., several countries), particu-
process is continued until every item in the set larly with reference to a disease or disorder.
has been compared with every other item. The Compare endemic; epidemic.
method is mainly associated with research into
psychophysical judgments but has also been panel study a longitudinal study (see longitu-
used to study preferences between works of art or dinal design) in which one or more groups
different personality characteristics. (panels) are followed over time.
paleologic thinking prelogical thinking panic n. a sudden, uncontrollable fear reaction
characterized by concrete, dreamlike thought that may involve terror, confusion, and irratio-
processes, as occurs in children. Mental activity nal behavior, precipitated by a perceived threat
is limited to feeling and perception and excludes (e.g., earthquake, fire, or being stuck in an eleva-
logic and reasoning. [defined by Italian-born tor).
U.S. psychiatrist Silvano Arieti (1914–1982)] panic attack a sudden onset of intense appre-
paleopsychology (palaeopsychology) n. hension and fearfulness in the absence of actual
1. the study of certain psychological processes in danger, accompanied by the presence of such
contemporary humans that are believed to have physical symptoms as palpitations, difficulty in
originated in earlier stages of human and, per- breathing, chest pain or discomfort, choking or
smothering sensations, excessive perspiration,
haps, nonhuman animal evolution. These in-
and dizziness. The attack occurs in a discrete pe-
P
clude unconscious processes, such as the
collective unconscious. The term was intro- riod of time and often involves fears of going
duced in this sense by Carl jung. 2. the present- crazy, losing control, or dying. In DSM–IV–TR
day reconstruction of the psychological reac- the diagnosis of a panic attack requires the pres-
tions of prehistoric human beings. —pa- ence of at least 4 of 13 somatic or cognitive
leopsychological adj. symptoms. Attacks may occur in the context of
any of the anxiety disorders as well as in other
palinopsia n. the persistence or reappearance of
mental disorders (e.g., mood disorders, sub-
a visual image after the stimulus has been re-
stance-related disorders) and in some general
moved. Palinopsia is associated with posterior
medical conditions (e.g., hyperthyroidism). See
brain injury, drug effects, and seizures. Also
also cued panic attack; situationally pre-
called palinopia; paliopsy; visual per-
disposed panic attack; uncued panic at-
severation. See also visual illusion.
tack.
palinphrasia n. involuntary repetition of words
panic control treatment a cognitive be-
or phrases in speaking. Also called paliphrasia.
havior therapy for panic disorder focusing on
paliphrasia n. see palinphrasia. education about panic, training in slow breath-
palliative care terminal care that focuses on ing, and graded in vivo exposures to cues associ-
symptom control and comfort instead of aggres- ated with panic. [developed by U.S. clinical
sive, cure-oriented intervention. This is the basis psychologists Michelle G. Craske and David H.
of the hospice approach. Emphasis is on careful Barlow (1942– )]
assessment of the patient’s condition through- panic disorder in DSM–IV–TR, an anxiety dis-
out the end phase of life in order to provide the order characterized by recurrent, unexpected
most effective medications and other procedures panic attacks that are associated with (a) per-
to relieve pain. sistent concern about having another attack,
pallidotomy n. a neurosurgical technique in (b) worry about the possible consequences of the
which electrodes are used to selectively lesion attacks, (c) significant change in behavior re-
411
pansexualism
lated to the attacks (e.g., avoiding situations, en- developed by Austrian psychiatrist Viktor E.
gaging in safety behavior, not going out Frankl (1905–1997) for the treatment of phobias]
alone), or (d) a combination of any or all of paradoxical reaction in pharmacology, a
these. Panic disorder associated with significant drug reaction that is contrary to the expected ef-
avoidance is classified as panic disorder with ag- fect, for example, worsening of anxiety after the
oraphobia (see agoraphobia). administration of an anxiolytic agent.
pansexualism n. the view that all human be- paradoxical sleep see rem sleep.
havior is motivated by the sexual drive. Sigmund
paradoxical technique a therapeutic tech-
freud has been popularly associated with such a
nique in which a client is directed by the the-
view; however, although he emphasized the
rapist to continue undesired symptomatic
power of the sexual instinct, Freud also recog-
behavior, and even increase it, to show that the
nized nonsexual interests, such as the self-
client has voluntary control over the symptoms.
preservative drives (e.g., hunger and thirst) and
Also called paradoxical intervention. See
the aggressive drive associated with the death
also paradoxical directive.
instinct. —pansexual adj.
paradoxical thinking cognition marked by
pantomime n. a nonverbal therapeutic tech- contradiction of typical logical processes. Al-
nique sometimes employed when verbal expres-
though this type of thinking can be associated
sion is blocked.
with distorted thought processes, such as those
papaverine n. an opium alkaloid first isolated present in schizoid personality disorder or
in the 1840s. It has no psychopharmacological some forms of schizophrenia, it can also be used
activity but is a potent vasodilator, being occa- as a way of reframing problems or negative be-
sionally used in the treatment of angina pectoris, liefs in a positive manner. This approach is often
to increase blood flow in the cerebral arteries, embraced to promote creativity and used as a ve-
or—when injected into the corpora cavernosa of hicle for personal, familial, and organizational
the penis—to produce erection in the manage- change.
ment of impotence. U.S. trade name: Para-Time parahippocampal gyrus a ridge (gyrus) on
S.R. the medial (inner) surface of the temporal lobe
Papez circuit a circular network of nerve cen- of cerebral cortex, lying over the hippocampus.
ters and fibers in the brain that is associated with It is a component of the limbic system thought
emotion and memory. It includes the hippo- to be involved in spatial or topographic mem-
campus, fornix, mammillary body, anterior ory. Also called parahippocampal cortex.
thalamus, cingulate gyrus, and parahippo- paralalia n. 1. a speech disorder or disturbance
campal gyrus. Damage to any component of that involves the substitution of one speech
this system leads to amnesia. Also called Papez sound for another (e.g., saying “wabbit” for rab-
circle. [first described in 1937 by James W. bit or “lellow” for yellow). See also lalling. 2. a
Papez (1883–1958), U.S. neuroanatomist] rarely used term for speech disorders generally.
P paracetamol n. see acetaminophen. paraldehyde n. a sedative and hypnotic drug
parachlorophenylalanine n. a substance formerly used in the treatment of agitation or
that blocks the synthesis of serotonin from delirium tremens. It was relatively toxic, with a
tryptophan, resulting in depletion of serotonin noted side effect of producing a characteristic
from brain cells. breath odor, and has been abandoned in favor of
safer alternatives. U.S. trade name: Paral.
paradoxical directive an instruction by a
therapist to the client to do precisely the oppo- paralexia n. the substitution or transposition of
site of what common sense would dictate in letters, syllables, or words during reading. See
order to show the absurdity or self-defeating na- also visual dyslexia.
ture of the client’s original intention. See also parallel processing information process-
paradoxical technique. ing in which two or more sequences of op-
paradoxical intention a psychotherapeutic erations are carried out simultaneously by
technique in which the client is asked to mag- independent processors. A capacity for parallel
nify a distressing, unwanted symptom. For ex- processing in the human mind would account
ample, an individual who is afraid of shaking in for people’s apparent ability to carry on different
a social situation would be instructed to imagine cognitive functions at the same time, as, for ex-
the feared situation and purposely exaggerate ample, when driving a car while also listening to
the shakiness. The aim is to help clients distance music and having a conversation. However,
themselves from their symptoms, often by ap- those who believe that there is no truly parallel
preciating the humorous aspects of their exag- processing in the brain explain this ability in
gerated responses. In this way clients can learn terms of very rapid shifts between functions and
that the predicted catastrophic consequences at- information sources. The term parallel process-
tributed to their symptoms are very unlikely to ing is usually reserved for processing at a higher,
occur. Paradoxical intention may be used to symbolic level. Also called simultaneous pro-
treat anxiety disorders but is not appropriate for cessing. Compare serial processing.
suicidal behavior or schizophrenia. [originally paralogia n. insistently illogical or delusional
412
paranoid state
thinking and verbal expression, sometimes ob- jealousy, or, most frequently, delusions of
served in schizophrenia. Swiss psychiatrist persecution.
Eugen Bleuler (1857–1939) cited the example paranoid disorder see delusional disorder.
of a patient who justified his insistence that he
was Switzerland by saying “Switzerland loves paranoid hostility anger and desire to harm
freedom. I love freedom. I am Switzerland.” others arising out of the delusion that they are
Also called paralogical thinking; perverted persecuting or plotting against one.
logic; perverted thinking. See also evasion. paranoid ideation thought processes involv-
paralysis n. loss of function of voluntary mus- ing persistent suspiciousness and nondelusional
cles. A common cause is a lesion of the nervous beliefs of being persecuted, harassed, or treated
or muscular system due to injury, disease, or unfairly by others.
congenital factors. The lesion may involve the paranoid litigious state see litigious para-
central nervous system, as in a stroke, or the pe- noia.
ripheral nervous system. —paralytic adj. paranoid personality disorder in DSM–IV–
paramedic n. a health care professional who is TR, a personality disorder characterized by (a)
specially trained and certified to assist medical pervasive, unwarranted suspiciousness and mis-
professionals and, especially, to provide a wide trust (such as expectation of trickery or harm,
range of emergency services prior to and during guardedness and secretiveness, avoidance of ac-
transportation to a hospital. cepting blame, overconcern with hidden mo-
parameter n. a numerical constant that charac- tives and meanings, and pathological jealousy);
terizes a population with respect to some attrib- (b) hypersensitivity (such as being easily slighted
ute, for example, the location of its central point. and quick to take offense, exaggerated concerns
—parametric adj. over significant behaviors or events, and readi-
parametric statistics statistical procedures ness to counterattack); and (c) restricted af-
that are based on assumptions about the distri- fectivity (such as emotional coldness, no true
bution of the attribute (or attributes) in the pop- sense of humor, or absence of tender feelings).
ulation being tested. Compare nonparametric paranoid pseudocommunity see pseudo-
statistics. community.
paramimia n. the use of gestures inappropriate paranoid psychosis a psychotic condition
to or not congruent with one’s underlying feel- characterized by persecutory delusions without
ings. personality disorganization or deterioration. See
paramimism n. a gesture or other movement delusional disorder; paranoid state.
that has a meaning to the patient although oth- paranoid-schizoid position in the object
ers may not understand its significance. relations theory of Melanie klein, the period
paramnesia n. see false memory. from birth up to the 6th month of life during
which infants perceive the world in terms of
paranoia n. 1. a paranoid state. 2. in DSM–III,
part-objects and develop a fear of annihilation
a relatively rare disorder, distinct from paranoid
and persecutory anxiety due to the power of
P
schizophrenia, in which the person reasons
their death instinct. Infants use various primi-
rightly from a wrong premise and develops a per-
tive defense mechanisms against these fears,
sistent, well-systematized, and logically con-
including (a) projection of aggression onto an
structed set of persecutory delusions, such as
external object; (b) directing their own aggres-
being conspired against or poisoned or ma-
sion against the imagined persecutory object;
ligned. The equivalent DSM–IV–TR diagnostic
and (c) introjection and splitting of the
category is persecutory-type delusional disor-
breast into a good object and a bad object (see
der. 3. historically, any psychiatric disorder
bad breast; good breast). Compare depres-
characterized by persistent delusions. See also
sive position.
classical paranoia. —paranoiac n., adj.
paranoiac character a personality type whose paranoid schizophrenia in DSM–IV–TR, a
primary characteristic is a tendency to blame the subtype of schizophrenia, often with a later
environment for his or her difficulties. onset than other types, characterized by promi-
nent delusions or auditory hallucinations. Delu-
paranoia querulans see litigious paranoia. sions are typically persecutory, grandiose, or
paranoid adj. 1. relating to or exhibiting both; hallucinations are typically related to the
extreme distrust or suspiciousness. See also pa- content of the delusional theme. Cognitive
ranoid personality disorder; paranoid ten- functioning and mood are affected to a much
dency. 2. relating to or characterized by lesser degree than in other types of schizophre-
delusions. See also delusional disorder; pa- nia. The DSM–III designation was paranoid type
ranoid schizophrenia. schizophrenic disorder.
paranoid condition see paranoid state. paranoid state a condition characterized by
paranoid delusion loosely, any of a variety of delusions of persecution or grandiosity that are
false personal beliefs tenaciously sustained even not as systematized and elaborate as in a delu-
in the face of incontrovertible evidence to the sional disorder or as disorganized and bizarre
contrary: delusions of grandeur, delusional as in paranoid schizophrenia. Paranoid states are
413
paranoid system of beliefs
described in the International Classification of Dis- physician Karl Ludwig Kahlbaum (1828–1899)]
eases (9th edition) but not in DSM–IV–TR. Also 3. loosely, any of a variety of psychotic condi-
called paranoid condition. tions, such as late-onset schizophrenia,
paranoid system of beliefs delusional beliefs paranoid schizophrenia, or certain paranoid
of persecution, reference to the self, grandiosity, states.
and the like. See also circumscribed belief. parapraxis n. an error that is believed to express
paranoid tendency a propensity toward feel- unconscious wishes, attitudes, or impulses. Ex-
ings of mistrust, persecutory beliefs, and nega- amples of such errors include slips of the pen,
tive perceptions of oneself and others. See also slips of the tongue and other forms of verbal
paranoid personality disorder; paranoid leakage, forgetting significant events, mislay-
state. ing objects with unpleasant associations, unin-
tentional puns, and motivated accidents. Also
paranosic gain see primary gain. called parapraxia. See also freudian slip;
paraphasia n. a speech disturbance character- symptomatic act.
ized by the use of incorrect, distorted, or inap- paraprofessional n. a trained but not profes-
propriate words, which in some cases resemble sionally credentialed worker who assists in the
the correct word in sound or meaning and in treatment of patients in both hospital and com-
other cases are irrelevant or nonsensical. For munity settings.
example, a wheelchair may be called a “spinning parareaction n. an abnormal or exaggerated re-
wheel,” and a hypodermic needle might be action to a relatively minor incident (e.g., trip-
called a “tie pin.” The disorder occurs in a variety ping), which may become the basis for a
of forms (e.g., literal paraphasia, semantic delusion.
paraphasia) and is seen most commonly in
organic brain disorders and pick’s disease. parasomnia n. a sleep disorder characterized
—paraphasic adj. by abnormal behavior or physiological events
occurring during sleep or the transitional state
paraphemia n. a speech disorder marked by the between sleep and waking. In DSM–IV–TR
habitual introduction of inappropriate words or parasomnias comprise nightmare disorder,
by the meaningless combination of words. sleep terror disorder, sleepwalking disor-
paraphilia n. in DSM–IV–TR, a sexual disorder der, and parasomnia not otherwise speci-
in which unusual or bizarre fantasies or behavior fied and form one of two broad groups of
are necessary for sexual excitement. The fan- primary sleep disorders, the other being
tasies or acts persist over a period of at least dyssomnias. See also dysfunctions associ-
6 months and may take several forms: preference ated with sleep, sleep stages, or partial
for a nonhuman object, such as animals or arousals.
clothes of the opposite sex; repetitive sexual ac- parasomnia not otherwise specified in
tivity involving real or simulated suffering or DSM–IV–TR, a diagnostic category reserved for
humiliation, as in whipping or bondage; or re- sleep disturbances that are characterized by ab-
P petitive sexual activity with nonconsenting part- normal behavior or physiological events during
ners. Paraphilias include such specific types as sleep but do not meet criteria for a more specific
fetishism, frotteurism, pedophilia, exhibi- parasomnia. Examples include rem behavior
tionism, voyeurism, sexual masochism, and disorder and sleep paralysis.
sexual sadism. —paraphiliac adj.
parasuicide n. a range of behaviors involving
paraphilia not otherwise specified in deliberate self-harm that falls short of suicide
DSM–IV–TR, a residual category comprising and may or may not be intended to result in
paraphilias, such as coprophilia, necro- death. It includes attempted suicide and pas-
philia, and urophilia, that do not meet the di- sive suicide.
agnostic criteria for any specific type. parasympathetic drug see cholinergic
paraphonia n. an abnormal change in voice drug.
quality. parasympathetic nervous system one
paraphrenia n. 1. a late-onset psychotic condi- of two branches of the autonomic nervous
tion that is marked by delusions and hallucina- system (ANS, which controls smooth muscle
tions but is distinct from schizophrenia by virtue and gland functions), the other being the sym-
of the absence of generalized intellectual impair- pathetic nervous system. Anatomically it
ment and distinct from degenerative dementias comprises the portion of the ANS whose pre-
by virtue of the absence of a progressively deteri- ganglionic fibers leave the central nervous sys-
orating course. Although paraphrenia is not tem from the brainstem via the oculomotor,
listed in DSM–IV–TR or ICD–10, it is still used as a facial, glossopharyngeal, and vagus nerves and
diagnostic entity in some parts of the world. See the spinal cord via three sacral nerves (see spinal
also late paraphrenia. [first described by Ger- nerve). It is defined functionally as the system
man psychiatrist Emil Kraepelin (1856–1926)] controlling rest, repair, enjoyment, eating, sleep-
2. any of various mental disorders that are asso- ing, sexual activity, and social dominance,
ciated with transitional periods of life (i.e., ado- among other functions. The parasympathetic
lescence or old age). [defined in 1863 by German nervous system stimulates salivary secretions
414
parent effectiveness training
and digestive secretions in the stomach and pro- and competitive, while men become more con-
duces pupillary constriction, decreases in heart templative and expressive. [proposed by U.S.
rate, and increased blood flow to the genitalia psychologist David L. Gutmann (1925– )]
during sexual excitement. Also called parasym- parental perplexity a parent–child relation-
pathetic division. ship marked by a lack of parental spontaneity,
parasympatholytic drug see anticholi- extreme indecisiveness, and an inability to sense
nergic drug. and satisfy the child’s needs. Such primary rela-
parasympathomimetic drug see choliner- tionships may result in psychological problems
gic drug. (e.g., overdependency) during childhood and
have further consequences throughout develop-
parataxic distortion in psychoanalytic the- ment.
ory, a distorted perception or judgment of others
on the basis of past experiences or of the uncon- parental rejection persistent denial of ap-
scious. Also called transference distortion. proval, affection, or care by one or both parents,
[introduced by U.S. psychoanalyst Harry Stack sometimes concealed beneath a cover of overin-
Sullivan (1892–1949)] dulgence or overprotection. The frequent result
is corrosion of the child’s self-esteem and self-
parataxis n. broadly, a lack of integration
confidence, a poor self-image, inability to form
among components of personality, cognitive
attachments to others, tantrums, generalized
style, or emotions. The term is now infrequently
hostility, and development of psychophysical
used.
and emotional disturbances. See child ne-
Para-Time S.R. a trade name for papaverine. glect.
paraverbal therapy a method of psychother- parent–child psychotherapy a psycho-
apy, introduced in the 1970s, for children who dynamically informed, attachment-based inter-
have difficulty communicating verbally and are vention for infants, toddlers, and preschoolers
also affected by such conditions and disorders as (i.e., children age 0–5 years) whose behavior and
hyperactivity, autism, withdrawal, or language emotions have been adversely affected by nega-
disturbances. Assuming that these children tive relationships with their mothers or other
would feel more intrigued and less threatened by primary caregivers. Common difficulties in these
a nonverbal approach, the therapy uses various young children include oppositionality or ag-
expressive media, including the components of gression, frequent tantrums, eating problems,
music (tempo and pitch), mime, movement, and and sleeping disturbances. In this approach, the
art to help the children express themselves. The therapist offers guidance that helps the parent to
therapist participates on the children’s level, and recognize recurring perceptions, attributions, af-
eventually the children feel safe enough to fects, and behavioral responses in himself or her-
verbalize their real feelings, enabling them to self and to understand how these influence the
participate in more conventional therapy. [de- child and contribute to current relationship dif-
veloped by Evelyn P. Heimlich] ficulties. In a typical therapeutic session, the
paregoric n. a medication containing a tincture mother and child play together while the thera- P
of opium that is administered to control severe pist comments upon the child’s actions and
cases of diarrhea. It relieves pain and discomfort emotions and links these to the parent’s past ex-
and reduces intestinal motility. It is also used to periences, current stresses, and current attitudes.
treat opioid withdrawal in neonates and may be In thus reflecting upon themselves and becom-
used as well with children and adults. Besides ing aware of their own emotional patterns and
opium, paregoric contains camphor, benzoic behavioral tendencies, parents theoretically be-
acid, glycerin, anise oil, and alcohol. It was de- come better able to understand what the young
veloped in the early 18th century. Also called child is experiencing and to respond more sensi-
camphorated tincture of opium. tively to his or her physiological and psychologi-
cal needs. This in turn theoretically creates a
parens patriae a doctrine promoting the power
healthier, more loving relationship between the
and interest of the government (Latin, “parent
parents and child and consequently improves
of the country”) in caring for and protecting mi-
the child’s socioemotional functioning. Parent–
nors and individuals who are unable to care for
child psychotherapy is an extension of the ear-
themselves or to provide for their own basic
lier parent–infant psychotherapy, developed in
needs, even if this necessitates restricting their
the 1970s by U.S. clinical social worker Selma H.
rights. In the United States, this power and inter-
Fraiberg (1918–1981). [created by Paraguayan-
est is vested with the individual states.
born U.S. developmental psychologist Alicia F.
parental imperative a hypothesis stating that Lieberman (1947– )]
while raising children both men and women
adopt distinct, stereotypical gender roles as parent counseling professional guidance of
a means of successfully fulfilling the demands parents on problems related to raising their chil-
of parenthood. Once this parental imperative dren, including their own roles in this process.
lessens, however, these gender role orientations parent effectiveness training (PET) a set of
change in favor of more androgynous identities; principles providing guidance for prosocial in-
for example, women become more assertive teractions between children and parents related
415
parenteral drug administration
to discipline, communication, and responsible behavior in their children. Also called parent
relationships. Guidelines are also provided for training.
client-centered discussions of principles, prac- parent management training a treatment
tices, and problems of child rearing conducted approach based on the principles of operant
by a mental health professional on a group basis. conditioning. Parents use antecedents, behav-
A balance is maintained between the child’s feel- iors, and consequences to change child and ado-
ings and needs and those of the parents. One of lescent behavior at home, at school, and in other
the most notable concepts is to determine who is settings. The goals are to help children develop
responsible for (i.e., owns) the problem and who prosocial behaviors and decrease oppositional,
owns the solution for resolving a conflict. [intro- aggressive, and antisocial behaviors.
duced in 1962 by U.S. psychologist Thomas
Gordon (1918–2002)] Parents Anonymous a peer-led, profession-
ally facilitated group for parents who would like
parenteral drug administration any route to learn more effective methods of childrearing,
of administration of a drug other than via the thus strengthening families and providing a
digestive tract (parenteral literally means not means of preventing child abuse.
enteric, or not through the gut). Such routes in-
clude subcutaneous, intramuscular, and intrave- Parents Without Partners an international
nous injection; rectal and vaginal suppositories; organization providing mutual social support,
inhalation; and absorption through the skin or educational programs, and activities for single
mucous membranes. parents and their children.
parergasia n. 1. a symptom of schizophrenia
parent image a representation of the parent
in which the individual performs an action that
that exists in the mind of the individual but not
is not intended, such as opening the mouth
necessarily as an accurate image: for example, it
when asked to close the eyes. [defined by Ger-
may be an idealized version of the real parent.
man psychiatrist Emil Kraepelin (1856–1926)]
parenting n. all actions related to the raising of 2. a former name for schizophrenia, introduced
offspring. Researchers have described different by Swiss-born U.S. psychiatrist Adolf Meyer
human parenting styles—ways in which parents (1866–1950) to replace dementia praecox,
interact with their children—with most classifi- since he believed this disorder is best described
cations varying on the dimensions of emotional in terms of disorganized behavior and distorted
warmth (warm versus cold) and control (high in thought processes.
control versus low in control). One of the most
paresthesia n. an abnormal skin sensation, such
influential of these classifications is that of U.S.
as tingling, tickling, burning, itching, or prick-
developmental psychologist Diana Baumrind
ing, in the absence of external stimulation.
(1927– ), involving four types of styles: autho-
Paresthesia may be temporary, as in the “pins
ritarian parenting, in which the parent or
and needles” feeling that many people experi-
caregiver stresses obedience, deemphasizes col-
ence (e.g., after having sat with legs crossed
laboration and dialogue, and employs strong
P forms of punishment; authoritative parenting,
too long), or chronic and due to such factors as
neurological disorder or drug side effects. —par-
in which the parent or caregiver encourages a
esthetic adj.
child’s autonomy yet still places certain limita-
tions on behavior; permissive parenting, in parica n. see epena.
which the parent or caregiver is accepting and parietal lobe one of the four main subdivisions
affirmative, makes few demands, and avoids of each cerebral hemisphere. It occupies the
exercising control; and rejecting–neglecting upper central area of each hemisphere, behind
parenting, in which the parent or caregiver is the frontal lobe, ahead of the occipital lobe,
unsupportive, fails to monitor or limit behavior, and above the temporal lobe. Parts of the pari-
and is more attentive to his or her needs than etal lobe participate in somatosensory activities,
those of the child. such as discrimination of size, shape, and texture
Parenting Stress Index (PSI) an instrument of objects; visual activities, such as visually
used to assess stress in parent–child interactions guided actions; and auditory activities, such as
and to identify potentially dysfunctional speech perception.
parenting behaviors or potential behavior prob- parietal neglect see unilateral neglect.
lems in the child. It currently consists of 120 Paris Medical School a group of doctors and
questionnaire items to which parents respond students at the Salpêtrière hospital in Paris who
using a 5-point likert scale format, ranging advanced the hypotheses and research of French
from “strongly agree” to “strongly disagree.” Or- neurologist Jean-Martin Charcot (1825–1893),
iginally published in 1983, the PSI is now in its particularly with regard to his neurological
third edition (published in 1995). [developed by studies of a posited relation between hysteria
U.S. educational psychologist Richard R. Abidin and hypnotism. Sigmund freud, who studied
(1938– )] through a fellowship under Charcot, was greatly
parenting training any program that in- influenced by the Paris Medical School in his
structs parents and other caregivers in tech- early studies and in the direction of his future
niques for effectively dealing with problem work.
416
participant modeling
Parkes–Weber syndrome see sturge–weber the receptor site as do full agonists and may act
syndrome. as competitive inhibitors of full agonists. Minor
parkinsonism n. any disorder whose symp- variations in the chemical structure of either the
toms resemble those of parkinson’s disease receptor or the binding substance may dictate
without the actual presence of the disease en- whether the substance acts as a full or partial ag-
tity. Antipsychotic agents with strong dopa- onist at any particular receptor site.
mine-blocking activity, particularly the high- partial correlation the correlation between
potency antipsychotics (e.g., haloperidol), two variables with the influence of one or more
may cause the reversible syndrome known other variables on their intercorrelation statisti-
as drug-induced parkinsonism (pseudoparkin- cally removed or held constant.
sonism). partial hospitalization hospital treatment of
Parkinson’s disease a progressive neuro- patients on a part-time basis (i.e., less than 24
degenerative disease caused by the death of do- hours per day). See day hospital; night hospi-
pamine-producing neurons in the substantia tal; weekend hospitalization.
nigra of the brain, which controls balance and partial insanity a borderline condition in
coordinates muscle movement. Symptoms typi- which mental impairment is present but is not
cally begin late in life with mild tremors (see sufficiently severe to render the individual com-
resting tremor), increasing rigidity of the pletely irresponsible for his or her criminal acts.
limbs, and slowness of voluntary movements. In legal proceedings, a conclusion of partial in-
Later symptoms include postural instability, im- sanity may arise when there is evidence that a
paired balance, and difficulty walking. demen- mental disorder was probably a contributing
tia occurs in some 20–60% of patients, usually cause to a defendant’s actions, or that the disor-
in older patients in whom the disease is far ad- der rendered the individual incapable of deliber-
vanced. [first described in 1817 by James Parkin- ation, premeditation, malice, or another mental
son (1755–1824), British physician] state usually requisite for first-degree offenses; in
Parlodel n. a trade name for bromocriptine. such circumstances it may lead to conviction for
parole n. 1. in psychology and psychiatry, a a lesser offense. See also diminished responsi-
method of maintaining supervision of a patient bility; insanity; mcnaughten rule.
whose treatment is mandated by the court and partial instinct see component instinct.
who has not been discharged, but who is away partialism n. a type of paraphilia in which a
from the confines of a restrictive setting, such as person obtains sexual satisfaction from contact
a mental institution or halfway house. A patient with a body part of the sexual partner other than
on parole may be returned to the hospital at any the usual erotic areas such as lips, breasts, and
time without formal action by a court. 2. super- genitals (e.g., a leg). Partialism is distinguished
vised release from confinement in a correctional from fetishism in which an object, such as a
facility. shoe, replaces the sexual partner.
parorexia n. a pathological compulsion to con- partial seizure a seizure that begins in a local-
sume unusual foods or nonnutritive substances. P
ized area of the brain, although it may sub-
See also cissa; pica. sequently progress to a generalized seizure.
paroxetine n. an antidepressant of the ssri Simple partial seizures produce no alteration of
class. It is currently one of the most commonly consciousness despite clinical manifestations,
prescribed antidepressants. Like other SSRIs, it is which may include sensory, motor, or auto-
used to treat depression and anxiety disorders, nomic activity. complex partial seizures may
such as panic disorder, social phobia, and obses- produce similar sensory, motor, or autonomic
sive-compulsive disorder. It differs from other symptoms but are also characterized by some
SSRIs in that most patients find it to be sedating impairment or alteration of consciousness dur-
rather than activating; paroxetine should there- ing the event. Partial seizures of both types are
fore be taken in the evening rather than on ris- most commonly focused in the temporal lobe.
ing. It should not be taken by patients who are Also called focal seizure.
already taking monoamine oxidase inhibi- participant n. a person who takes part in an in-
tors. Paroxetine is available in immediate- and vestigation, study, or experiment, for example
controlled-release preparations. U.S. trade name: by performing tasks set by the experimenter or
Paxil. by answering questions set by a researcher. The
paroxysm n. 1. the sudden intensification or re- participant may be further identified as an
currence of a disease or an emotional state. 2. a experimental participant (see experimental
convulsion, spasm, or seizure. —paroxysmal group) or a control participant (see control
adj. group). Participants are also called subjects, al-
partial agonist a substance that binds to a re- though the former term is now often preferred
ceptor but fails to produce the same degree of re- when referring to humans.
sponse as a full agonist at the same receptor site participant modeling a procedure for chang-
or exerts only part of the action exerted by the ing behavior in which effective styles of behavior
endogenous neurotransmitter that it mimics. are modeled (i.e., broken down, demonstrated
Partial agonists may exhibit the same affinity for step-by-step, and analyzed) by a therapist for an
417
partner abuse
individual. Various aids are introduced to help neutral but that indirectly displays an uncon-
the individual master the tasks, such as the view- scious aggressive motive. For example, a child
ing of videotaped enactments of effective and in- who appears to be compliant but is routinely late
effective behavioral responses to prototypical for school, misses the bus, or forgets his or her
situations in a variety of social contexts (e.g., at homework may be expressing unconscious re-
school or work). [developed by Albert bandura] sentment at having to attend school.
partner abuse see domestic violence. passive-aggressive personality disorder a
part-object n. 1. in psychoanalytic theory, an personality disorder of long standing in which
object toward which a component instinct is ambivalence toward the self and others is ex-
directed. Such an object is usually a part of the pressed by such means as procrastination, daw-
body rather than a whole person. 2. in the ob- dling, stubbornness, intentional inefficiency,
ject relations theory of Melanie klein, an “forgetting” appointments, or misplacing im-
early object representation that derives from portant materials. These maneuvers are inter-
splitting the object into parts containing nega- preted as passive expressions of underlying
tive and positive qualities. It is held that such ob- ambivalence and negativism. The pattern per-
jects constitute the infant’s first experience of sists even where more adaptive behavior is
the world, being perceived as a good object or clearly possible; it frequently interferes with oc-
a bad object according to whether they are cupational, domestic, and academic success.
gratifying or frustrating. internalization of This disorder is classified in the appendix of
part-objects is further posited to represent the DSM–IV–TR and given an alternative name,
beginning of the inner world of objects whose negativistic personality disorder, in accordance
relationships create the infant’s personality. See with the theoretical proposals of U.S. psycholo-
also depressive position; paranoid-schizoid gist Theodore Millon (1929– ).
position. passive algolagnia interest and pleasure de-
pasmo n. see susto. rived from experiencing pain during sexual ac-
tivity, that is, from being the masochist in a
passionate love a type of love in which sexual relationship involving sadomasochism.
passion and a high level of emotional arousal are
prominent features; along with companionate passive avoidance a type of operant condi-
love, it is one of the two main types of love tioning in which the individual must refrain
identified by social psychologists. Passionate from an explicit act or response that will produce
lovers typically are greatly preoccupied with the an aversive stimulus. Compare active avoid-
loved person, want their feelings to be reci- ance.
procated, and are usually greatly distressed when passive coping a stress-management strategy in
the relationship seems awry. See also limer- which a person absolves himself or herself of re-
ence; romantic love; triangular theory of sponsibility for managing a stressor and instead
love. relinquishes control over its resolution to exter-
passionflower n. a climbing herb, Passiflora nal resources, such as other people and environ-
P mental factors. Individuals who cope passively
incarnata, indigenous to the southeastern United
States and other subtropical areas but also culti- often withdraw from interpersonal relationships
vated as an ornamental plant. Parts of the plant and instead engage in such activities as hoping,
have been used both externally and internally praying, or avoiding the stressor. This type of
for a variety of medicinal purposes, ranging from coping strategy generally is considered
treatment of burns and hemorrhoids to the alle- maladaptive, having been associated with in-
viation of neuralgia and spasms or seizures. creased depression, poorer psychological adjust-
Passionflower tea has long been a folk remedy ment, and other adverse consequences. It is
for the relief of nervous tension. Although some similar to the earlier conceptualization of emo-
studies suggest passionflower has sedative prop- tion-focused coping but distinguished by its
erties and it has been approved by Commission focus upon external factors and abdication of
E, a committee of 24 interdisciplinary health personal responsibility. Compare active cop-
care professionals formed in 1978 by the Ger- ing. [identified in 1987 by Gregory K. Brown
man Federal Institute for Drugs and Medical De- and Perry M. Nicassio (1947– ), U.S. clinical
vices, for treatment of insomnia and anxiety, psychologists]
definitive clinical evidence of this effect has not passive deception the withholding of certain
been established. Adverse reactions are rare, but information from research participants, such as
may include nausea, vomiting, and rapid heart not informing them of the full details of the
rate. study. Also called deception by omission.
passive adj. 1. acted upon rather than acting. Compare active deception.
2. describing a personality pattern that is sub- passive-dependent personality see de-
missive, compliant, easily influenced by external pendent personality disorder.
forces, and dependent on others. See also de- passive euthanasia the intentional withhold-
pendent personality disorder. ing of treatment that might prolong the life of a
passive-aggressive adj. characteristic of behav- person who is approaching death. It is distin-
ior that is seemingly innocuous, accidental, or guished from active euthanasia, in which di-
418
pathological gambling
rect action (e.g., a lethal injection) is taken to parental care undergo some hormonal changes
end the life. Courts have ruled that physicians similar to those in females: increased secretion of
do not have to try every possible intervention to prolactin and estrogens. Early experience
prolong life, but opinions differ on where the with young offspring is important for competent
line should be drawn. There is also controversy paternal behavior in many species.
regarding the significance of the passive–active path analysis a set of quantitative procedures
distinction, since both approaches result in used to verify the existence of causal relation-
shortening the life. See also euthanasia. ships among several variables, the results of
passive listening in psychotherapy and coun- which are displayed graphically to show the vari-
seling, attentive listening by the therapist or ous hypothesized routes of causal influence. The
counselor without intruding upon or interrupt- causal relationships are theoretically deter-
ing the client in any way. See also active listen- mined, and the path analysis determines both
ing. the accuracy and the strength of the hypothe-
passive negativism see negativism. sized relationships.
pathogen n. any agent (e.g., a bacterium or
passive scopophilia sexual interest in and
virus) that contributes to disease or otherwise
arousal by having others view one’s genitals. Pas-
induces unhealthy structural or functional
sive scopophilia differs from exhibitionism in
changes. —pathogenicity n.
that it usually involves the participation of a
consenting partner rather than a stranger. pathogenesis n. the origination and develop-
ment of a mental or physical disease or dis-
passive suicide ambiguous behavior that tends
order. Also called nosogenesis; pathogeny.
to be self-destructive, but not actively so, and is
—pathogenetic adj.
sometimes thought to reflect suicidal intentions.
Examples of this behavior include failing to feed pathogenic family pattern negative or
oneself or to engage in rudimentary self-care. harmful family attitudes, standards, and behav-
ior that lay the groundwork for mental and
passivity n. a form of adaptation, or mal- behavioral disorder. Examples are parental rejec-
adaptation, in which the individual adopts a pat-
tion; triangulation of the child into the mari-
tern of submissiveness, dependence, and retreat
tal relationship between the parents; and
into inaction.
excessively harsh, excessively lenient, or incon-
passivity phenomena phenomena in which sistent discipline.
individuals feel that some aspect of themselves is pathogeny n. see pathogenesis.
under the control of others. These aspects can in-
clude acts, impulses, movements, emotions, or pathognomonic adj. describing a sign, symp-
thoughts; patients typically report feeling that tom, or a group of signs or symptoms that is in-
they are being made to do or think things by dicative of a specific physical or mental disorder
someone else or that they are experiencing the and not associated with other disorders.
behaviors or emotions of someone else. pathognomy n. the recognition of feelings,
pastoral counseling a form of counseling or emotions, and character traits, particularly when P
psychotherapy in which insights and principles they are signs or symptoms of disease.
derived from the disciplines of theology and the pathological aging changes that occur be-
behavioral sciences are used in working with in- cause of age-related disease, as distinct from
dividuals, couples, families, groups, and social changes associated with normal healthy aging.
systems to achieve healing and growth. Pastoral pathological doubt 1. abnormal concern
counseling is centered in theory and research about having failed to perform a particular ac-
concerning the interaction of religion and sci- tion, such as locking the door upon leaving the
ence, spirituality and health, and spiritual direc- house. Pathological doubt is a common feature
tion and psychotherapy. A pastoral counselor of obsessive-compulsive disorder. 2. a nega-
receives advanced training in one or several of tive belief about one’s ability or future that often
the behavioral sciences (often psychology specif- results in the inhibition of behavior and is com-
ically) in addition to religious training, theologi- monly associated with a major depressive epi-
cal training, or both. Also called pastoral sode.
psychotherapy. pathological fallacy an error of over-
Patau’s syndrome see chromosome-13 tri- generalization in which pathological character-
somy. [Klaus Patau, 20th-century U.S. geneti- istics observed in one individual or in a limited
cist] group of individuals are extrapolated and attrib-
paternal behavior actions by males directed uted to the general population. For example,
toward care and protection of their young. Di- most non-Freudians contend that Sigmund
rect paternal behavior consists of such actions freud’s theories are tenuous because they are
as feeding, carrying, or otherwise nurturing the based on a handful of clinical cases.
offspring; indirect paternal behavior consists pathological gambling an impulse-control
of acquiring resources or defending the group disorder characterized by chronic, maladaptive
from harm, which indirectly leads to increased wagering, leading to significant interpersonal,
survival of the young. Males of species with bi- professional, or financial difficulties. In DSM–
419
pathological inertia
IV–TR it is included in the category impulse- (a) the provision of adequate information re-
control disorders not elsewhere classified. garding benefits, risks, costs, and alternatives;
pathological inertia 1. the inability to switch (b) fair treatment (e.g., respect, responsiveness,
sets or show flexibility due to a brain injury or timely attention to health issues); (c) autonomy
psychological condition. 2. severely impaired over medical decisions (e.g., obtaining full con-
initiative, drive, or motivation sometimes associ- sent for medical interventions); and (d) confi-
ated with brain damage, particularly to the fron- dentiality.
tal lobes. See abulia. patricide n. 1. the murder of one’s own father.
pathological intoxication see idiosyn- 2. a person who murders his or her own father.
cratic intoxication. Compare matricide. —patricidal adj.
pathological jealousy see delusional jeal- Pavlov, Ivan Petrovich (1849–1936) Russian
ousy. physiologist. Pavlov earned a medical degree in
pathological lying a persistent, compulsive 1883 at the Military-Medical Academy of Saint
tendency to tell lies out of proportion to any ap- Petersburg and subsequently worked in the la-
parent advantage that can be achieved. This boratories of the German physiologists Rudolph
often occurs among people with alcohol de- Heidenhain (1834–1897) and Carl Ludwig
pendence or brain damage, but it is most com- (1816–1895). He then returned to the Military-
mon among individuals with antisocial Medical Academy, where he remained for the
personality disorder, who in some cases do rest of his career. Pavlov’s major interest was in
not seem to understand the nature of a false- the physiology of digestion and the manner in
hood. See also pseudologia fantastica. which it is controlled by the nervous system. Al-
though he was awarded the 1904 Nobel Prize in
pathology n. 1. the scientific study of func- physiology or medicine for his research on the
tional and structural changes involved in physi-
digestive processes, it is for his subsequent re-
cal and mental disorders and diseases. 2. more
search on the conditioned response that he is
broadly, any departure from what is considered
best known in psychology (see pavlovian con-
healthy or adaptive. —pathological adj. —pa-
ditioning). His observations led to further ex-
thologist n.
periments that yielded the concepts of the
pathomimicry n. conscious or unconscious unconditioned response (or reflex), the con-
mimicking, production, or feigning of symp- ditioned stimulus, discrimination of stimuli,
toms of disease or disorder. Also called patho- extinction of response, and the production
mimesis. See factitious disorder; lasthenie and elimination of experimental neuroses in an-
de ferjol syndrome; malingering. imals. He later focused on human neuroses, de-
pathomiosis n. a patient’s minimization or developing the theory that they are due to an
nial of his or her illness. imbalance between the excitatory and inhibi-
pathophysiology n. the functional alterations tory functions of the cortex; for this condition
that appear in an individual or organ as a result he advocated treatment by prolonged sleep, sed-
P of disease or disorder, as distinguished from atives, and verbal and environmental therapy.
structural alterations. —pathophysiological —Pavlovian adj.
adj. Pavlovian conditioning a type of learning in
patient n. a person receiving health care from a which an initially neutral stimulus—the condi-
licensed health professional (including the ser- tioned stimulus (CS)—when paired with a
vices of most psychologists and psychiatrists). stimulus that elicits a reflex response—the
See inpatient; outpatient. See also patient– unconditioned stimulus (US)—results in a
client issue. learned, or conditioned, response (CR) when the
CS is presented. For example, the sound of a tone
patient–client issue the dilemma of how to may be used as a CS, and food in a dog’s mouth
identify the recipient of psychological services or
as a US. After repeated pairings, namely, the tone
intervention (i.e., the nomenclature used for the
followed immediately by food, the tone, which
recipient). Psychiatrists, many clinical psycholo-
initially had no effect on salivation (i.e., was
gists, and some other mental health providers
neutral with respect to it), will elicit salivation
tend to follow the traditional language of the
even if the food is not presented. Also called
medical model and refer to the people seeking
classical conditioning; respondent condi-
their services as patients. Counseling psycholo-
tioning; Type I conditioning; Type S con-
gists, some clinical psychologists, social workers,
ditioning. See conditioning. [discovered in
and counselors tend to avoid the word “patient,”
the early 20th century by Ivan pavlov]
which is associated with illness and dysfunction,
using instead the word client to refer to the per- pavor n. a frightening dream characterized by its
son seeking their services. realism and residual feelings of terror on waking.
patients’ rights any statement, listing, sum- Pavor nocturnus occurs during the night (see
mary, or the like, that articulates the rights that sleep terror disorder); pavor diurnus may
health care providers (e.g., physicians, medical occur in young children during a daytime nap.
facilities) ethically ought to provide to those re- See also nightmare.
ceiving their services in such basic categories as Paxil n. a trade name for paroxetine.
420
pedigree
PCP 1. n. 1-(1-phenylcyclohexyl)piperidine (phen- progress-monitoring test in which sets of four

cyclidine): a hallucinogenic drug sometimes re- full-color drawings are presented to the partici-
ferred to as a “psychedelic anesthetic” because it pant, who selects the one that corresponds to a
was originally developed as an amnestic analge- word uttered by the examiner. There are 228
sic for use in surgical anesthesia and was later stimulus words each in two parallel forms (A and
found to produce a psychedelic or dissociative B) that are administered individually. The test,
reaction. Its medical use was discontinued be- now in its fourth edition (PPVT–4, 2006), may be
cause of adverse reactions, including agitation, used with individuals aged 2 years 6 months to
delirium, disorientation, and hallucinations. over 90 years to assess receptive vocabulary and
PCP has a complex mechanism of action. It verbal ability. [originally developed in 1959 by
binds as an antagonist to the nmda receptor; psychologists Lloyd M. Dunn (1917–2006) and
it also acts as a dopamine-receptor agonist Leota M. Dunn (1917–2001) at Peabody College
and blocks the reuptake of dopamine, norepi- of Vanderbilt University, Nashville]
nephrine, and serotonin, among other actions. peak experience in the humanistic psychol-
Because intoxication with PCP can produce ogy of U.S. psychologist Abraham Maslow
symptoms resembling both the positive and (1908–1970), a moment of awe, ecstasy, or sud-
negative symptoms of schizophrenia, some conden insight into life as a powerful unity tran-
sider it to be a useful drug model of schizophre- scending space, time, and the self that may at
nia. High doses of PCP may induce stupor or times be experienced by individuals in their pur-
coma. PCP became common as an illicit drug in suit of self-actualization. See also being cog-
the 1970s. It can be smoked (often in combina- nition; timeless moment; transpersonal
tion with marijuana or tobacco), insufflated (in- psychology.
haled nasally), or taken orally or intravenously
(see angel dust). Despite speculation about its pederasty n. anal sexual intercourse, especially
potential neurotoxicity (ability to damage nerve between an adult male (pederast) and a boy
tissue), it remains a popular illicit drug. PCP is or young man (see catamite). Also called pedi-
still used in veterinary medicine, primarily as an cation.
immobilizing anesthetic during surgical proce- pediatric adj. pertaining to the health and medi-
dures. See also hallucinogen. 2. abbreviation cal care of children or to child development.
for primary care provider.
pediatric psychology an interdisciplinary
PCP intoxication a reversible syndrome due to
field of research and practice that addresses the
the recent ingestion of pcp. It includes clinically
interaction of physical, behavioral, and emo-
significant behavioral or psychological changes
tional development with health and illness
(e.g., belligerence, assaultiveness, impulsiveness,
issues affecting children, adolescents, and fami-
unpredictability, psychomotor agitation, im-
lies. Related to the larger field of health psy-
paired judgment, and impaired social or occupa-
chology, pediatric psychology differs not only
tional functioning), as well as one or more signs
in its specific focus but also in its emphasis on
of physiological involvement (e.g., vertical or
horizontal nystagmus, hypertension or tachy-
the child in the contexts of the family, school, P
and health care settings. The field tends to take
cardia, numbness or diminished responsiveness
a normative developmental view of adaptation
to pain, unsteady gait, unclear speech, muscle ri-
based on physical conditions, medical treat-
gidity, seizures, and coma). See also substance
ment, and psychosocial interactions with family
intoxication.
and peers, rather than a psychopathological
PCP intoxication delirium a reversible syn- view of adjustment to disease and disorders.
drome that develops over a short period of time
(usually hours to days) following heavy pcp con- pediatric psychopharmacology the branch
sumption. It includes disturbance of conscious- of pharmacology that is involved in the under-
ness (e.g., reduced ability to focus, sustain, or standing and administration of drugs used in the
shift attention), accompanied by changes in cog- treatment of mental and behavioral disorders of
nition (e.g., memory deficit, disorientation, or childhood and adolescence. It helps determine
language disturbance) in excess of those usually the choice of drug according to the age of the
associated with pcp intoxication. See also sub- child, the diagnosis, the duration of the disorder,
stance intoxication delirium. the severity of the illness, and the availability of
the patient for behavioral and laboratory moni-
Pcs abbreviation for preconscious. toring of the drug effects.
PD abbreviation for personal disposition.
pedication n. see pederasty.
PDAT abbreviation for presenile dementia of
the alzheimer’s type. pedigree n. 1. in medical genetics, a pictoral rep-
resentation of the history of an illness in a fam-
PDDNOS abbreviation for pervasive develop-
ily. It depicts the relationship of family members
mental disorder not otherwise specified.
and—for each member—current status (alive or
PDM abbreviation for psychodynamic diag- not), the date of diagnosis, kind of relevant ill-
nostic manual. ness, and age at diagnosis. Geneticists can often
Peabody Picture Vocabulary Test (PPVT) estimate a family member’s likelihood of devel-
a norm-referenced screening, diagnostic, and oping the disease from reviewing such a pedi-
421
pedomorphism
gree. 2. family lineage or ancestry, especially tion includes blockade of dopamine reuptake.
when this is regarded as distinguished or notable. Pemoline has been associated with rare but occa-
pedomorphism n. the attribution of childish sionally fatal liver failure and with the develop-
behavior characteristics to adults. Compare ad- ment of tourette’s disorder. Safety concerns
ultomorphism. —pedomorphic adj. led to its withdrawal from the Canadian market
in 1999 and the U.S. market in 2005. U.S. trade
pedomorphosis n. the retention of juvenile name (among others): Cylert.
characteristics in adult organisms.
PEN acronym for psychoticism, extraversion,
pedophilia n. a paraphilia in which sexual acts neuroticism. See eysenck’s typology.
or fantasies with prepubertal children are the
persistently preferred or exclusive method of penetration n. the entry of the penis into the
achieving sexual excitement. The children are vagina. In the United States, legal definitions in
usually many years younger than the pedophile cases of rape or illicit intercourse vary from state
(or pedophiliac). Sexual activity may consist of to state, but penetration is generally considered
looking and touching but sometimes includes to have occurred if the glans penis passes beyond
intercourse, even with very young children. the labia majora. In some states, if penetration
Pedophilia is rarely seen in women. —pedo- has not occurred during sexual assault, there
philic adj. cannot be a charge of rape. In such cases, the
crime is some variety of felonious sexual assault,
peduncular hallucinosis recurrent visual which usually has lower penalties than rape.
hallucinations caused by pathological processes
in the upper brainstem, which indirectly affect penetration response a response in a projec-
the central visual system. The hallucinations, tive test that can be interpreted to contain a sug-
which may be long-lasting, vivid, and scenic, are gestion of weakness or penetrability (e.g., “a hole
often accompanied by agitation and sleep distur- in the wall”). Such interpretation ultimately de-
bances. The hallucinations are usually recog- rives from an imprecise use of the psychoana-
nized as such by the patient, who may see a lytic concept of projection and is of limited
panorama of people and events from his or her validity.
past life. Peduncular hallucinosis may be mixed penile prosthesis an implanted device that is
with nonhallucinatory perceptions. used to restore male sexual potency. Such de-
peer counseling counseling by an individual vices are typically either made of malleable ma-
who has a status equal to that of the client, such terial or are inflatable, and their insertion
as a college student trained to counsel other stu- requires surgery.
dents or an employee trained to counsel his or penilingus n. see fellatio.
her coworkers. penis envy in the classic psychoanalytic theory
peer pressure the influence exerted by a peer of Sigmund freud, the hypothesized desire of
group on its individual members to fit in with or girls and women to possess a male genital organ.
adapt to group expectations by thinking, feeling, Freud held it to originate in the phallic stage,
P and (most importantly) behaving in a similar between ages 3 and 6, when the girl discovers
or acceptable manner (see conformity). Peer that she lacks this organ, and further posited
pressure may have positive socialization value that the girl feels “handicapped and ill-treated,”
but may also have negative consequences for blames her mother for the loss, and wants to
mental or physical health. Also called peer- have her penis back. German-born U.S. psycho-
group pressure. analyst Karen D. Horney (1885–1952), among
pegboard test a test of manual dexterity and others, later argued that penis envy is not an
fine motor speed in which the participant—first envy of the biological organ itself but represents
with his or her dominant hand, then with the women’s envy of men’s superior social status. In
nondominant hand, and finally with both any sense, the concept has been actively dis-
hands—inserts pegs in a series of holes as rapidly puted from the beginning and is rarely consid-
as possible. One of the best known examples is ered seriously in current psychology. See also
the Purdue Pegboard Test (developed at Purdue castration complex.
University, West Lafayette, Indiana). Pennhurst Consent Decree a judicial decree
pejorism n. severe pessimism. ordering the closure of the Pennhurst State
School and Hospital in Philadelphia, Pennsylva-
pellagra n. deficiency of the B vitamin nicotinic nia, and the movement of its residents with
acid (niacin), marked by weakness, gastrointesti- mental retardation to least restrictive environ-
nal disturbances, skin disorders, and neurologi- ments within the community. The decree fur-
cal symptoms, for example, apathy, confusion, ther ordered team planning for individual
disorientation, and neuritis. Also called nico- movement to the community, provision of case
tinic acid deficiency. management, and establishment of individual
pemoline n. a nonamphetamine cns stimu- habilitation plans. The decree was based on the
lant used for the management of attention- court’s determination that conditions at the fa-
deficit/hyperactivity disorder (ADHD). Its effects cility were dangerous to the well-being of resi-
resemble those of the amphetamines and dents and violated the due process and equal
methylphenidate, and its mechanism of ac- protection clauses of the U.S. Constitution and
422
perceptual organization
other federal and state legislation. The Penn- of the scores in the set are equal to or lower than
hurst facility closed in 1980. See also young- that score.
berg v. romeo. percept n. the product of perception: the stim-
pentazocine n. see opioid antagonist. ulus object or event as experienced by the indi-
pentobarbital n. a short- to intermediate- vidual.
acting barbiturate formerly in common use as perception n. the process or result of becoming
a sedative and hypnotic drug. Like all barbitu- aware of objects, relationships, and events
rates, it has been supplanted by safer agents, by means of the senses, which includes such ac-
such as the benzodiazepines. It is still used in tivities as recognizing, observing, and discrimi-
the induction of anesthesia and very rarely in nating. These activities enable organisms to
the treatment of a specific epileptic condition; organize and interpret the stimuli received into
otherwise it has no mental health applications. meaningful knowledge.
It was formerly used in psychotherapy to perceptual defense in psychoanalytic theory,
make clients less inhibited and therefore able a misperception that occurs when anxiety-
to express themselves more effectively, but this arousing stimuli are unconsciously distorted.
use has been discredited. U.S. trade name: Nem- If taboo words are rapidly presented, they may
butal. be misinterpreted; for example, if the stimulus
Pentothal n. a trade name for thiopental. word anal is presented, participants may report
people-first language language that places a seeing the innocuous canal.
person before his or her disability by describing perceptual distortion an inaccurate interpre-
what a person has rather than equating the per- tation of perceptual experience. Examples in-
son with the disability. Examples of the use of clude the distorted images produced by dreams
such language include “a child with a learning or hallucinogenic drugs, geometric illusions, vi-
disability” (rather than “a learning-disabled sions occurring in states of sensory deprivation
child”), “a child with Down syndrome” (rather or dehydration, and distortions produced by
than “a Down child”), and “a person who uses a modifying auditory stimuli. Perceptual distor-
wheelchair” (rather than “a wheelchair-bound tion may also occur as a consequence of acquired
person”). brain injury.
peptide n. a short chain of amino acids linked perceptual expansion 1. the development of
by peptide bonds. Peptides are usually identified the ability to recognize, interpret, and organize
by the number of amino acids in the chain, for intellectual, emotional, and sensory data in a
example, dipeptides have two, tripeptides three, meaningful way. 2. the enriched understanding
tetrapeptides four, and so on. See also protein. of experience that takes place in psychotherapy
perceived reality a person’s subjective experi- when greater insight is achieved through the
ence of reality, in contrast to objective, external therapeutic dynamic and process.
reality. Client-centered, humanistic-existential, perceptualization n. 1. see perceptual or-
and related phenomenological theories propose ganization. 2. in schizophrenia, the transfor- P
that individuals behave in accordance with per- mation of abstract concepts into specific per-
ceived, rather than objective, reality. ceptions. For example, an individual who thinks
perceived risk the extent to which individuals poorly of him- or herself may later experience
feel they are subject to a health threat. Risk is a hallucinations that bad odors are emanating
joint function of the probability of occurrence of from his or her body; the rotten personality be-
a negative event and the magnitude of its conse- comes the rotten body that smells. Perceptual-
quence. ization is the most advanced level of active
concretization. [defined by Italian-born U.S.
perceived self the subjective appraisal of per- psychiatrist Silvano Arieti (1914–1982)]
sonal qualities that one ascribes to oneself.
perceptual neglect see neglect.
perceived self-efficacy an individual’s sub-
jective perception of his or her capability for per- perceptual organization the process en-
formance in a given setting or ability to attain abling such properties as structure, pattern, and
desired results, proposed by Albert bandura as a form to be imposed on the senses to provide con-
primary determinant of emotional and motiva- ceptual organization. Each of the senses estab-
tional states and behavioral change. lishes (or learns) such organizational schemata.
According to traditional gestalt psychology,
perceived susceptibility a subjective esti- the parts of a group are organized to form whole
mate of the likelihood of personally contracting figures that constitute more than the parts
a disease, without any consideration of severity. separately (see gestalt principles of organi-
Also called perceived vulnerability. zation). Recent research has more precisely de-
percentile n. the location of a score in a distribu- fined the properties that enable such organized
tion coded to reflect the percentage of cases in tasks. Artists have traditionally used the princi-
the set that have scores equal to or below the ples of perceptual organization to create desired
score in question. Thus, if a score is said to be at moods or feelings and to challenge viewers’ ex-
the 90th percentile, the implication is that 90% pectations. Also called perceptualization.
423
perceptual schema
perceptual schema a mental model that pro- rassment, or humiliation, the anxiety may be
vides a frame of reference for interpreting in- classified as a social phobia.
formation entering the mind through the senses performance assessment an appraisal of
or for activating an expectation of how a particu- growth or deterioration in learning, memory, or
lar perceptual scene may look. See schema. both through performance on ability and
perceptual sensitization the lowering of an achievement tests.
individual’s sensory thresholds for events that performance goal 1. in the motivational the-
are emotionally sensitive or threatening. ory of U.S. personality psychologist Carol Dweck
perceptual set 1. a temporary readiness to per- (1946– ), the goal of demonstrating to others
ceive certain objects or events rather than oth- who may be evaluating one’s performance that
ers. For example, a person driving a car has a one possesses a particular ability or other attrib-
perceptual set to identify anything that might ute. This is in contrast to a learning goal, in
impact his or her safety. See set. 2. a schema or which one aims to develop an ability or attrib-
frame of reference that influences the way in ute. 2. a goal that is set in terms of a specific level
which a person perceives objects, events, or peo- of achievement, such as running a mile in 5 min
ple. For example, an on-duty police officer and a 30 s.
painter might regard a crowded street scene with performance test any test of ability requiring
very different perceptual sets. primarily motor, rather than verbal, responses,
such as a test requiring manipulation of a variety
perceptual sociogram see sociogram.
of different kinds of objects.
perceptual style the characteristic way in periaqueductal gray (PAG) a region of the
which an individual attends to, selects, alters, brainstem, rich in nerve cell bodies (i.e., gray
and interprets sensory stimuli. Some believe per- matter), that surrounds the cerebral aqueduct. A
ceptual functions are distorted among individu- component of the limbic system, it plays an im-
als manifesting various forms of psychological portant role in organizing defensive behaviors
dysfunction. (e.g., freezing). Also called central gray.
perceptual transformation 1. any modifi- perinatal herpes-virus infection a compli-
cation in a percept produced by (a) an addition cation of infection with herpes simplex Type 2
to, deletion from, or alteration in a physical in which the virus in a pregnant woman may be
stimulus or (b) a novel interpretation of the stim- transmitted to the fetus. The fetal infection may
ulus, a change in a set or attitude, or a sudden develop into a severe blood disorder and can also
insight concerning the material. 2. a change in result in a fatal form of encephalitis. The compli-
the way a problem, event, or person is perceived cation is most likely to develop in late preg-
by the inclusion of new information or a differ- nancy. See herpes infection.
ent perspective.
periodicity n. the state of recurring more or less
perdida del alma see susto. regularly, that is, at intervals.
P peregrination n. widespread or excessive trav- peripheral anticholinergic syndrome see
eling from place to place. Peregrination is one anticholinergic syndrome.
of the essential features of munchausen syn- peripheral dyslexia a form of acquired dys-
drome: The individual feels impelled to travel lexia (see alexia) that is characterized by diffi-
from town to town or from hospital to hospital culties in processing the visual aspects of words
in order to find a new audience every time the (e.g., difficulties identifying letter forms) and re-
false nature of the illness is discovered. Also sults from damage to the visual analysis system.
called itinerancy. Compare central dyslexia.
perfectionism n. the tendency to demand of peripheral dysostosis with nasal hy-
others or of oneself an extremely high or even poplasia a congenital abnormality character-
flawless level of performance, particularly when ized by short, wide hands and feet and a short,
this is not required by the situation. It is thought flat nose with nostrils bent forward. Most af-
by some to be a risk factor for depression and fected individuals show some degree of mental
other disorders. —perfectionist adj., n. retardation. Because of foot anomalies, learning
performance anxiety anxiety associated with to walk may be slow.
the apprehension and fear of the consequences peripheralism n. the view of some behaviorists
of being unable to perform a task or of per- that emphasizes events at the periphery of an or-
forming the task at a level that will lead to ex- ganism, such as the skeletal and laryngeal mus-
pectations of higher levels of performance cles and sex organs, rather than the functions of
achievement. test anxiety is a common exam- the central nervous system. For example, John B.
ple of performance anxiety. Other examples in- watson believed (falsely) that thinking was not
clude fear of public speaking, participating in a function taking place in the brain but involved
classes or meetings, playing a musical instru- minute movements of the vocal apparatus
ment in public, or even eating in public. If the (subvocal speech) and thus was an objective be-
fear associated with performance anxiety is fo- havior. Also called peripheralistic psychol-
cused on negative evaluation by others, embar- ogy. Compare centralism.
424
personal adjustment
peripheral nervous system (PNS) the por- delusion is persecutory (e.g., that one is being
tion of the nervous system that lies outside the plotted against).
brain and spinal cord, that is, all parts outside persecutory delusion see delusion of perse-
the central nervous system. Afferent fibers of cution.
the PNS bring messages from the sense organs to
the central nervous system; efferent fibers trans- perseverance n. see persistence.
mit messages from the central nervous system to perseverance effect the phenomenon in
the muscles and glands. It includes the cranial which people’s beliefs about themselves and
nerves, spinal nerves, and parts of the auto- others persist despite a lack of supporting evi-
nomic nervous system. dence or even a contradiction of supporting evi-
peripheral neuropathy a neuromuscular dis- dence.
order of the extremities caused by damage to the perseveration n. 1. in neuropsychology, the in-
peripheral nervous system and usually charac- appropriate repetition of behavior that is often
terized by weakness, numbness, clumsiness, and associated with damage to the frontal lobe of
sensory loss. Causes are numerous and include the brain. 2. an inability to interrupt a task or to
diabetes, nutritional deficiencies, injury or shift from one strategy or procedure to another.
trauma, and exposure to toxic substances. It is Perseveration may be observed, for example, in
seen in 5–15% of chronic alcoholics (see alco- workers under extreme task demands or envi-
holic neuropathy). ronmental conditions. 3. the repetition, after a
peritraumatic dissociation a transient dis- learning experience, of neural processes that are
sociative experience (see dissociation) that oc- responsible for memory formation, which is nec-
curs at or around the time of a traumatic event. essary for the consolidation of long-term mem-
Affected individuals may feel as if they are ory. 4. in speech and language, the persistence
watching the trauma occur to someone else, as if of abnormal or inappropriate repetition of a
in a movie, or they may feel “spaced out” and sound, word, or phrase, as occurs in stuttering.
disoriented after the trauma. The occurrence of —perseverate vb.
peritraumatic dissociation is a predictor for the persistence n. 1. continuance or repetition of a
later development of posttraumatic stress dis- particular behavior, process, or activity despite
order. cessation of the initiating stimulus. 2. the qual-
permeable family a more fluid and flexible ity or state of maintaining a course of action or
version of the nuclear family that some sociol- keeping at a task and finishing it despite the ob-
ogists regard as an emerging norm in contem- stacles (such as opposition or discouragement)
porary Western society. The permeable family or the effort involved. Also called industrious-
differs from the stereotypical nuclear family in ness; perseverance. —persistent adj.
five main areas: (a) the greater variety of family
persistent puberism a condition in which
structures produced by divorce, remarriage, and
secondary sexual characteristics become arrested
the acceptance of cohabitation and single-
parent families; (b) a looser sense of family
in development and individuals remain in effect P
pubescent for the rest of their lives.
boundaries, so that the offspring of former rela-
tionships may be regarded as part of the family persistent vegetative state (PVS) a pro-
unit for some purposes but not for others (see longed biomedical condition in which rudimen-
boundary ambiguity); (c) the erosion of tradi- tary brain function and, usually, spontaneous
tional sex roles within the family and the greater respiration continue but there is no awareness
role played by women in the workforce; (d) the of self or environment, no communication, and
erosion of a sense of hierarchy and deference no voluntary response to stimuli. The condition
within the family, so that children and teenagers should be distinguished from brain death.
expect greater freedom and respect for their Young trauma victims have sometimes recov-
views and preferences; and (e) the tendency for ered from PVS, but adults rarely recover after 3
all members of the family to expect greater au- months in this state. The term permanent vege-
tonomy, so that individual activities sometimes tative state is sometimes used for people who
take precedence over shared pursuits and rituals have been in PVS for an extended period.
(e.g., family meals). See also stepfamily. persona n. in the analytic psychology of Carl
perphenazine n. a conventional (typical or jung, the public face an individual presents to
first-generation) antipsychotic agent of the the outside world, in contrast to more deeply
piperazine phenothiazine class. It is used for rooted and authentic personality characteristics.
the treatment of schizophrenia, and its efficacy This sense has now passed into popular usage.
and side effects are similar to those of other The term is taken from the mask worn by actors
phenothiazines. As with all phenothiazines, in Roman antiquity.
long-term use may be associated with the pro- personal adjustment 1. adaptation by an in-
duction of tardive dyskinesia or other neu- dividual to living and working conditions in his
romuscular deficits. U.S. trade name: Trilafon. or her family and community, especially in re-
persecution delusional disorder a type spect of social interactions with those with
of delusional disorder in which the central whom regular personal contacts are necessary.
425
personal audit
2. the degree to which a person is able to cope ing) that seeks to develop the participants’ capa-
with the demands of life. bilities for constructive relationships, creative ef-
personal audit an oral or written interview or fort, leadership, and understanding of others.
questionnaire designed to encourage individuals This is achieved by various methods, such as art
to assess their own personal strengths and weak- activities, intellectual discussions, sensory stim-
nesses. ulation, and emotional interactions.
personal construct one of the concepts by personal identity see identity.
which an individual perceives, understands, pre- personalism n. 1. the philosophical position
dicts, and attempts to control the world. Un- that human personality is the sole means
derstanding a client’s personal constructs is a through which reality can be understood or in-
central way of beginning to help that person terpreted. At the core of this approach is the con-
change rigid or negative beliefs. See repertory cept of the person as a unique living whole
grid. [formulated by U.S. psychologist George irreducible in value or worth, who is striving to-
A. Kelly (1905–1967)] ward goals and is simultaneously self-contained
personal construct therapy a therapy based yet open to the world around him or her.
on the concept of the personal construct. Personalism thus reorients the material of psy-
The essence of the approach is to help individu- chology around an experiencing individual as a
als test the usefulness and validity of their con- systematic focal point. In other words, the find-
structs and to revise and elaborate them as ings of psychology can be organized only by ref-
necessary to enhance their understanding and erence to such a unique, living individual as the
positive interpretations of and interactions with originator, carrier, and regulator of all psycho-
the world. [developed in the 1950s by U.S. psy- logical states and processes. This school of psy-
chologist George A. Kelly (1905–1967)] chology stressing individual personality is more
properly termed personalistic psychology. 2. a
personal disjunction an individual’s feeling
tendency to believe that another person’s ac-
or perception of dissimilarity or discrepancy be-
tions are directed at oneself rather than being an
tween what is or might be and the objective real-
expression of that individual’s characteristics.
ity or likelihood.
personalistic psychology a school of psy-
personal disposition (PD) in the personality
chology in which the primary emphasis is on
theory of Gordon W. allport, any of a number
personality as the core of psychology (see
of enduring characteristics that describe or deter-
personalism), the uniqueness of every human
mine an individual’s behavior across a variety of
being, and the study of an individual’s traits
situations and that are peculiar to and uniquely
(and organization of traits) as the key to person-
expressed by that individual. Personal disposi-
ality and adjustment to the environment.
tions are divided into three categories according
Personalistic psychology originated with Ger-
to their degree of influence on the behavior
man psychologists Eduard Spranger (1882–
of the person possessing them. Cardinal disposi-
1963), Louis William Stern (1871–1938), and
P tions, such as a thirst for power, are so pervasive
other Europeans and was developed in the
as to influence virtually every behavior of that
United States by Gordon allport.
person; central dispositions, such as friendliness,
are less pervasive but nonetheless generally in- personality n. the configuration of characteris-
fluential and easy to identify; and secondary dis- tics and behavior that comprises an individual’s
positions, such as a tendency to keep a neat desk, unique adjustment to life, including major
are much more narrowly expressed and situation traits, interests, drives, values, self-concept, abili-
specific. ties, and emotional patterns. Personality is gen-
personal documents writings (diaries, letters, erally viewed as a complex, dynamic integration
essays, etc.), recordings, and similar material or totality, shaped by many forces, including:
produced by a person that, when examined in hereditary and constitutional tendencies; physi-
personal-document analysis, may provide in- cal maturation; early training; identification
sights into that person’s personality, values, atti- with significant individuals and groups; cultur-
tudes, beliefs, fears, and so forth. ally conditioned values and roles; and critical ex-
periences and relationships. Various theories
personal fable a belief in one’s uniqueness and explain the structure and development of per-
invulnerability, which is an expression of ado- sonality in different ways but all agree that per-
lescent egocentrism and may extend further into sonality helps determine behavior. See also
the lifespan. personality development; personality psy-
personal-growth group a small group of in- chology; personality structure.
dividuals that uses “encounter” methods, such personality assessment the evaluation of
as games, confrontation, and reenactment, for such factors as intelligence, skills, interests, apti-
self-discovery and the development of the mem- tudes, creative abilities, attitudes, and facets of
bers’ potential. See also encounter group; hu- psychological development by a variety of tech-
man-potential movement. niques. These include (a) observational methods
personal-growth laboratory a sensitivity- that use behavior sampling, interviews, and rat-
training course or group (see sensitivity training scales; (b) personality inventories, such as
426
personality psychology
the minnesota multiphasic personality in- clinical treatment. According to this approach,
ventory; and (c) projective techniques, such as psychopathology emerges from poorly function-
the rorschach inkblot test and thematic ing personality systems. Thus, to best facilitate
apperception test. The uses of personality as- a client’s long-term recovery and return to
sessment are manifold, for example, in clinical healthy functioning, the approach does not ad-
evaluation of children and adults; in educational dress symptoms per se but rather focuses on
and vocational counseling; in industry and changing the underlying ways of thinking, feel-
other organizational settings; and in rehabilita- ing, perceiving, and relating that are associated
tion. with the pathology. Once a practitioner becomes
personality breakdown a disintegration of familiar with the whole person, he or she may
personality structure and defenses that results in then selectively apply various therapeutic tech-
maladaptive and regressive behavior. niques and perspectives (cognitive–behavioral,
humanistic, psychodynamic, etc.) if and when
personality change a modification of psycho-
appropriate to a given personality system. For
logical functioning in relation to personality
example, a nurturing, supportive approach to
that could be manifested in many ways. For ex-
treating depression would be appropriate for cli-
ample, there may be a change in the degree to
ents with dependent personalities (who feel
which one is shy versus socially open or a shift in
helpless and fear abandonment) but not for
how internally controlled versus externally de-
those with antisocial personalities (who are ex-
termined one views events and behavior.
ploitative and impulsive). [introduced in 1999
personality correlates 1. personality traits by U.S. psychologist Theodore Millon (1929– )]
that are associated with a particular illness or dis-
personality inventory a personality assess-
order. For example, personality correlates of stress
ment device that usually consists of a series of
sensitivity may include introversion, obsession,
statements covering various characteristics and
and dependency. 2. variables that correlate with
behavioral patterns to which the participant re-
measures of personality. Correlations between
sponds by fixed answers, such as True, False, Al-
personality traits and observed behaviors, for ex-
ways, Often, Seldom, or Never, as applied to
ample, provide evidence for the validity of mea-
himself or herself. The scoring of such tests is ob-
sures of such traits.
jective, and the results are interpreted according
personality deterioration a progressive de- to standardized norms. An example is the min-
cline in an individual’s sense of personal iden- nesota multiphasic personality inventory.
tity, self-worth, motivational forces, and
personality processes the dynamics of per-
emotional life to the point at which he or she ap-
sonality functioning, that is, personality systems
pears to be a “changed person” or even a
that change over time and across situations as
“nonperson.” See deterioration.
the individual interacts with different people
personality development the gradual devel- and events in the environment. Personality pro-
opment of personality in terms of characteristic cesses are usually contrasted with personality
emotional responses or temperament, a recog- structure, that is, the stable, enduring ele-
nizable style of life, personal roles and role be- P
ments of an individual’s personality.
haviors, a set of values and goals, typical patterns
personality profile a presentation of the re-
of adjustment, characteristic interpersonal rela-
sults of psychological testing in graphic form so
tions and sexual relationships, characteristic
as to provide a summary of a person’s traits or
traits, and a relatively fixed self-image. See
other unique attributes and tendencies. Person-
also personality psychology; personality
ality profiles are used to summarize the charac-
structure.
teristics of groups of individuals as well (e.g.,
personality disintegration a rapid break- people with a particular disorder, people em-
down in personality, cohesion, and functioning, ployed in a particular profession).
usually owing to particularly stressful life cir-
personality psychology the systematic study
cumstances.
of the human personality, including (a) the na-
personality disorder a group of disorders in- ture and definition of personality; (b) its matura-
volving pervasive patterns of perceiving, relating tion and development; (c) the structure of the
to, and thinking about the environment and self; (d) key theories (e.g., trait theories, psycho-
the self that interfere with long-term function- analytic theories, role theories, learning theo-
ing of the individual and are not limited to ries, type theories); (e) personality disorders; (f)
isolated episodes. DSM–IV–TR recognizes 10 individual differences; and (g) personality tests
specific personality disorders—paranoid, schiz- and measurements. Personality psychologists
oid, schizotypal, histrionic, narcissistic, antiso- tend to study more-or-less enduring and stable
cial, borderline, avoidant, dependent, and individual differences in adults and have tradi-
obsessive-compulsive—each of which has its tionally assigned a central role to human moti-
own entry in the dictionary. vation and the internal dynamics of human
personality-guided therapy a therapeutic behavior, including both conscious and uncon-
framework that considers an understanding of scious motivational forces, factors, and conflicts.
each individual’s unique cognitive, affective, Personality theories aim to synthesize cognitive,
and behavioral traits to be essential for effective emotional, motivational, developmental, and
427
personality structure
social aspects of human individuality into inte- personal plan 1. a conception of one’s future
grative frameworks for making sense of the in- that includes goals to be achieved. 2. in psycho-
dividual human life. The major families of therapy, a written plan of intervention and ac-
personality theories include the psycho- tion developed for a client with the participation
dynamic, behavioral, and humanistic families. of all parties concerned. Usually compiled with
personality structure the organization of the reference to diagnostic and other data relevant
personality in terms of its basic components and to the client’s situation, it identifies a contin-
their relationship to each other. Structural theo- uum of development outlining progressive steps
ries vary widely according to their key concepts, to be achieved by the client.
for example, clusters of personality traits in personal projects the aims of an individual
Gordon allport’s approach; the surface traits that involve an organized set of activities of per-
and source traits in cattell’s personality sonal relevance over an extended period. [ana-
trait theory; the id, ego, and superego of lyzed by Canadian personality psychologist
Sigmund freud; the individual style of life of Al- Brian R. Little]
fred adler’s approach; and needs and motiva-
tions in maslow’s motivational hierarchy. personal strivings personal goal systems that
involve multiple interrelated aims, some of
personality test any instrument used to help which may support one another while others
evaluate personality or measure personality may be in conflict. [analyzed by U.S. personality
traits. Personality tests may be self-reports, in psychologist Robert A. Emmons (1958– )]
which participants answer questions about their
personality or select items that describe them- personal therapy see individual therapy.
selves, or they may take the form of projective personal unconscious in the analytic psy-
tests (see projective technique), which claim chology of Carl jung, the portion of each indi-
to measure unconscious aspects of a partici- vidual’s unconscious that contains the elements
pant’s personality. of his or her own experience as opposed to the
personality trait a relatively stable, consistent, collective unconscious, which contains
and enduring internal characteristic that is in- the archetypes universal to humankind. The
ferred from a pattern of behaviors, attitudes, feel- personal unconscious consists of everything
ings, and habits in the individual. Personality subliminal, forgotten, and repressed in an indi-
traits can be useful in summarizing, predicting, vidual’s life. Some of these contents may be re-
and explaining an individual’s conduct, and a called to consciousness, as in Sigmund freud’s
variety of personality trait theories exist, among notion of the preconscious, but others cannot
them allport’s personality trait theory and and are truly unconscious. The personal uncon-
cattell’s personality trait theory. However, scious also contains complexes based on the in-
because they do not explain the proximal causes dividual’s personal experience. In Jung’s view
of behavior nor provide a developmental ac- the personal unconscious must be integrated
count, they must be supplemented by dynamic into the conscious ego for individuation to
P and processing concepts, such as motives, occur.
schemas, plans, projects, and life stories. person-centered planning an individual
personality type any of the specific categories planning process that focuses on people’s gifts,
into which human beings may be classified on strengths, preferences, and achievements. In the
the basis of personality traits, attitudes, behavior case of a person with a developmental disability,
patterns, physique (see constitutional type), emphasis is placed on the person, his or her fam-
or other outstanding characteristics. Examples ily members, and the supports needed to enable
are the introversion–extraversion distinc- the person to make choices, participate in the
tion and functional types of Carl jung and community, and achieve dignity. The process
Erich fromm’s character types, such as the ex- requires an extended commitment from partici-
ploitative orientation and marketing ori- pants and the development of an action-
entation. oriented plan. Methods of person-centered plan-
ning include Essential Lifestyles Planning,
Personal Orientation Inventory (POI) an
Making Action Plans (MAPS), Personal Future
inventory intended to measure self-actuali-
Planning, Planning Alternative Tomorrows
zation. Originally developed in 1966, it consists
With Hope (PATH), and Whole Life Planning.
of 150 items that each contain two statements
See also person-centered team.
descriptive of values or behavior. For each item,
the participant selects the statement most deperson-centered team a group of people who
scriptive of him- or herself. The POI is scored for meet periodically in order to develop plans for
2 major scales (time ratio, support ratio) plus 10 supports and services to enhance the lifestyle
subscales: self-actualizing value, existentiality, and self-determination of someone with men-
feeling reactivity, spontaneity, self-regard, self- tal retardation or a related condition. The team
acceptance, nature of man, synergy, acceptance uses methods based on principles of person-
of aggression, and capacity for intimate contact. centered planning. Team participants are in-
[developed by U.S. psychologist Everett L. vited by the person with mental retardation or
Shostrom (1921–1992)] his or her advocate, rather than by a service orga-
428
pessimism
nization or agency, and they need not be trained persuasion therapy a type of supportive psy-
professionals in human services. chotherapy in which the therapist attempts to
person-centered therapy see client- induce the client to modify faulty attitudes and
centered therapy. behavior patterns by appealing to the client’s
powers of reasoning, will, and self-criticism. The
person–environment interaction the rela- technique was advocated by Alfred adler and
tionship between a person’s psychological and others, notably Swiss-born French physicians
physical capacities and the demands placed on Paul-Charles Dubois (1848–1918) and Joseph
those capacities by the person’s social and physi- Jules Déjerine (1849–1917), as a briefer alterna-
cal environment in which an “environmental tive to reconstructive methods (see recon-
press,” or a stimulus or situation, arouses a need, structive psychotherapy) in some therapies.
especially for adaptation. Quality of life is
strongly influenced by person–environment perturbation n. 1. an anxious or distressed
congruence: Too little or too much environmen- mental state. In the context of a completed or at-
tal press can lead to poor quality of life. tempted suicide, it is a measure of the extent to
which a person is (or was) upset or disturbed.
personification n. 1. in the approach of U.S. 2. an influence or activity that causes an inter-
psychoanalyst Harry Stack Sullivan (1892–1949), ruption or interference in a mental or physical
the pattern of feelings and attitudes toward an- phenomenon or system.
other person arising out of interpersonal rela-
tions with him or her. 2. a person viewed as pervasive developmental disorder any
representing or embodying some quality, thing, one of a class of disorders characterized by severe
or idea. —personify vb. and widespread impairment in social interaction
and verbal or nonverbal communication or the
person in the patient in the psychosomatic presence of stereotyped behavior, interests, and
approach to therapy, the role of the patient’s activities. These disorders are frequently appar-
personality, character, and emotional factors as ent from an early age; they include asperger’s
causative agents. disorder, autistic disorder, childhood
personology n. 1. the study of personality from disintegrative disorder, and rett syn-
the holistic point of view, based on the theory drome. This term is synonymous with autistic
that an individual’s actions and reactions, spectrum disorder.
thoughts and feelings, and personal and social pervasive developmental disorder not
functioning can be understood only in terms of otherwise specified (PDDNOS) in DSM–IV–
the whole person. 2. the theory of personality as TR, a residual category comprising pervasive
a set of enduring tendencies that enable individ- developmental disorders characterized by
uals to adapt to life, proposed by U.S. psychol- impaired development of social interaction skills
ogist Henry Alexander Murray (1893–1988). associated with communication difficulties or
According to Murray, personality is also a media- stereotyped behavior that do not conform to the
tor between the individual’s fundamental needs, diagnostic criteria of other pervasive develop-
both viscerogenic (see viscerogenic need) and mental disorders, such as autistic disorder, P
psychogenic (see psychogenic need), and the asperger’s disorder, rett syndrome, or
demands of the environment. childhood disintegrative disorder. This
person-years pl. n. the sum of the number of category includes atypical autism, a disorder in
years that each individual in a population of in- which children have notable difficulties in play,
terest has been affected by an event, occurrence, nonverbal communication, social interaction,
or condition of interest (e.g., by a particular dis- and speech but are more social than peers diag-
order or disease or by a certain treatment proto- nosed with autistic disorder. Also, unlike this
col). disorder, which must occur by the age of 3 years,
perspective n. 1. the ability to view objects, onset of atypical autism may not be noted until
events, and ideas in realistic proportions and re- the age of 5 to 6 years. Recent research has sug-
lationships. 2. the capacity of an individual to gested that about half of the children with atypi-
take into account and potentially understand cal autism also manifest varying degrees of
the perceptions, attitudes, or behaviors of him- mental retardation. See also autistic spectrum
or herself and of other individuals. disorder.
perspective taking looking at a situation from perversion n. a culturally unacceptable or pro-
a viewpoint that is different from one’s usual hibited form of behavior, particularly sexual be-
viewpoint. This may involve adopting the per- havior. See sexual perversion.
spective of another person or that associated perverted logic (perverted thinking) see
with a particular social role, as in role play exer- paralogia.
cises. pessimism n. the attitude that things will go
perspectivism n. a philosophical position ap- wrong and that people’s wishes or aims are un-
plied to psychotherapy in which it is assumed likely to be fulfilled. Pessimists are people who
that there is no objective, context-independent expect unpleasant or bad things to happen to
truth. [derived from the work of German philos- them and to others or who are otherwise doubt-
opher Friedrich Nietzsche (1844–1900)] ful or hesitant about positive outcomes of behav-
429
PET
ior. Pessimism can be defined in terms of tivity in the pons, lateral geniculate nucleus, and
expectancy: lack of confidence of attaining de- occipital cortex. They are associated with dream-
sired goals (compare optimism). Most individu- ing. See dream state.
als lie somewhere on the spectrum between the Phaedra complex the incestuous love of a
two polar opposites of pure optimism and pure mother for her son. The name derives from the
pessimism but tend to demonstrate sometimes Greek myth of Phaedra, wife of Theseus. When
strong, relatively stable or situational tendencies her stepson, Hippolytus, rejected her love,
in one direction or the other. —pessimistic adj. Phaedra accused him of violating her and hanged
PET 1. abbreviation for parent effectiveness herself. See also mother–son incest.
training. 2. acronym for positron emission phagomania n. an insatiable hunger or morbid
tomography. desire to consume food.
pet-assisted therapy see animal-assisted phallic adj. of, relating to, or resembling the
therapy. penis.
pethidine n. see meperidine. phallic character see phallic personality.
petit mal see absence seizure. phallic mother in psychoanalytic theory, the
pet therapy see animal-assisted therapy. fantasy that the mother has a penis.
petting behavior sexual activity that may not phallic personality in psychoanalytic theory,
continue to orgasm or may be foreplay engaged a pattern of narcissistic behavior exemplified
in prior to orgasm. Petting behavior may include by boastfulness, excessive self-assurance, vanity,
kissing, caressing the breasts and genitals, oral compulsive sexual behavior, and in some
sex, and placing the genitals in apposition. cases aggressive or exhibitionistic behavior.
Also called phallic character; phallic-
peyote n. a small, spineless cactus, Lophophora
narcissistic character; phallic-narcissistic
williamsii, that grows wild in Mexico and south-
personality.
ern Texas. The name is derived from the Aztec
word peyotl, which describes the plant as resem- phallic phase see phallic stage.
bling a caterpillar’s cocoon. The principal active phallic pride in psychoanalytic theory, the
ingredient is the hallucinogen mescaline, found sense of superiority and feelings of power experi-
in discoid protuberances on the crown of the enced by boys when they discover that they
plant that are called mescal buttons. These but- have a penis and girls do not. These feelings are
tons are cut from the roots and dried, and then believed to help master intense castration
generally chewed or soaked in water to produce anxiety. See also phallic stage.
an intoxicating liquid. From earliest recorded phallic sadism in psychoanalytic theory, ag-
time, peyote has been used by indigenous peo- gression that is associated with the child’s phal-
ples of northern Mexico and the southwestern lic stage of psychosexual development. The
United States as a part of their religious ceremo- child interprets sexual intercourse as a violent,
nies; it is still incorporated into the rituals of the aggressive activity on the part of the man, and
P Native American Church. Both peyote and mes- particularly on the part of the penis. See also pri-
caline are classified by the U.S. Drug Enforce- mal scene; sadism.
ment Administration as Schedule I controlled phallic stage in the classic psychoanalytic
substances (see scheduled drug). theory of Sigmund freud, the third stage
P factor analysis factor analysis that in- of psychosexual development beginning
volves statistically analyzing multiple responses around age 3, when the libido is focused on the
provided by a single individual across multiple genital area (penis or clitoris) and discovery and
occasions, rather than studying multiple re- manipulation of the body become a major
sponses of a large number of individuals, each of source of pleasure. During this period boys are
whom is studied on only one occasion. posited to experience castration anxiety, girls
Pfaundler–Hurler syndrome see hurler’s to experience penis envy, and both to experi-
syndrome. ence the oedipus complex. Also called phallic
Pfeiffer’s syndrome an inherited disorder phase.
marked by premature fusion of the cranial phallic symbol any object that resembles or
bones, causing a skull deformity. The patients might be taken as a representation of the penis,
also have facial deformities with protruding, such as a cigar, pencil, tree, skyscraper, snake, or
widely spaced eyes (which often show signs of hammer.
strabismus), large thumbs, and large toes. Some phallus n. (pl. phalli) the penis or an object that
affected individuals have below average intelli- resembles the form of the penis. As a symbolic
gence. The syndrome is inherited as a dominant object, it often represents fertility or potency.
trait (see acrocephalosyndactyly). Also phantasm n. an illusion or apparition, often of
called acrocephalosyndactyly Type V. [Emil an absent person appearing in the form of a
Pfeiffer (1846–1921), German physician] spirit or ghost. The observer may recognize it as
PGO spikes pontine–geniculo–occipital spikes: being imaginary or illusory, unlike a true halluci-
peaks, recorded on an electroencephalogram, nation, which is associated with lack of insight
that occur during sleep and indicate neural ac- on the part of the observer.
430
phenobarbital
phantasticum n. (pl. phantastica) a category slowly. They require only a fraction of the stan-
of drugs identified in the 1920s as capable of dard dose.
producing hallucinatory experiences. These pharmacogenomics n. the study of the ways
drugs are now known as hallucinogens. in which genetic knowledge can be utilized for
[named by German toxicologist Louis Lewin the accurate and effective administration of
(1850–1929)] medications and other drugs.
phantasy n. in the object relations theory of pharmacokinetics n. the study of how phar-
Melanie klein, one of the unconscious construc- macological agents are processed within a bio-
tions, wishes, or impulses that are presumed to logical system, in vivo or in vitro, including
underlie all thought and feeling. The ph spelling factors that influence the absorption, distribu-
is used to distinguish this from the everyday tion, metabolism, and elimination of the sub-
form of fantasy, which can include conscious stance or its metabolic products.
daydreaming. pharmacological antagonism see antago-
phantom limb the feeling that an amputated nist.
limb is still present, often manifested as a tin- pharmacology n. the branch of science that
gling or, occasionally, painful sensation in the involves the study of substances that interact
area of the missing limb (phantom limb pain). In with living organisms to alter some biological
some cases the individual may even deny that process affecting the homeostasis of the organ-
the limb has been removed. It is thought that the ism. Therapeutic (or medical) pharmacology
brain’s representation of the limb remains intact deals with the administration of substances
and becomes active spontaneously or as a result to correct a state of disease or to enhance well-
of stimulation from other brain tissue. being. —pharmacological or pharmaco-
phantom-lover syndrome a type of erotic logic adj.
delusion elaborated around a person who in pharmacopeia (pharmacopoeia) n. a book,
fact does not exist. [defined in 1978 by Canadian usually issued by a recognized authority, that
psychiatrist Mary V. Seeman] lists drugs and their chemical properties, prepa-
ration, recommended dosages, method of ad-
phantosmia n. perception of an odor when no
ministration, side effects, dangers, and other
smell stimulus is present (i.e., an olfactory hallu-
information.
cination).
pharmacotherapeutic regimen a plan for
pharmacodynamics n. the study of the effects the treatment of a condition through the use of
of drugs on the body and their mechanism of ac- medication, outlining, for example, the type of
tion. Basic studies involve the activity of drugs at drug or drugs to be used, dosage requirements,
the receptor sites to which the drugs attach as schedule of administration, and expected dura-
well as the changes in cell function and behavior tion of use.
that result. —pharmacodynamic adj.
pharmacotherapy n. the treatment of a disor-
pharmacodynamic tolerance a form of der by the administration of drugs, as opposed P
drug tolerance in which the chemistry of the to such means as surgery, psychotherapy, or
brain becomes adjusted to the presence of the complementary and alternative methods. Also
drug, which in turn then loses its capacity called drug therapy. See psychopharmaco-
for modifying brain activity. Neurons adapt therapy.
to continued drug presence by reducing the phase shift 1. a disruption of the normal sleep–
number or sensitivity of receptors available to wake cycle, with the result that the individual is
the drug (i.e., down-regulation). This cellular- alert during a usual sleeping period and sleepy
adaptive tolerance is associated with the use of when he or she should be alert. See circadian
many drugs, including sedative-hypnotics and rhythm sleep disorder; disorders of the
psychostimulants, and may be followed by with- sleep–wake cycle schedule. 2. a change in the
drawal symptoms when regular doses of the drug diurnal or circadian rhythm brought about by
are interrupted. This may be contrasted with such things as changes in daylight exposure or
metabolic tolerance, in which the body reacts to changing time zones.
continued presence of the drug by metabolizing
it at an increased rate. Both forms of tolerance phencyclidine n. see pcp.
lead to higher doses of the drug being needed to phenelzine n. a monoamine oxidase inhibi-
produce the same effects. tor that exerts its antidepressant effects by irre-
versibly binding to monoamine oxidase, thus
pharmacogenetics n. the study of genetic fac-
preventing the breakdown of monoamine
tors that influence the response of individuals to
neurotransmitters. As with other drugs in its
different drugs and to different dosages of drugs.
class, phenelzine has been supplanted by safer
Inherited variations in enzymes or other meta-
drugs without the associated toxicities, dietary
bolic components can affect the efficacy of a
restrictions, and potentially fatal drug interac-
drug or cause adverse reactions to normal doses.
tions. U.S. trade name: Nardil.
For example, some 40–70% of Caucasians have
an enzyme variant that causes them to metabo- Phenergan n. a trade name for promethazine.
lize the antituberculosis drug, isoniazid, very phenobarbital n. an anticonvulsant barbitu-
431
phenocopy
rate used for treatment of generalized tonic– construct. [proposed by U.S. psychologist
clonic or partial seizures. Formerly widely used George A. Kelly (1905–1967)]
as a sedative and hypnotic, it has been largely phenomenological therapy any form of
supplanted for these purposes by safer medica- therapy, perhaps best exemplified by client-
tions lacking the toxicity and adverse effects as- centered therapy, in which the emphasis is on
sociated with barbiturates. Phenobarbital is also the client’s process of self-discovery as opposed
sometimes used in the management of seda- to an interpretive focus, such as that found in
tive, hypnotic, or anxiolytic withdrawal. psychoanalysis.
U.S. trade name: Luminal.
phenomenology n. a movement in modern Eu-
phenocopy n. an imitation of a phenotype re- ropean philosophy initiated by German philos-
sulting from the interaction of an environmen- opher Edmund Husserl (1859–1938). In his
tal factor and a genotype. An example is the writings of the 1910s and 1920s, Husserl argued
effect of sunlight on skin or hair, resulting in for a new approach to human knowledge in
variations that mimic the natural coloring or which both the traditional concerns of philoso-
texture of other phenotypes. phy (such as metaphysics and epistemology) and
phenomenal field see phenomenal space. the modern concern with scientific causation
phenomenal self the self as experienced by would be set aside in favor of a careful attention
the individual at a given time. Only a small por- to the nature of immediate conscious experi-
tion of self-knowledge is active in working mem- ence. Mental events should be studied and de-
ory or consciousness at any time, with the scribed in their own terms, rather than in terms
remainder lying dormant or inactive. The same of their relationship to events in the body or in
person might have a very different phenomenal the external world. However, phenomenology
self at different times, without any change in ac- should be distinguished from introspection as it
tual self-knowledge, simply because different is concerned with the relationship between acts
views are brought into awareness by events. Also of consciousness and the objects of such acts (see
called working self-concept. intentionality). Husserl’s approach proved
widely influential in psychology (especially ges-
phenomenal space the environment as experi-
talt psychology) and the social sciences; it
enced by a given individual at a given time. The
also inspired the work of German philosopher
term refers not to objective reality but to per-
Martin Heidegger (1889–1976), whose existen-
sonal and subjective reality, including every-
tial phenomenology provided the basis for ex-
thing within one’s field of awareness. In the
istentialism and existential psychology.
phenomenological personality theory of Carl
—phenomenological adj. —phenomenolo-
rogers, it is also known as the pheno-
gist n.
menological field. Also called phenomenal
field. phenothiazine n. any of a group of chemically
related compounds most of which are used as
phenomenological analysis an approach to
antipsychotic drugs, originally developed as
psychology in which mental experiences are de-
P scribed and studied without theoretical presup-
such in the 1950s. The drugs in this class of tradi-
tional (or first-generation) antipsychotics were
positions or speculation as to their causes or
formerly the most widely used agents for the
consequences. In general, such an approach will
treatment of schizophrenia. The phenothiazines
favor observation and description over analysis
were the first effective antipsychotic medica-
and interpretation; it will also attempt to under-
tions and largely responsible for the deinsti-
stand a person’s experience from the point of
tutionalization of tens of thousands of people
view of that person, rather than from some more
with schizophrenia. It is commonly assumed
abstract theoretical perspective. See also phe-
that their therapeutic effects are produced by
nomenology.
blockade of dopamine D2 receptors (see dopa-
phenomenological death the subjective mine-receptor antagonists); they also block
sense that one has become inert, insensitive, and acetylcholine, histamine, and norepinephrine
unresponsive. Phenomenological death occurs receptors, actions that are associated with many
in some psychotic conditions. Patients may of their adverse effects. Phenothiazines are
speak of themselves as dead and behave (al- used for the treatment of acute mania, psychotic
though inconsistently) in accord with that agitation, and schizophrenia as well as nausea
belief. Phenomenological death is conceived as and vomiting and for preanesthesia sedation.
the extreme point on a continuum of self- They can be divided into three subgroups:
assessment; it is not necessarily a condition that aliphatic, piperazine, and piperidine. A variety
is permanent. of adverse side effects is associated with their use,
phenomenological field see phenomenal including extrapyramidal symptoms, tardive
space. dyskinesia, sedation, and anticholinergic ef-
phenomenological theory an approach to fects.
personality theory that places questions of indi- phenotype n. the observable characteristics of
viduals’ current experiences of themselves and an individual, such as morphological or bio-
their world at the center of analyses of personal- chemical features and the presence or absence of
ity functioning and change. See also personal a particular disease or condition. Phenotype is
432
phobia
determined by the expression of the individual’s phenylketonuria leads to severe mental retarda-
genotype coupled with the effects of environ- tion and other nervous-system disorders. Most
mental factors (e.g., nutritional status or cli- untreated patients have IQs below 20. Women
mate). —phenotypic adj. who have been treated for the disease must
phensuximide n. see succinimide. adopt a restricted diet during pregnancy to pre-
vent neurological damage to their children (see
phentermine n. an appetite suppressant with maternal pku).
a mechanism of action similar to the amphet-
amines. Like other appetite suppressants, it is phenylpyruvic oligophrenia a severe form
effective only for short-term weight loss: Long- of mental retardation that is associated with or
term results require concurrent adherence to due to an inborn error of metabolism of
effective behavioral weight-loss strategies. phenylalanine, as in cases of phenylketonuria.
Phentermine was previously marketed in combi- Early dietary restriction of phenylalanine may
nation with fenfluramine or dexfenfluramine— bring intelligence up to average or near-average
a combination known as “phen-fen”—which range.
was taken off the market after cases of pulmo- phenytoin n. an anticonvulsant drug: the
nary hypertension and heart-valve disease were prototype of the hydantoins. Phenytoin is pre-
reported in users. These serious side effects can- scribed mainly for the management of partial
not be ruled out with the use of phentermine and tonic–clonic seizures but is also used in the
alone. Phentermine should not be given in com- treatment of some cases of migraine and neural-
bination with monoamine oxidase inhibitors, gia. It is occasionally used to manage behavio-
and should be used with caution in individuals ral disturbances in children. U.S. trade name
taking SSRI antidepressants. U.S. trade names: (among others): Dilantin.
Adipex; Ionamin. pheromone n. a chemical signal that is released
phentolamine n. an alpha-adrenergic block- outside the body by members of a species and
ing agent with direct action on heart and that influences the behavior of other members
smooth muscle. It is a potent vasodilator used in of the same species. For example, it may serve to
the management of severe hypertension associ- attract the opposite sex or to act as an alarm. In
ated with catecholamine excess. It is in infre- nonhuman animals, sensitivity to pheromones
quent clinical use. U.S. trade name: Regitine. occurs via specialized receptor cells called the
phenylalkylamines pl. n. a group of natural vomeronasal system. The existence of true
and synthetic drugs that can produce halluci- pheromones in humans is controversial, al-
nogenic effects. They include the phenyl- though scents (e.g., perfumes, body odors) may
ethylamines, such as mescaline, and the play a role in sexual attraction and arousal.
phenylisopropylamines (substituted phenyl- Pheromones have also been suggested as a
ethylamines), such as mdma. cause of menstrual synchrony. Also called ecto-
hormone.
phenylcyclohexyl derivatives a category of
drugs introduced in 1960 as potential general Phillips Rating Scale of Premorbid Ad-
justment in Schizophrenia a method of P
anesthetics but discontinued because they
caused serious psychological disturbances in pa- analyzing the premorbid adjustment of pa-
tients. The prototype drug, pcp, produces sen- tients with schizophrenia as part of a determina-
sory deprivation effects similar to those observed tion of their prognosis. It is based on questions
in some cases of schizophrenia. Drugs of this se- derived by a researcher from case-history infor-
ries are considered to be hallucinogens but mation. Also called Phillips scale; Phillips
may be used as anesthetics and analgesics in vet- scale of premorbid adjustment. [developed
erinary medicine. in 1953 by psychopharmacologist Leslie Phillips]
phenylethylamines pl. n. a group of drugs philosophical psychotherapy psychother-
with hallucinogenic effects and a common basic apy based on philosophical principles of belief
chemical structure. The prototype is mescaline, and attitude generally, as they relate to cogni-
an alkaloid first isolated from the peyote cactus tion, emotion, and behavior, or based on the
in 1896. Mescaline is one of the least potent of principles of some particular philosophical
the hallucinogens, but potency is increased by perspective (e.g., existential psychotherapy).
adding methyl groups to the basic molecule, Training in philosophy without appropriate
thereby creating substituted phenylethylamines. training in the mental health field, however, is
The latter include the amphetamine derivatives deemed inadequate for offering psychotherapy
dom, mda, and mdma. See also phenyl- or counseling services.
alkylamines. PHO abbreviation for physician–hospital or-
phenylketonuria (PKU) n. an inherited meta- ganization.
bolic disease transmitted as an autosomal reces- phobia n. a persistent and irrational fear of a spe-
sive trait and marked by a deficiency of an cific situation, object, or activity (e.g., heights,
enzyme (phenylalanine hydroxylase) needed to dogs, water, blood, driving, flying), which is
utilize the amino acid phenylalanine. Unless it consequently either strenuously avoided or en-
is diagnosed in early infancy and treated by dured with marked distress. In DSM–IV–TR the
a restricted dietary intake of phenylalanine, many types of individual phobia are classified
433
phobic anxiety
under the heading specific phobia. See also so- scribed in 1979 by Marie-France Beauvois and
cial phobia. —phobic adj. Jacqueline Derouesné]
phobic anxiety anxiety that focuses on or is di- phonological loop see working memory.
rected toward objects or situations (e.g., insects, photism n. 1. a false perception or hallucina-
telephone booths, open areas) that represent the tion of light. See photopsia. 2. a form of syn-
real fear but pose little if any actual danger them- esthesia in which light or color sensations oc-
selves. cur in response to stimulation of other senses
phobic attitude a behavior pattern apparently (e.g., hearing).
characterized by disruptions in the awareness of photocounseling n. the use of photographs or
and attention to experience in the present. An videotapes depicting aspects of a client’s life to
example is engaging in a fantasy of the future to obtain insight into his or her behavior and needs
escape a painful present reality. [defined by Ger- and also to increase the rapport between the cli-
man-born U.S. psychotherapist Frederick (Fritz) ent and the therapist.
S. Perls (1893–1970)]
photoma n. a visual hallucination in which
phobic avoidance the active evasion of feared sparks or light flashes are seen in the absence of
objects or situations by individuals with pho- external stimuli. See also photopsia.
bias. photomania n. 1. an abnormal craving for
phobic character in psychoanalytic theory, an light, particularly sunlight. See also seasonal
individual who tends to deal with anxiety by ex- affective disorder. 2. the practice of sun wor-
treme or fearful avoidance. [first used in 1945 by ship.
Austrian psychoanalyst Otto Fenichel (1897– photophobia n. an extreme and often painful
1946)] sensitivity to light. It may be associated with mi-
phobic disorders in DSM–III, a group of disor- graine headaches or with certain types of brain
ders in which the essential feature is a persistent, trauma. —photophobic adj.
irrational fear and consequent avoidance of spe- photopsia n. visual sensations in the absence of
cific objects, activities, or situations (see pho- external visual stimuli, which can be unstruc-
bia). The fear is recognized as unreasonable, but tured or structured. Structured photopsia con-
is nevertheless so intense that it interferes with sists of regular achromatic or chromatic visual
everyday functioning and is often a significant patterns (e.g., circles, squares, diamonds) and is
source of distress. Phobic disorders included spe- caused by pathological activation of prestriate
cific phobias, social phobia, and agorapho- cortical neurons. Also called photopsy. See also
bia. visual hallucination.
Phoenix House an organization devoted to the photosensitivity n. sensitivity to light, espe-
treatment and prevention of substance abuse in cially sunlight, as occurs in albinism. Conditions
adolescents and adults. Phoenix House offers marked by increased sensitivity to the effects
both residential and outpatient programs, as of sunlight on the skin include systemic lupus
P well as other services related to or in support of erythematosus and xeroderma pigmento-
the treatment process. See also therapeutic sum. Photosensitivity may occur as an adverse
community. reaction to certain drugs, such as the pheno-
phonological disorder in DSM–IV–TR, a com- thiazines (e.g., chlorpromazine), carbamazepine,
munication disorder characterized by failure to St. John’s wort, thiazides, sulfonamides, and tetra-
develop and consistently use speech sounds that cyclines. In such cases it often takes the form of a
are appropriate for the child’s age. It most com- rash or other skin reaction. Photosensitivity may
monly involves misarticulation of the later ac- also represent an immune reaction in some indi-
quired speech sounds, such as [l], [r], [s], [z], [ch], viduals who manifest allergy symptoms after ex-
[sh], or [th] (as in lalling or lisps), but may also posure to intense light. —photosensitive adj.
include substitution of sounds (e.g., [t] for [k]) phototherapy n. therapy involving exposure to
or omission of sounds (e.g., final consonants). ultraviolet or infrared light, which is used for
These problems are not due to, or are in excess of treating not only certain skin conditions or dis-
those normally associated with, hearing loss, orders (e.g., jaundice, psoriasis) but also depres-
structural deficits in the mechanism of speech sion, particularly for patients with seasonal
production (e.g., cleft palate), or a neurological affective disorder (SAD). Typically, in pho-
disorder. In DSM–III this disorder was catego- totherapy for SAD, a specially designed lamp
rized as developmental articulation disorder. that delivers 5,000 to 10,000 lx of light is shone
phonological dyslexia a form of acquired on the retina, and a signal is transmitted via the
dyslexia (see alexia) characterized primarily by optic nerve to the pineal gland, which secretes
difficulties in reading pronounceable nonwords. melatonin in response to darkness. Inhibition
Semantic errors are not seen in this type of dys- of melatonin release by bright light relieves the
lexia, a feature that distinguishes it from deep symptoms of SAD. Also called bright light
dyslexia. Phonological dyslexia manifested as a therapy.
form of developmental dyslexia has also been phrenology n. a theory of personality formu-
described. See also surface dyslexia. [first de- lated in the 18th and 19th centuries by German
434
physiognomy
physician Franz Josef Gall (1757–1828) and Aus- body and its specific functions, generally by a
trian philosopher and anatomist Johann Kaspar physician or other health care professional,
Spurzheim (1776–1832). It stated that specific using inspection, palpation, percussion, and
abilities or personality traits are represented by auscultation. It also frequently includes labora-
specific areas of the brain: The size of these brain tory tests and other forms of screening for vari-
areas determines the degree of the correspond- ous physiological abnormalities, malfunctions,
ing skill or trait. Proponents of the theory argued and diseases.
that the size of such locations could be indicated physicalism n. 1. the doctrine that reality is
by bumps and hollows on the skull surface, composed of matter and that mind is therefore
based on the observation that the contours of reducible to matter. See identity theory; ma-
the brain follow the skull contours. Although terialism; mind–body problem. 2. the view
wrong in most respects, the theory suggested the that all meaningful propositions can be stated in
idea of localization of function. See also the language of the physical sciences and in op-
physiognomy. —phrenological adj. —phre- erational definitions. See logical positivism;
nologist n. positivism. —physicalist adj.
phylogenetic principle the theory that on- physically correct doll see anatomically
togeny recapitulates phylogeny in the devel- detailed doll.
opment of an organism: In humans, this
supposes that human life, across development physical medicine the branch of medicine
from embryo to adult, repeats the stages of or- that specializes in the diagnosis and treatment of
ganic and social evolution. illness and disorders through physical means
(e.g., exercise and massage) and mechanical de-
phylogeny n. 1. the evolutionary origin and devices. Physical medicine is also concerned with
velopment of a particular group of organisms. the rehabilitation of patients with physi-
Also called phylogenesis. Compare ontog- cal disabilities. Also called physiatrics; phy-
eny. 2. a diagram that shows genetic linkages be- siatry.
tween ancestors and descendants. Also called
phylogenetic tree. —phylogenetic adj. physical modality a therapeutic intervention
that involves the use of a physical agent, such as
physical abuse deliberately aggressive or vio- heat or ice.
lent behavior by one person toward another that
results in bodily injury. Physical abuse may in- physical therapy (PT) 1. the treatment of
volve such actions as punching, kicking, biting, pain, injury, or disease using physical or me-
choking, burning, shaking, and beating, which chanical methods, such as exercise, heat, water,
may at times be severe enough to result in per- massage, or electric current (diathermy). The
manent damage (e.g., traumatic brain injury) treatment is administered by a trained physical
or death. It is most frequently observed in rela- therapist. Also called physiotherapy. 2. a
tionships of trust, particularly between parents branch of medicine and health care that identi-
and children or between intimate partners (e.g., fies, corrects, alleviates, and prevents temporary,
in a marriage); indeed, violence against women prolonged, or permanent movement dysfunc- P
and children is recognized as a major public tion or physical disability.
health problem. Individuals who experience physician assistant (PA) a licensed health
physical abuse often feel helpless and isolated, care professional who provides services under
and are prone to the subsequent development of the direction of a supervising physician.
numerous pathological conditions, including physician-assisted suicide see assisted
depression, eating disorders, posttraumatic death.
stress disorder, anxiety disorders, and substance
use problems. See also battered-child syn-
physician–hospital organization (PHO)
an organization formed, owned, and governed
drome; battered-woman syndrome.
by one or more hospitals and physician groups
physical activity any bodily movement pro- to obtain payer contracts and to further mutual
duced by the contraction of skeletal muscle that interests.
increases energy expenditure above the basal
level.
physiogenic adj. pertaining to a disorder that is
organic in origin.
physical dependence the state of an individ-
ual who has repeatedly taken a drug and will ex- physiognomy n. 1. the form of a person’s phys-
perience unpleasant physiological symptoms ical features, especially the face. 2. the attempt
(see substance withdrawal) if he or she stops to read personality from facial features and ex-
taking the drug. In DSM–IV–TR, substance de- pressions, assuming, for example, that a person
pendence with physical (or physiological) de- with a receding chin is weak or one with a high
pendence is diagnosed if there is evidence of forehead is bright. The idea dates back to Greek
withdrawal or tolerance. Compare psycho- philosopher Aristotle (383–322 bce) and was
logical dependence. later developed into a pseudoscientific system by
Swiss pastor Johann Lavater (1741–1801) and
physical disorder see general medical con- Italian psychiatrist Cesare Lombroso (1835–
dition. 1909). Also called physiognomics. See also
physical examination an assessment of the characterology; phrenology.
435
physiological antagonism
physiological antagonism see antagonist. in the formal operational stage, abstract think-
physiological assessment evaluation of the ing, deductive reasoning, and moral reason-
functioning state of the body, a tissue, or an ing develop. Among Piaget’s most influential
organ, including physical and chemical factors works are The Origins of Intelligence (1936), The
and processes. Construction of Reality (1937), and (with Barbel
Inhelder) The Growth of Logical Thinking from
physiological factors factors pertaining to
Childhood to Adolescence (1953) and The Early
the functions of a living organism and its parts as
Growth of Logic in the Child (1959). In 1969 Piaget
well as to the chemical and physical processes in-
was awarded the Distinguished Scientific Con-
volved in this functioning.
tribution Award of the American Psychological
physiological need any of the requirements Association. See also constructivism. —Pia-
for survival, such as food, water, oxygen, and getian adj.
sleep. Physiological needs make up the low-
est level of maslow’s motivational hierar- piblokto n. a culture-bound syndrome ob-
chy. Also called basic need; fundamental served primarily in female Inuit and other arctic
need. See also primary need; viscerogenic populations. Individuals experience a sudden
need. dissociative period of extreme excitement in
which they often tear off clothes, run naked
physiological paradigm the concept that through the snow, scream, throw things, and
mental disorders are caused by abnormalities in perform other wild behaviors. This typically
neurological structures and processes. This per- ends with convulsive seizures, followed by an
spective, which underlies the field and practice acute coma and amnesia for the event. Also
of psychiatry, holds that mental disorders can be called arctic hysteria; pibloktoq.
treated with drugs, surgery, or other techniques
ordinarily used to correct malfunctioning of the pica n. a rare eating disorder found primarily in
body. young children and marked by a persistent crav-
ing for unnatural, nonnutritive substances, such
physiological psychology a term used inter-
as plaster, paint, hair, starch, or dirt. In DSM–IV–
changeably with psychophysiology or, less
TR it is classified with the feeding and eating
commonly, biological psychology.
disorders of infancy or early childhood.
physostigmine n. a cholinergic drug—an Lead pica is often found in children living in
alkaloid derived from the dried seed of an Afri- older housing with lead paint and can lead to ir-
can vine—used in the treatment of glaucoma reversible mental impairment. Studies on rats
and to cause the pupil of the eye to contract. It is and monkeys demonstrated that lead pica can be
also employed as a cholinesterase inhibitor to re- induced by calcium deficiency. Animals with
verse the toxic effects on the central nervous sys- normal nutrition learn that lead ingestion is
tem of overdoses of anticholinergic drugs. aversive, but calcium-deficient animals do not
U.S. trade names: Antilirium; Isopto Eserine. learn aversions to lead.
phytoestrogens pl. n. see estrogen. Pick’s disease a form of dementia character-
P Piaget, Jean (1896–1980) Swiss child psycho- ized by progressive degeneration of the frontal
logist and epistemologist. Piaget earned his doctor- and temporal areas of the brain with the pres-
ate from the University of Neuchâtel in 1918, with ence of particles called Pick bodies in the cyto-
a dissertation on the classification of mollusks. plasm of the neurons. The disease is charac-
He then studied psychology and philosophy at terized by personality changes and deterioration
the universities of Zürich and Paris before taking of social skills and complex thinking; symptoms
a position at the Jean-Jacques Rousseau Institute include problems with new situations and ab-
of Geneva, a center for research on child devel- stractions, difficulty in thinking or concentrat-
opment. Piaget is best known for his research ing, loss of memory, lack of spontaneity, gradual
and theoretical work on cognitive development. emotional dullness, loss of moral judgment, and
He proposed that all children develop through a disturbances of speech. [described in 1892 by Ar-
prescribed series of cognitive stages: sensorimotor, nold Pick (1851–1924), Czech psychiatrist and
preoperational, concrete operational, and formal neuroanatomist]
operational. He held that although the age of
onset for each stage might vary due to cultural picrotoxin n. a cns stimulant derived from
and historical factors, the order of the stages is the berries of a southeast Asian shrub, Anamirta
the same for all cultures. In the sensorimotor cocculus. Originally used as a fish poison, pic-
stage, the child’s ability to recognize object per- rotoxin was introduced in the 1930s as therapy
manence develops; the older infant becomes for barbiturate overdose. It is a convulsant agent
aware that an object exists even when it is out of and acts as a gaba antagonist by binding to
sight. During the preoperational stage, the child a specific site on the GABAA receptor complex,
is egocentric, showing little awareness of the per- blocking the effects of GABA agonists (e.g., the
spective of others; language develops, as well as a benzodiazepines). Picrotoxin has no modern
rudimentary number system. The concrete oper- clinical applications but may be used to induce
ational stage is characterized by the develop- seizures in nonhuman animals for research pur-
ment of conceptually based thinking rather than poses.
the earlier perceptually based thinking. Finally, pictophilia n. sexual interest in and arousal by
436
pituitary gland
viewing erotic pictures or films, alone or with a damaging to the heart (e.g., haloperidol), it
partner. should be used in Tourette’s disorder only if
picture-anomalies test a type of nonverbal other medications have failed to produce the de-
test of social intelligence that depends on the sired response. U.S. trade name: Orap.
ability of the participant to detect absurdities in pineal gland a small, cone-shaped gland at-
cartoon pictures. tached by a stalk to the posterior wall of the
picture-completion test a type of test con- third ventricle of the brain; it is part of the
sisting of drawings of familiar objects with fea- epithalamus. In amphibians and reptiles, the
tures missing. The task is to recognize and gland appears to function as a part of the visual
specify the missing parts. system. In mammals it secretes the hormone
melatonin and is an important component of
picture-interpretation test a test in which the circadian system regulating biological
the participant is asked to interpret a visual rhythms. Because it is an unpaired organ lo-
image (e.g., a drawing, photograph, or painting). cated in the middle of the brain, French philoso-
This type of test may aid in the assessment of in- pher René Descartes (1596–1650) believed it was
telligence or personality traits. the seat of the rational soul and the connection
picture-world test a projective technique between mind and body. Also called epiphysis
for children in which the participant composes a cerebri; pineal body.
story about realistic scenes, adding objects or fig- Pinel’s system a classification of mental dis-
ures as he or she wishes. The child is instructed orders and symptoms outlined in the 18th
to picture either a world that actually exists or century. The four major categories were
one that he or she would like to exist. melancholias, manias with delirium, manias
Pierre Robin’s syndrome a congenital disor- without delirium, and dementia or mental dete-
der with anomalies that include micrognathia rioration. [Philippe Pinel (1745–1826), French
(abnormally small jaw) and cleft palate. Serious psychiatrist]
eye disorders occur in most affected individuals, piperidinediones pl. n. a class of chemically re-
along with a small, receding chin and a tongue lated drugs formerly used for daytime sedation
that falls backward into the pharynx (glos- or the management of insomnia but no longer
soptosis), interfering with breathing and feed- in common clinical use. Their mechanism of
ing. The incidence of mental retardation ranges action and toxicity are similar to the barbitu-
from 5 to 50%. [initially reported in 1923 by Pi- rates. The prototype of the class is glutethi-
erre Robin (1867–1950), French pediatrician] mide.
Pigem’s question a question designed to elicit pithiatism n. a former name (from Greek
projective responses by a patient undergoing a pithanotes, “persuasiveness”) for somatization
mental status examination. The question is disorder, proposed in 1918 by French neurolo-
usually a variation of “What would you like most gist Joseph Babinski (1857–1932) as a substitute
to change in your life?” [Spanish psychiatrist for hysteria. It was based on the theory that
José M. Pigem] some hysterical symptoms are produced by sug-
P
PIL abbreviation for purpose in life. gestion and can therefore be eliminated by
pilocarpine n. an alkaloid derived from several suggestion and would therefore distinguish hys-
tropical American plants but mainly from Pilo- terical disorders from those on which persuasion
carpus jaborandi. Pilocarpine is a powerful para- has no effect.
sympathomimetic agent, affecting postganglionic pituitarism n. disordered functioning of the
cholinergic receptors (see cholinergic drug). pituitary gland, which may be overactive
It is used in the treatment of glaucoma and to (hyperpituitarism) or underactive (hypopitu-
contract the pupil of the eye. U.S. trade names itarism).
(among others): Isopto Carpine; Pilocar; Pilostat. pituitary gland a gland, pea-sized in humans,
pimozide n. a first-generation (typical or con- that lies at the base of the brain, connected by a
ventional) antipsychotic of the diphenyl- stalk (the infundibulum) to the hypothalamus.
butylpiperidine class. Like other conventional The pituitary gland is divided into an anterior
antipsychotics, it is a blocker of postsynaptic do- and a posterior lobe, which differ in func-
pamine D2 receptors. In the United States it is tion. The anterior lobe (adenohypophysis) pro-
officially approved by the Food and Drug Ad- duces and secretes seven hormones—thyroid-
ministration only for the management of vocal stimulating hormone, follicle-stimulating hor-
and motor tics associated with Tourette’s disor- mone, adrenocorticotropic hormone, growth
der, although it is widely used as an anti- hormone, luteinizing hormone, prolactin, and
psychotic drug in Europe and South America. melanocyte-stimulating hormone—in response
Pimozide has been associated with potentially to releasing hormones from the hypothala-
lethal disturbances of heart rhythm, and it mus. The posterior lobe (neurohypophysis) se-
should not be used in patients with histories of cretes two hormones, vasopressin and oxytocin,
arrhythmias or in doses exceeding 10 mg/day. which are synthesized in the hypothalamus and
Because pimozide has no apparent special ad- transported down axons in the infundibulum to
vantages over similar antipsychotics that are less the neurohypophysis in response to direct neu-
437
pituri
ral stimulation. The pituitary’s role of secreting planned behavior behavior that is under the
tropic hormones, which regulate the production organism’s direct control, as opposed to more re-
of other hormones, has resulted in its desig- active behavior or reflexive behavior. In social
nation as the “master gland of the endocrine psychology, the theory of planned behavior sug-
system.” Also called hypophysis; hypophysis gests that the intent to engage in a specific be-
cerebri. havior is determined by attitudes, norms, and
pituri n. an Australian shrub, Duboisia hopwoodii, perceived control surrounding the behavior in
whose leaves have traditionally been used for question.
their stimulant, analgesic, and hallucinogenic Planned Parenthood Federation of
effects by members of Aboriginal tribes. The America (PPFA) an organization that pro-
leaves were cured, powdered, and then rolled motes comprehensive reproductive and comple-
into a quid to be chewed or smoked. The primary mentary health care services; advocates public
active ingredient is nicotine. Although some policy that guarantees access to such services
indigenous peoples still use pituri, it was most and the privacy and rights of individuals using
popular during the 19th and early 20th centu- such services; and supports research and tech-
ries. nology in reproductive health care, as well
PKU abbreviation for phenylketonuria. as education on human sexuality. Formerly
placebo n. (pl. placebos) 1. a pharmacologically known as the American Birth Control League,
inert substance, such as a sugar pill, that is often the organization adopted its current name in
administered as a control in testing new drugs. 1942.
Placebos used in double-blind trials may be plaque n. a small patch of abnormal tissue on or
dummies or active placebos. Formerly, pla- within a bodily structure, formed as the result of
cebos were occasionally used as diagnostic or an accumulation of substances or as the result of
psychotherapeutic agents, for example, in reliev- localized damage. Examples of the former type
ing pain or inducing sleep by suggestion, but include the senile plaques of Alzheimer’s
the ethical implications of deceiving patients in disease, arising from clumps of beta-amyloid
such fashion makes this practice problematic. protein, and the atheromatous plaques of ath-
2. any medical or psychological intervention or erosclerosis, consisting of lipid deposits on
treatment that is believed to be “inert,” thus the lining of arterial walls. Examples of the latter
making it valuable as a control condition against type include the demyelination plaques on the
which to compare the intervention or treatment protective nerve sheaths of individuals with
of interest. See placebo effect. multiple sclerosis.
placebo control group a group of partici- plasticity n. flexibility and adaptability. Plastic-
pants in a study who receive an inert substance ity of the nervous or hormonal systems makes it
(placebo) instead of the active drug under inves- possible to learn and register new experiences.
tigation, thus functioning as a neutral condition Early experiences can also modify and shape
against which to make comparisons regarding gene expression to induce long-lasting changes
P the actual pharmacological effects of the active in neurons or endocrine organs. See also func-
drug. tional plasticity; neural plasticity. Com-
placebo effect a clinically significant response pare rigidity.
to a therapeutically inert substance or nonspe- plateau phase see sexual-response cycle.
cific treatment, based on the recipient’s expecta-
tions or beliefs regarding the intervention. It is play n. activities that appear to be freely sought
now recognized that placebo effects accompany and pursued solely for the sake of individual or
the administration of any drug (active or inert) group enjoyment. Although play is typically re-
and contribute to the therapeutic effectiveness garded as serving no immediate purpose beyond
of a specific treatment. See placebo. enjoyment, studies indicate that the motivation
to play is as natural as the urge to eat or sleep and
placement counseling 1. services designed that it contributes significantly to development.
to advise and assist individuals to find suitable In the research in this area, various types of play
or optimal employment. Placement counseling have been described, ranging from locomotor
may include coaching or training for job interplay to object play to social play to cognitive
views, procedures for filling out applications, play, and numerous theories about play have
and assistance with other activities relevant to been proposed. Jean piaget, for example, re-
obtaining a job. 2. in education, a service that garded it as advancing children’s cognitive de-
provides guidance to students in deciding upon velopment through mastery play, playing games
an appropriate educational program, class, or with defined rules (such as hide-and-seek), and
level of instruction. 3. in foster care, services pro- symbolic play. Advocates of the practice theory
vided to help children and their adoptive of play propose that play prepares children for
parents adjust to adoptive placement. 4. in vo- activities or roles they will encounter as adults,
cational rehabilitation, a service that ad- whereas others suggest that it serves a more im-
vises and prepares people with disabilities for mediate function, such as exercise, establishing
appropriate job opportunities. social relations among peers, or—according to
Placidyl n. a trade name for ethchlorvynol. the surplus energy theory—using up excess en-
438
pointing
ergy. Although the preponderance of research when gratification is lacking. According to psy-
on play focuses on the activities of children, the choanalytic theory, the pleasure principle is
play behavior of nonhuman animals is also ac- the psychic force that motivates people to seek
tively studied. Also called ludic activity. immediate gratification of instinctual, or libi-
playacting n. dramatic play in which children, dinal, impulses, such as sex, hunger, thirst, and
adolescents, or adults (including group-therapy elimination. It dominates the id and oper-
participants) take different roles. In the process, ates most strongly during childhood. Later, in
the participants test out relationships; rehearse adulthood, it is opposed by the reality princi-
different ways of dealing with situations; iden- ple of the ego. Also called pleasure–pain
tify with significant figures; and play out any of a principle.
broad range of affective states and behaviors pleniloquence n. a compulsion to talk inces-
within the safe realm of make-believe. See also santly. —pleniloquent adj.
psychodrama. pleonexia n. 1. an abnormal greediness or desire
play-group psychotherapy a technique used for the acquisition of objects. 2. an abnormal in-
in group therapy for preschool and early elemen- take of oxygen.
tary school children. Materials of many kinds PLISSIT n. acronym for a model, developed in
(e.g., clay, toys, blocks, and figurines) are used to the 1970s, that is used in counseling clients
foster the expression of conflicts and fantasies about sexual problems. The model offers succes-
and to give the therapist an opportunity to ask sive levels of communication or intervention:
questions and help the children in the group un- (a) Permission, in which the client is told it is ac-
derstand their feelings, behavior, and relation- ceptable to do things he or she might think are
ships within the context of the group. See also not allowed; (b) Limited Information, in which
group therapy. [introduced in the early 1940s the client is given information limited to that di-
by Russian-born U.S. psychotherapist Samuel rectly relevant to his or her concerns; (c) Specific
Richard Slavson (1890–1981)] Suggestion, in which actions are specified; and
play therapy the use of play activities and ma- (d) Intensive Therapy, which may be required if
terials (e.g., clay, water, blocks, dolls, puppets, the client has a complex problem (usually in-
drawing, and finger paint) in child psycho- volving another therapist). The approach en-
therapy. Play-therapy techniques are based on ables the counselor or therapist to determine at
the theory that such activities mirror the child’s which point the problem is beyond his or her
emotional life and fantasies, enabling the child level of comfort and competence and it is appro-
to “play out” his or her feelings and problems priate to refer the client elsewhere.
and to test out new approaches and understand plutomania n. an inordinate striving for money
relationships in action rather than words. This and possessions.
form of psychotherapy, which focuses on a PM abbreviation for primary memory.
child’s internal world and unconscious conflicts PMS abbreviation for premenstrual syndrome.
in addition to his or her daily life and current re-
lationships, may be nondirective, but may alter- PNES abbreviation for psychogenic nonepi- P
natively be conducted on a more directive or a leptic seizure.
more analytic, interpretive level (see directive PNS abbreviation for peripheral nervous sys-
play therapy; nondirective play therapy). tem.
See also projective play. poetry therapy a form of bibliotherapy that
pleasantness n. a conscious, hedonic state, typi- employs the reading or writing of poetry to facil-
cally deemed highly desirable, that is experi- itate emotional expression in an individual and
enced when an event is congruent with one’s foster healing and personal growth. Also (but
goals or is associated with pleasure. See also di- less frequently) called psychopoetry.
mensional theory of emotion. —pleasant POI abbreviation for personal orientation in-
adj. ventory.
pleasure center any of various areas of the point biserial correlation coefficient a
brain (including areas of the hypothalamus and numerical index reflecting the degree of rela-
limbic system) that, upon intracranial stimula- tionship between two random variables, one
tion, have been implicated in producing plea- continuous and one dichotomous.
sure. The existence of pure pleasure centers has point estimate a single estimated numerical
not been definitively established, particularly value of a given population parameter. Compare
because the self-stimulation response rate varies interval estimate.
according to such factors as the duration and pointing n. a test in which the participant, first
strength of the electrical stimulation. Also called with the eyes open and then with the eyes
reward center. [proposed by U.S. psychologist closed, extends a forefinger and touches the fore-
James Olds (1922–1976)] fingers of the examiner as they stand facing each
pleasure principle the view that human be- other. Knowing the location of the examiner’s
ings are governed by the desire for instinctual fingers, participants should be able to touch
gratification, or pleasure, and for the discharge them with their eyes closed. Failure to do so is
of tension that builds up as pain or “unpleasure” called past-pointing.
439
polarized thinking
polarized thinking see dichotomous areas and white morphs in nonpolluted areas.
thinking. 2. in genetics, the presence in a population of
Pollitt syndrome see trichorrhexis nodosa two or more variants of a gene (i.e., alleles) at a
with mental retardation. [reported in 1968 given genetic locus. For example, the variety of
by Rodney J. Pollitt, British physician] human blood groups is due to polymorphism
of particular genes governing the characteristics
polydipsia n. excessive thirst, manifest as an ex- of red blood cells. See also single-nucleotide
treme amount of drinking. It commonly results polymorphism. —polymorphic adj.
from diabetes, and can be an important diag-
nostic sign of the condition, or—in the case of polymorphous perversity in the classic psy-
psychogenic polydipsia—may be related to psychoanalytic theory of Sigmund freud, the re-
chological factors. It may also be induced by sponse of the human infant to many kinds of
conditioning procedures (schedule-induced po- normal, daily activities posited to provide sexual
lydipsia). Compare adipsia. excitation, such as touching, smelling, sucking,
viewing, exhibiting, rocking, defecating, urinat-
polydrug abuse substance abuse involving ing, hurting, and being hurt.
more than one drug.
polyneuropathy n. any disease that affects
polydrug dependence dependence (physical, many or all of the peripheral nerves. See periph-
psychological, or both) on more than one drug eral neuropathy.
of abuse. Also called polysubstance depend-
polyopia n. the formation of multiple images of
ence. See substance dependence.
one object on the retina due to a refractive error
polydystrophic oligophrenia see sanfi- of the eye, brain injury (see palinopsia), fatigue,
lippo’s syndrome. or psychogenic disorder. See visual illu-
polygamy n. marriage to more than one spouse sion.
at the same time, which is an accepted custom in polyphagia n. an abnormal compulsion to eat
certain cultures. See also bigamy; group mar- excessive quantities of food.
riage. Compare monogamy. —polygamous
polypharmacy n. the simultaneous use of a va-
adj. —polygamist n.
riety of drugs of the same or different classes
polygenic inheritance see multifactorial with the intent of producing a more robust
inheritance. therapeutic response. Polypharmacy for mental
polygraph n. a device that measures and records disorders may, for example, involve the adminis-
several physiological indicators of anxiety or tration of two or more antidepressants in the
emotion, such as heart rate, blood pressure, and hope that agents with different mechanisms
skin response to stimuli. The instrument has of action will produce greater clinical improve-
been widely used in the interrogation of crimi- ment than that seen with any one drug alone.
nal suspects and in employee screening to mea- Polypharmacy is often criticized because of the
sure marked physiological reactions to questions lack of well-controlled studies supporting its
about such issues as theft, sexual deviation, or use and the greater likelihood of drug inter-
P actions when two or more drugs are used
untruthfulness. It has been colloquially referred
to as a lie detector, although no one has ever simultaneously. However, for those individuals
documented a close relation between physiolog- unsuccessfully treated with several trials of
ical patterns and deceptive behavior. The accu- monotherapy, or for whom monotherapy
racy of polygraph examinations is controversial, achieves suboptimal results, polypharmacy may
and the results are not accepted as evidence in be therapeutically indicated and appropriately
many U.S. courts of law. The polygraph was managed.
invented in 1917 by U.S. experimental psycho- polyphasic sleep a sleep pattern in which sleep
logist William Marston (1893–1947); an im- occurs in relatively short naps throughout a 24-
proved version, the Keeler polygraph, was de- hour period. A human infant may begin life with
signed by U.S. criminologist Leonard Keeler a polyphasic sleep rhythm that consists of half
(1903–1949). a dozen sleep periods. The rhythm becomes
polyiterophilia n. sexual interest and arousal monophasic, with one long, daily sleep period,
focused on repeating the same sexual actions by about school age. Biphasic sleep patterns,
and behaviors many times, and with many dif- which include one daytime nap period in addi-
ferent partners. tion to the long, typically nocturnal, period of
sleep, are seen in a variety of cultures (e.g., as the
polymorphism n. 1. in biology, the condition
siesta) and in older adults. See also sleep–wake
of having multiple behavioral or physical types
cycle. Compare monophasic sleep.
within a species or population. In some fish spe-
cies there are two distinct sizes of males: Larger polysomnography n. the recording of various
males defend territory and attract females to physiological processes (e.g., eye movements,
mate with them; much smaller males, often with brain waves, heart rate, respiration) throughout
the physical appearance of females, stay close to the night, for the diagnosis of sleep-related disor-
the large male and inseminate some of the eggs. ders. —polysomnograph n.
Peppered moths in England are another exam- polysubstance dependence see polydrug
ple, existing as black morphs (forms) in polluted dependence.
440
positive correlation
polysurgical addiction a condition charac- als. Legal interpretations vary, but all focus on
terized by a compulsive drive to undergo one the violation of community standards and the
surgical procedure after another even when or- lack of any redeeming artistic value. See also
ganic pathology cannot be found. The condition erotica. —pornographic adj.
may be a manifestation of factitious disorder pornolagnia n. an obscure term for attraction
with predominantly physical signs and symp- to prostitutes as sexual partners, in preference to
toms, hypochondriasis, or somatization dis- partners who choose to have sex out of mutual
order. interest.
POMR abbreviation for problem-oriented medi- porphyria n. a metabolic disorder involving the
cal record. See problem-oriented record. excretion of excessive or abnormal porphyrins
POMS acronym for profile of mood states. (breakdown products of hemoglobin) in the
pons n. a part of the brainstem lying between the urine. The acute intermittent form is character-
midbrain and the medulla oblongata, ap- ized by abdominal pain, nausea, weakness or
pearing as a swelling on the ventral surface of the paralysis of the extremities, and psychiatric
brainstem. It consists of bundles of transverse, symptoms, such as irritability, depression, agita-
ascending, and descending nerve fibers and nu- tion, and delirium.
clei, including facial nerve nuclei. It serves pri- PORT abbreviation for schizophrenia patient
marily as a bridge, or transmission structure, outcomes research team.
between different areas of the nervous system.
It also works with the cerebellum in con- Portman Clinic a major British clinic set up in
trolling equilibrium, and with the cerebral 1933 in Portman Square, London, England, by
cortex in smoothing and coordinating volun- three psychoanalysts to work with criminals and
tary movements. With the cerebellum it forms psychopaths. This led to the study and treat-
the region called the metencephalon. —pon- ment of all mental and behavioral abnormalities
tine adj. and disorders. The clinic joined the tavistock
clinic in the Tavistock and Portman National
pontine sleep dreaming sleep; sleep character- Health Service Trust in 1994. Apart from clinical
ized by the presence of pgo spikes. See dream and mental health services, this trust now pro-
state. vides training in forensic psychotherapy to qual-
pooled variance the estimate of a single com- ified psychiatrists.
mon variance achieved by combining several in- positioning n. in psychotherapy, deviation of
dependent estimates of that variance. Also called the therapist from his or her typical method of
pooled within-cell variance; within-cell operation or of conducting a session. For exam-
variance. ple, the therapist may give information or direc-
poor premorbid schizophrenia see pro- tion contrary to that anticipated by the client on
cess schizophrenia. the basis of the therapist’s usual approach.
popular psychology 1. psychological knowl- positive addiction a concept based on the as-
edge as understood by members of the general sumption that some life activities in which a per- P
public, which may be oversimplified, misinter- son feels a need or urge to participate, such
preted, and out of date. 2. psychological knowl- as meditation or exercising, are positive even
edge intended specifically for use by the general though they may possibly attain a level or a form
public, such as self-help books and television of addiction. Positive addictions are considered
and radio advice programs. healthy therapeutic alternatives relative to nega-
population n. in statistics, a theoretically de- tive addictions, such as drug abuse, alcohol de-
fined, complete group of objects (people, ani- pendence, or cigarette smoking. [developed by
mals, institutions) from which a sample is drawn U.S. psychiatrist William Glasser (1925– )]
in order to obtain empirical observations and positive affect the internal feeling state (af-
to which results can be generalized. Also called fect) that occurs when a goal has been attained,
universe. a source of threat has been avoided, or the indi-
POR abbreviation for problem-oriented re- vidual is satisfied with the present state of affairs.
cord. The tendency to experience such states is called
poriomania n. an irresistible impulse to run positive affectivity.
away or wander off, either consciously or in a positive attitude in psychotherapy, the cli-
state of amnesia. The condition may occur in ent’s feelings of self-approval or of acceptance
some types of epilepsy and dementia. Also called and approval of the therapist or another person,
poriomanic fugue. See also fugue; no- or object, or event. Compare negative atti-
madism. tude.
pornographomania n. 1. a morbid impulse to positive correlation a relationship between
write obscene letters. 2. sexual arousal associated two variables in which as the value of one vari-
with writing obscenities. able increases or decreases the value of the other
pornography n. writings or images (e.g., illus- variable does as well. For example, people with
trations, films) with sexual content that are more years of education tend to have higher in-
likely to cause sexual arousal in some individu- comes. See also correlation coefficient.
441
positive emotion
positive emotion an emotional reaction de- ple, if a response results in presentation of a loud
signed to express a positive affect, such as hap- noise and the response becomes less likely as a
piness when one attains a goal, relief when a result of this experience, then positive punish-
danger has been avoided, or contentment when ment has occurred. Compare negative punish-
one is satisfied with the present state of affairs. ment.
Compare negative emotion. positive regard feelings of warmth, caring, ac-
positive exercise addiction an inordinate at- ceptance, and importance expressed by someone
traction to habitual participation in physical ex- toward another. Positive regard is considered
ercise activities that brings about a positive sense necessary for psychological health and the de-
of physical and psychological well-being. Com- velopment of a consistent sense of self-worth
pare negative exercise addiction. and is also a cornerstone of certain therapeutic
positive feedback 1. an arrangement whereby approaches, particularly that of U.S. psycholo-
some of the output of a system, whether me- gist Carl Rogers (1902–1987). See also condi-
chanical or biological, is fed back to increase the tional positive regard; unconditional
effect of input signals. Positive feedback is rare positive regard.
in biological systems. 2. in social psychology, positive reinforcement 1. an increase in the
acceptance, approval, affirmation, or praise re- probability of occurrence of some activity be-
ceived by a person in response to his or her per- cause that activity results in the presentation of a
formance. Compare negative feedback. stimulus or of some circumstance. 2. the proce-
dure of presenting a positive reinforcer after a
positive hallucination a false experience
response. See reinforcement. Compare nega-
characterized by perceiving that something is
tive reinforcement.
there when it is not there. In general, positive
hallucination is an exaggeration of normal per- positive schizophrenia a form of schizophre-
ception. Although positive hallucinations are a nia in which positive symptoms predominate,
hallmark of psychotic disturbances, such as as evidenced in the person’s bizarre behavior,
schizophrenia, these perceptual experiences can illogical speech or writing, or expression of
also be generated by hypnosis. See hallucina- hallucinations and delusions. Although more
tion. Compare negative hallucination. dramatically evident than negative schizo-
phrenia, the positive aspect is usually less chal-
positive illusion a belief about oneself that is
lenging to treat. [defined in 1982 by U.S.
pleasant or positive and that is held regardless of
psychiatrist Nancy C. Andreasen and Scott A.
its truth. The most common positive illusions
Olsen]
involve exaggerating one’s good traits (benef-
fectance), overestimating one’s degree of control positive self-regard an attitude of self-esteem
over personally important events (see illusion or self-worth. Positive self-regard is often sought
of control), and sustaining unrealistic opti- as a goal in treatment and is fostered by the ther-
mism (see repressive coping style). apist’s regard for the client.
P positive incentive an object or condition that positive symptom a symptom of schizophre-
constitutes a desired goal and may result in nia that represents an excess or distortion of nor-
goal-directed behavior. Compare negative mal function, as distinct from a deficiency in or
incentive. lack of normal function (compare negative
symptom). Positive symptoms include delusions
positive motivation the impulse to engage in or hallucinations, disorganized behavior, and
behaviors that result in desired outcomes, for ex- manifest conceptual disorganization. Positive
ample, wanting to work hard in order to obtain symptoms are more dramatic than negative
praise or promotion from an employer. symptoms and are less distinctive of schizophre-
positive Oedipus complex see oedipus com- nia: Swiss psychiatrist Eugen Bleuler (1857–
plex. 1939) regarded them as secondary symptoms.
positive psychology a field of psychological See positive schizophrenia.
theory and research that focuses on the psycho- positive transference in psychoanalytic the-
logical states (e.g., contentment, joy), individual ory, displacement onto the therapist of feelings
traits or character strengths (e.g., intimacy, of attachment, love, idealization, or other posi-
integrity, altruism, wisdom), and social institu- tive emotions that were originally experienced
tions that enhance subjective well-being and toward the parents or other significant indivi-
make life most worth living. A manual, Character duals. Compare negative transference. See
Strengths and Virtues: A Handbook and Classifica- transference.
tion, serves this perspective in a manner parallel positivism n. a family of philosophical positions
to the DSM–IV–TR for the categorization of men- holding that all meaningful propositions must
tal illness. [term coined by Abraham maslow be reducible to sensory experience and observa-
and adapted by U.S. psychologist Martin P. tion, and thus that all genuine knowledge is to
Seligman] be built on strict adherence to empirical meth-
positive punishment punishment that results ods of verification. Positivism first became an ex-
because some stimulus or circumstance is pre- plicit position in the work of French thinkers
sented as a consequence of a response. For exam- Auguste Comte (1798–1857) and Claude Henri
442
postschizophrenic depression
de Rouvroy, Comte de Saint-Simon (1760–1825), viduals with disabilities adjust to their new job
although it is implicit to varying degrees in most situation. Examples include counseling, finan-
earlier forms of empiricism. Its effect is to estab- cial support, and continuing medical treatment
lish science as the model for all forms of valid in- and care. 2. training and services provided to
quiry and to dismiss the truth claims of religion, help individuals who are economically disad-
metaphysics, and speculative philosophy. Posi- vantaged (e.g., those receiving public assistance
tivism, particularly logical positivism, was ex- in the form of welfare) obtain employment, de-
tremely influential in the early development of velop various work-related skills essential to sus-
psychology and helped to form its commitment tained long-term employment, and enhance
to empirical methods. It continues to be a major their potential for wage increases and career ad-
force in contemporary psychology. See also vancement. Such services may include access to
machian positivism. —positivist adj. and assistance with child care and transporta-
positron emission tomography (PET) a tion; flexible work hours; on-the-job training;
technique used to evaluate cerebral metabo- continuing education classes; and mentoring
lism using radiolabeled tracers, such as 2- programs designed to help newly hired individu-
deoxyglucose labeled with fluorine-18, which als adjust to the workplace.
emit positrons as they are metabolized. This post hoc comparison a comparison among
technique enables documentation of functional two or more means in analysis of variance or
changes that occur during the performance of multiple regression analysis that is formu-
mental activities. lated after the data have been examined. Also
possession trance see dissociative trance called post hoc contrast.
disorder. posthypnotic amnesia an individual’s inca-
possessiveness n. 1. in general, excessive striv- pacity to remember what transpired during a pe-
ing to claim possession or ownership. 2. an ab- riod of hypnosis, typically by instruction of the
normal tendency to control or dominate others, hypnotist. However, highly susceptible individ-
generally involving the restriction of their social uals may show spontaneous posthypnotic am-
relationships. In its most extreme form, this pat- nesia.
tern of behavior is often associated with abusive
posthypnotic suggestion a suggestion made
relationships. See also jealousy.
to a person under hypnosis and acted upon
possible self in models of self-concept, a mental after awakening from the hypnotic trance.
representation of what one could become. Possi- Usually, the act is carried out in response to a
ble selves are cognitive manifestations of endur- prearranged cue from the hypnotist, and the par-
ing goals, aspirations, fears, and threats that ticipant does not know why he or she is perform-
provide plans and strategies for the future. They ing the act.
may be positive, providing an image of some-
thing to strive for, or negative, providing an postictal adj. following a sudden attack, espe-
image of something to be avoided. cially a seizure or a stroke. During the postictal
period following a seizure, the individual may be P
postcaptivity health problems health confused, disoriented, and unable to form new
problems that develop after a period of captivity, memories. The length of the postictal period
especially in prisoners of war, which may in- may vary from less than a second to many hours
clude injuries, posttraumatic stress reactions, af- and depends on the type of seizure.
fective reactions, or a combination of these.
Many former captives, but not all, may show postpartum blues see baby blues.
posttraumatic stress disorder in the years postpartum depression a major depressive
following release, sometimes with a delayed episode or, less commonly, minor depressive
onset. disorder that affects women within 4 weeks
postconcussion syndrome persistent, perva- after childbirth. Compare baby blues.
sive changes in cognitive abilities and emotional postpartum emotional disturbance 1. any
functioning that occur as a result of diffuse mood disorder that affects women following
trauma to the brain during concussion. An indi- childbirth. 2. fluctuations in mood following
vidual with this syndrome may appear to be childbirth that do not meet the criteria for any
within normal limits neurologically but suffers mood disorder.
from persistent depression, fatigue, impulse-
control problems, and difficulties with concen- postpartum psychosis psychotic symptoms
tration and memory. Postconcussion syndrome (e.g., delusions or hallucinations) that occur in
is frequently seen in individuals who have been women shortly after childbirth, often associated
repeatedly beaten on the head and face, such with postpartum depression.
as battered children or women (see battered- postschizophrenic depression a depressive
child syndrome; battered-woman syn- episode that may follow an acute schizo-
drome). phrenic episode. Postschizophrenic depression
postemployment services 1. in vocational is viewed variously as a routine event in recovery
rehabilitation, follow-up assistance or pro- from schizophrenic decompensation, as a mood
grams designed to help recently employed indi- disturbance that existed previously and was
443
postsynaptic receptor
masked by the schizophrenic episode, or as a side ing), with disinterest in significant activities and
effect to drug treatment for schizophrenia. with feelings of detachment and estrangement
postsynaptic receptor any receptor that is lo- from others; and (c) chronic physiological
cated on the cell membrane or in the interior of arousal, leading to such symptoms as exagger-
a postsynaptic neuron. Interaction with an ated startle response, disturbed sleep, difficulty
effector substance (e.g., a neurotransmitter), rein concentrating or remembering, guilt about
leased either by the presynaptic neuron or from surviving when others did not (see survivor
another site, initiates a chain of biochemical guilt), and avoidance of activities that call the
events contributing, for example, to excitation traumatic event to mind. Subtypes are chronic
or inhibition of the postsynaptic neuron. posttraumatic stress disorder and delayed
posttraumatic stress disorder. When the
posttest 1. n. a test administered after comple- symptoms do not last longer than 4 weeks a di-
tion of the principal test or instruction program. agnosis of acute stress disorder is given in-
It may be given in conjunction with a pretest to stead.
assess comprehension of the content and nature
of the main test as well as its effectiveness as an posttreatment follow-up a periodic check
assessment instrument. 2. n. a test administered on the progress of people who have received
after the application of an intervention or con- some form of psychotherapeutic or medical
trol condition. 3. vb. to administer a posttest. treatment. In research studies, posttreatment
follow-up is used to see if the effects of treatment
posttest counseling a type of genetic coun- are maintained or if relapse occurs. If the effects
seling that occurs during and after disclosure of of treatment are maintained, it is inferred that
genetic test results. Posttest counseling focuses the treatment has lasting rather than temporary
on the individual’s understanding of the mean- effects.
ing of the test result and of the options for
screening. Considerable attention is given to postural hypotension see orthostatic
the psychological status of the individual and to hypotension.
assessing whether the individual needs further posturing n. the assumption of a bizarre or inap-
genetic or psychological services. propriate body position or attitude for an ex-
posttraumatic amnesia (PTA) a disturbance tended period of time. It is commonly observed
of memory following a a physical injury (e.g., a in catatonia.
concussion) or a psychologically upsetting expe- postvention n. the emotional release needed by
rience (e.g., sexual abuse). The traumatic event helpers and others who work with those who
itself may be forgotten or events following the have survived a traumatic event or who have
trauma may be forgotten. The period of forget- directly experienced personal trauma or natural
ting may be continuous, or the person may expe- catastrophe. It is similar to debriefing following
rience vague, incomplete recollections of the experience in working with victims of disasters
traumatic event. (see critical-incident stress debriefing).
posttraumatic disorders emotional or other [defined by 20th-century U.S. psychologist Ed-
P win S. Schneidman]
disturbances whose symptoms appear after a
patient has endured a traumatic experience. pot n. slang for marijuana. See cannabis.
Common posttraumatic disorders include potassium channel see ion channel.
posttraumatic stress disorder, acute
potency n. 1. the ability of a male to perform sex-
stress disorder, the dissociative disorders,
ual intercourse, that is, to maintain an erection
and some types of phobias and anxiety disor-
and achieve ejaculation. Compare impotence.
ders.
2. in pharmacology, see dose–response rela-
posttraumatic personality disorder a per- tionship. —potent adj.
sonality disorder occasionally observed after a
potential-stress score see life-change unit.
severe head injury. Some patients become indif-
ferent and withdrawn, but most are irritable, potentiation n. a form of drug interaction
impulsive, petulant, extremely selfish, and irre- in which the addition of a second drug intensi-
sponsible. Older patients and those suffering fies certain properties of the first drug adminis-
from frontal-lobe damage may show impaired tered. It often refers to the ability of a nontoxic
memory with confabulation. See also post- drug to render the effects of a toxic drug more se-
concussion syndrome. vere than when the toxic agent is administered
singly.
posttraumatic stress disorder (PTSD) in
DSM–IV–TR, a disorder that results when an indi- potlatch n. a ceremony among some Native
vidual lives through or witnesses an event in American peoples of the northwestern United
which he or she believes that there is a threat States that involves a ceremonial feast and the
to life or physical integrity and safety and experi- distribution of impressive gifts, typically to es-
ences fear, terror, or helplessness. The symptoms tablish prestige or to affirm social status.
are characterized by (a) reexperiencing the Pötzl phenomenon (Poetzl phenomenon)
trauma in painful recollections, flashbacks, or re- the phenomenon whereby words or pictures
current dreams or nightmares; (b) diminished that are presented subliminally may appear in
responsiveness (emotional anesthesia or numb- imagery or dreams a short time later. It is taken
444
pragmatism
as an example of subliminal perception. [Otto and one of the variables that affect power, such
Pötzl (1877–1962), Austrian neurologist and as sample size.
psychiatrist] powerlessness n. a state of mind in which indi-
Pötzl’s syndrome a form of pure alexia associ- viduals feel they lack control or influence over
ated with visual field defects and disturbances of factors or events that affect their health (mental
the color sense. The syndrome is believed to be or physical), personal lives, or the society in
the result of a lesion in the medullary layer of the which they live.
lingual gyrus of the dominant hemisphere of the P-O-X triads see balance theory.
brain, with damage to the corpus callosum.
PPA abbreviation for preferred provider ar-
[Otto Pötzl]
rangement.
poverty of content of speech speech that is PPFA abbreviation for planned parenthood
adequate in quantity but too vague, repetitious, federation of america.
and lacking in content to be qualitatively ade-
quate. It is frequently observed in schizophrenia PPO preferred provider organization: a formally
and is distinct from poverty of speech, in organized entity created by contractual arrange-
which the quantity of speech is diminished. ments among hospitals, physicians, employers,
insurance companies, or third-party administra-
poverty of ideas a thought disturbance, often tors to provide health care services to subscribers
associated with schizophrenia, dementia, and at a negotiated, often discounted, price.
severe depression, in which there is reduced
spontaneity and productivity of thought as PPVT abbreviation for peabody picture vocab-
evidenced by speech that is vague or full of sim- ulary test.
ple or meaningless repetitions or stereotyped practical intelligence the ability to apply
phrases. The term is sometimes used inter- one’s intelligence in practical, everyday situ-
changeably with intellectual impoverish- ations. In the triarchic theory of intel-
ment. See also poverty of speech. ligence it is the aspect of intelligence that
poverty of speech excessively brief speech requires adaptation to, shaping of, and selection
with few elaborations that occurs in schizophre- of new environments. Compare analytical in-
nia or occasionally in the context of a major telligence; creative intelligence.
depressive episode. It is distinct from poverty practice guidelines criteria and strategies de-
of content of speech, in which the quality signed to assist mental health clinicians and
of speech is diminished. Also called laconic practitioners and physicians in the recognition
speech. and treatment of specific disorders and diseases,
as well as for ethical practice. Such guidelines are
power n. 1. the capacity to influence others,
often based on the latest and best available scien-
even when they try to resist this influence. Social
tific research or the considered judgment of ex-
power derives from a number of sources: control
pert panel committees representing specific
over rewards (reward power) and punishments
professions or subdisciplines. See also clinical
(coercive power); a right to require and demand
practice guidelines. P
obedience (legitimate power); others’ identifica-
tion with, attraction to, or respect for the practice trial the first of a series of opportuni-
powerholder (referent power); others’ belief that ties to respond to a test, which is given to partici-
the powerholder possesses superior skills and pants to acquaint them with the procedure of
abilities (expert power); and the powerholder’s the test and is therefore not scored.
access to and use of informational resources (in- Prader–Willi syndrome (PWS) a congenital
formational power). 2. in hypothesis testing, the disorder marked by mental retardation, short
probability that the null hypothesis will be re- stature, hypotonia (flaccid muscles), hypo-
jected when the alternative hypothesis is gonadism (underdeveloped sex organs), obesity,
true. In this case, it is likely that the experiment insensitivity to pain, and short hands and feet.
will be able to yield the results that the re- Caused by an abnormality of chromosome 15
searcher expects because the alternative hypoth- (lack of the paternal segment 15q11.2–12), it is
esis typically expresses the belief of the observed most frequently in males, perhaps be-
researcher. cause the gonadal abnormality is more easily de-
power function 1. a relationship in which the tected in males. Affected individuals have an
values for one variable vary as a function of an- excessive appetite and are constantly foraging
other variable raised to a power. In mathematics, for food. When diabetes mellitus is associated
b
it is expressed by the equation Y = aX , where X with the condition, it is called Royer’s syndrome.
and Y are the variables and a and b are numerical Also called Prader–Labhart–Willi syndrome;
constants. When plotted on paper, a power func- Prader–Labhart–Willi–Fanconi syndrome.
tion is linear. Power functions have been used to [reported in 1956 by Andrea Prader (1919–2001)
characterize the scales relating perceived and and Heinrich Willi (1900–1971), with Alexis
physical intensity, as well as to characterize the Labhart (1916– ), Swiss pediatricians]
relationship between response speed and prac- pragmatism n. a philosophical position hold-
tice. 2. in hypothesis testing, a functional re- ing that the truth value of a proposition or a the-
lationship between the power of a statistical test ory is to be found in its practical consequences:
445
Prägnanz
If, for example, the hypothesis of God makes visual stimulus before conscious perception of
people virtuous and happy, then it may be con- the word. Preattentive processing is thought to
sidered true. Although some forms of pragma- identify basic stimulus features in parallel, with
tism emphasize only the material consequences no limit on capacity. Also called preattentive
of an idea, more sophisticated positions, includ- analysis; preperceptual processing; un-
ing that of William james, recognize conceptual conscious processing. See also parallel pro-
and moral consequences. Arguably, all forms of cessing.
pragmatism tend toward relativism, because precipitating cause the particular factor,
they can provide no absolute grounds—only em- sometimes a traumatic or stressful experience,
pirical grounds—for determining truth, and no that is the immediate cause of a mental or physi-
basis for judging whether the consequences in cal disorder. A single precipitating event may
question are to be considered good or bad. turn a latent condition into the manifest form of
[coined by U.S. physicist and philosopher the disorder. Compare predisposing cause.
Charles Sanders Peirce (1839–1914)] —pragma-
preclinical psychopharmacology the area
tist adj., n.
of psychopharmacology that precedes the actual
Prägnanz n. one of the gestalt principles clinical application of a new drug on an individ-
of organization. It states that people tend to ual patient or patient population. It usually in-
perceive forms as the simplest and most mean- cludes laboratory studies of the pharmacological
ingful, stable, and complete structures that con- mechanisms of the drug, extrapolation of re-
ditions permit. Also called law of Prägnanz; search data into human-use terms, and evalua-
principle of Prägnanz. [German: “terseness”] tion of possible interactions with current drugs
prana n. see chi. or in patients with various medical conditions.
precocious puberty abnormally early devel-
prayer n. communication (voiced or contempla-
opment of sexual maturity, usually before the
tive) with a deity or other such entity, generally
age of 8 in a female and 10 in a male. True preco-
for the purposes of praise, thanksgiving, suppli-
cious puberty is marked by mature gonads capa-
cation, or self-examination or to seek forgive-
ble of ovulation or spermatogenesis, adult levels
ness, guidance, or serenity. The behavior has
of female or male sex hormones, and second-
been studied periodically, at least since William
ary sexual characteristics. Pseudoprecocious pu-
james, and with varied results, often supporting
berty is a condition usually caused by an
contradictory theoretical stances and goals. For
endocrine tumor that results only in premature
instance, researchers and practitioners have
development of secondary sex characteristics.
noted, variously, that prayer can be used, on the
Also called pubertas praecox.
one hand, as a defense or escape from the explo-
ration of painful issues and as a form of magical precocity n. very early, often premature, devel-
thinking, and, on the other hand, that it can be opment in a child of physical or mental func-
both cognitively meaningful and therapeutically tions and characteristics. —precocious adj.
beneficial in some conditions for those with spe- preconscious (Pcs) 1. n. in the classical psycho-
P cific religous beliefs or spirituality. Much work analytic theory of Sigmund freud, the level of
has been done, since the last quarter of the 20th the psyche that contains thoughts, feelings, and
century, by a growing body of researchers to in- impulses not presently in awareness, but which
tegrate religion or religious values and inter- can be more or less readily called into conscious-
vention with psychotherapy. In appropriate ness. Examples are the face of a friend, a ver-
circumstances, prayer may be explicitly used by bal cliché, or the memory of a recent event.
some therapists as a component of intervention Compare conscious; unconscious. 2. adj. de-
and treatment. The therapist and client may noting or relating to thoughts, feelings, and im-
pray individually or together for such goals as pulses at this level of the psyche. Also called
personal or interpersonal healing, forgiveness foreconscious.
and the ability to forgive, and the ability to ex- preconscious thinking 1. the pictorial, magi-
amine problems and issues freely and with dis- cal, fantasy thinking of children that precedes
cernment. the development of logical thinking. [intro-
preadolescence n. the period of childhood duced in 1938 by Austrian psychoanalyst Otto
preceding adolescence, comprising approxi- Fenichel (1897–1946)] 2. in psychoanalytic the-
mately the 2 years preceding the onset of ory, thinking that takes place at the level of
puberty. Also called prepubertal stage; the preconscious. Preconscious thinking has
prepuberty; prepubescence. —preadol- sometimes been cited to explain apparently un-
escent adj., n. conscious, intuitive thought processes, as well as
certain kinds of creative leaps and insights.
preattentive processing unconscious mental
processing of a stimulus that occurs before atten- predatory paraphilia sexual interest and
tion has focused on this particular stimulus from arousal focused on an activity that involves an
among the array of those present in a given en- unwilling participant rather than a consenting
vironment. An example of this is the dis- partner (see paraphilia). Examples include ex-
ambiguation of the meaning of a particular word hibitionism and frotteurism.
from among an array of words present in a given predicate thinking a thought process in
446
prejudice
which objects are considered similar or even (see hypertension), associated with edema or
identical because they share a particular attrib- proteinuria (the presence of protein in the
ute. Jean piaget considered such thinking to be urine), or both, occurring in a pregnant woman.
typical of early cognitive development. Likewise, There may also be signs of headaches, dizziness,
psychoanalysis associates it with the primary and nervous irritability. Preeclampsia may pro-
process thinking typical of the id, which mani- gress to the serious condition of eclampsia, or
fests itself in dreams and fantasies. convulsions usually followed by coma.
prediction n. an attempt to foretell what will preference for consistency a personality
happen in a particular case, generally on the trait reflecting the extent to which a person de-
basis of past instances or accepted principles. A sires to maintain consistency among elements in
theoretical prediction gives the expected results his or her cognitive system. See also cognitive
of an experiment or controlled observation in dissonance; cognitive dissonance theory.
accordance with the logic of a particular theory. [originally proposed by U.S. psychologists Rob-
In science, the use of prediction and observation ert B. Cialdini (1945– ), Melanie R. Trost, and
to test hypotheses is a cornerstone of the empiri- Jason T. Newsom (1965– )]
cal method. However, by their very nature, the
theories, constructs, and explanatory models preferred provider arrangement (PPA) a
current in psychology are not always open to di- contractual arrangement between a health care
rect validation or falsification in this way. In psy- insurer and a health care provider or group of
chological assessment, personality tests and providers who agree to provide services at re-
other psychometric instruments can often pre- duced or prenegotiated rates.
dict participants’ behaviors or other characteris- preferred provider organization see ppo.
tics with an impressive level of accuracy. In
prefrontal cortex the most anterior (forward)
psychiatry, it may be possible to predict the gen-
part of the cerebral cortex of each frontal lobe
eral behavior or prognosis of patients whose per-
in the brain. It functions in attention, planning,
sonality pattern is known but not their specific
working memory, and the expression of emo-
behavior, since so many factors are involved. See
tions and appropriate social behaviors and is
also pseudoscience. —predict vb. —predict-
divided into a dorsolateral region and an
able adj. —predictive adj.
orbitofrontal region. Damage to the prefrontal
predictive testing see predisposition. cortex in humans leads to emotional, motor,
predictive validity an index of how well a test and cognitive impairments. Also called frontal
correlates with a variable that is measured in the association area.
future, at some point after the test has been ad- prefrontal lobe the furthest forward area of
ministered. For example, the predictive validity each cerebral hemisphere of the brain, which
of a test designed to predict the onset of a disease is concerned with such functions as memory and
would be calculated by the extent to which it learning, emotion, and social behavior. See also
was successful at identifying those individuals frontal lobe.
who did, in fact, later develop that disease. P
prefrontal lobotomy see lobotomy.
predictor variable in regression analysis, a
variable that may be used to predict the value of pregenital organization in psychoanalytic
another variable; that is, an independent vari- theory, organization of libido functions in the
able. early stages of psychosexual development
predisposing cause a factor that increases the preceding the genital stage.
probability that a mental or physical disorder or pregenital phase in psychoanalytic theory,
hereditary characteristic will develop but is not the early stages of psychosexual development
the immediate cause of it. Compare precipitat- that precede the organization of the libido
ing cause. around the genital zone (i.e., the oral stage
predisposition n. 1. a susceptibility to develop- and the anal stage). Some theorists also in-
ing a disorder or disease, the actual development clude the phallic stage in the pregenital phase,
of which is initiated by the interaction of certain whereas others use the term synonymously with
biological, psychological, or environmental fac- the preoedipal phase.
tors. 2. in genetics, any hereditary factor that, prejudice n. a negative attitude toward another
given the necessary conditions, will lead to the person or group formed in advance of any expe-
development of a certain trait or disease. Predis- rience with that person or group. Prejudices in-
position testing is genetic testing for mutations clude an affective component (emotions that
that are less than 100% penetrant. Thus, a posi- range from mild nervousness to hatred), a cogni-
tive test result indicates that the individual has tive component (assumptions and beliefs about
an increased predisposition to develop the dis- groups, including stereotypes), and a behav-
ease but might not necessarily do so. If a muta- ioral component (negative behaviors, including
tion is fully penetrant, the testing is referred to as discrimination and violence). They tend to be re-
predictive testing, since all those who carry the sistant to change because they distort the preju-
mutated gene will develop the disease. diced individual’s perception of information
preeclampsia n. an increase in blood pressure pertaining to the group. Prejudice based on ra-
447
prelogical thinking
cial grouping is racism; prejudice based on sex is enced by women during the week prior to the
sexism. onset of menstruation and subsiding within the
prelogical thinking in psychoanalytic the- first few days of menstruation. Symptoms can
ory, primitive thought processes that are charac- include mood swings, irritability, fatigue, head-
teristic of early childhood, when thought is ache, bloating, abdominal discomfort, and
under the control of the pleasure principle breast tenderness. In contrast to the more severe
rather than the reality principle. Such think- premenstrual dysphoric disorder, pre-
ing may also occur later in life, as in daydream- menstrual syndrome has a less distinctive pat-
ing, in which wish-fulfillment is dominant. tern of symptoms and does not involve major
See also primary process. impairment in social and occupational function-
ing. Also called premenstrual stress syn-
premarital counseling educational and sup-
drome; premenstrual tension.
portive guidance provided to individuals plan-
ning marriage by a member of the clergy trained premorbid adj. characterizing an individual’s
in counseling, a therapist, or some other appro- condition before the onset of a disease or disor-
priately qualified person. Premarital counseling der. —premorbidity n.
may take the form of advice and answers to ques- premorbid abilities an estimate of an individ-
tions covering a wide range of matters, such ual’s psychological abilities prior to a neurologi-
as the timing of marriage, rights and respon- cal trauma or disease that is used to determine
sibilities of spouses in marriage, birth-control the degree of loss caused by the damage. This es-
methods, and sexual intimacy. Assessment intimate is based on testing and assessments con-
struments to identify potential conflicts in the ducted after the damage has occurred; it may
marriage can help the premarital counselor to include consideration of such factors as educa-
focus sessions appropriately. tional level, occupational history, and client and
premarital sex sexual relations before mar- family reports.
riage. See also fornication. premorbid adjustment a measure of the level
premature ejaculation a sexual dysfunction of a person’s functioning before the onset of
in which ejaculation occurs with minimal sex- an acute psychological disorder. The measure,
ual stimulation, before, on, or shortly after pene- as used in the phillips rating scale of
tration or simply earlier than desired. The premorbid adjustment in schizophrenia, has
diagnosis takes into account such factors as age, been found to be of value in predicting the
novelty of the sexual partner, and the frequency course of schizophrenia.
and duration of intercourse. The diagnosis does premorbid personality 1. personality traits
not apply if the disturbance is due to the direct that existed before a physical injury or other
effect of a substance (e.g., withdrawal from traumatic event or before the development of a
opioids). See also squeeze technique. disease or disorder. 2. personality strengths and
premature termination see termination. weaknesses that predispose the individual to-
premeditation n. a deliberate resolve to com- ward mental health and well-being or to a par-
P ticular mental disorder (e.g., depression or
mit a crime, especially a violent crime, as re-
vealed by evidence of planning or other schizophrenia) or that affect the speed or likeli-
forethought. A premeditated crime is often con- hood of recovery from a disorder. Also called
sidered more serious than the same offense com- primary personality.
mitted intentionally but without prior resolve. premorbid schizophrenia the quality of
See malice aforethought. —premeditated physical, psychological, and emotional func-
adj. tioning in an individual prior to the emergence
premenstrual dysphoric disorder a mood of schizophrenia.
disorder in women that begins in the week premotor area an area of the motor cortex
prior to the onset of menstruation and subsides concerned with motor planning. In contrast to
within the first few days of menstruation. the supplementary motor area, input to the
Women experience emotional mood swings, in- premotor area is primarily visual, and its activity
cluding markedly depressed mood, anxiety, feel- is usually triggered by external events. Also
ings of helplessness, and decreased interest in called Brodmann’s area 6; intermediate
activities. In contrast to premenstrual syn- precentral area; premotor cortex.
drome, the symptoms must be severe enough to
impair functioning in social activities, work, and prenatal adj. prior to birth: pertaining to that
relationships. The symptoms of premenstrual which exists or occurs between conception and
dysphoric disorder are of comparable severity to birth.
those experienced in minor depressive disor- prenatal care medical, health, and educational
der. Also called late luteal phase dysphoric services provided to or obtained by a woman
disorder; premenstrual stress syndrome. during pregnancy. Such services are intended to
See also depressive disorder not otherwise prevent complications and decrease the risk of
specified. maternal or prenatal mortality.
premenstrual syndrome (PMS) a collection prenatal counseling counseling given to cou-
of psychological and physical symptoms experi- ples or to single women who are expecting a
448
prescribing
baby or planning a pregnancy. It sometimes also considered either a rival or a love object. 2. more
covers advice on terminating the pregnancy (see generally, denoting organization or functions
abortion). For those who are considering adop- before the onset of the Oedipus complex. See
tion, prenatal counseling includes advice on the also prephallic.
child’s arrival and future, dealing with friends preorgasmic adj. 1. relating to the state imme-
and relatives, and coping with any impact on the diately before orgasm. It is characterized by
biological mother and father. increased breathing, heart rate, and blood pres-
prenatal developmental anomaly a con- sure; semispastic muscle contractions; and maxi-
genital abnormality that originates in the course mum increase in the size of the glans penis,
of development before birth. Examples include testes, and upper vaginal walls. 2. denoting the
cleft palate and spina bifida. status of a person who has never experienced or-
prenatal diagnosis determination of a patho- gasm. See primary orgasmic dysfunction.
logical condition or the presence of disease or preparation n. in cognitive psychology, the
genetic abnormalities in a fetus. See amniocen- process of increasing readiness for an activity, for
tesis; chorionic villus sampling; ultra- example, by planning or imagining a movement
sound. before it is executed. —prepare vb.
prenatal influence any influence on the de- preparatory response any response (except
veloping organism between conception and the final one) in a series of behaviors that leads
birth. Prenatal influences include radiation to a goal or reinforcement. Preparatory responses
effects, maternal diseases (e.g., rubella, toxo- themselves are not immediately goal-directed.
plasmosis), alcohol or drug abuse, excessive prepared learning a species-specific and in-
smoking, blood incompatibility, nutritional de- nate tendency to quickly learn a certain type of
ficiency, and emotional stress. knowledge. Some associations between stimuli,
prenatal stress stress in a pregnant woman, responses, and reinforcers may be more easily
which is marked by elevation of stress hormones formed due to biological preparedness. For ex-
and other biological changes, with an increased ample, animals may be prepared to associate
likelihood of intrauterine infection. Preterm new foods with illness, and it has been suggested
births and low birth weight are among the most that humans learn certain phobias more readily
widely recognized effects of maternal stress dur- due to preparedness.
ing pregnancy. Women who experience high prephallic adj. in psychoanalytic theory, refer-
levels of psychological stress are significantly ring to the stages of psychosexual devel-
more likely to deliver preterm. Preterm babies opment preceding the phallic stage (i.e., the
are susceptible to a range of complications, in- oral stage and the anal stage). See also pre-
cluding chronic lung disease. Some recent stud- genital phase; preoedipal.
ies suggest that stress in the womb can also affect pre–post design see before–after design.
a baby’s temperament and neurobehavioral de-
velopment: Infants whose mothers experienced prepsychotic panic a stage in the develop-
high levels of stress while pregnant, particularly ment of schizophrenia in which self-image is dis- P
in the first trimester, show signs of increased de- ordered: Individuals feel guilty, unlovable,
pression and irritability. humiliated, or otherwise different but have not
yet acquired symptoms of delusions and halluci-
preoccupation n. a state of being self-absorbed nations. [defined by Italian-born U.S. psychia-
and “lost in thought,” which ranges from tran- trist Silvano Arieti (1914–1982)]
sient absent-mindedness to a symptom of
schizophrenia in which the individual with- prepsychotic personality characteristics and
draws from external reality and turns inward behavior of a person, such as eccentricities, with-
upon the self. drawal, litigiousness, apathy, or hypersensitiv-
ity, that may be indicative of later development
preoccupied attachment an adult attach- of a psychotic disorder.
ment style that combines a negative internal
working model of attachment of oneself,
prepuberty n. see preadolescence.
characterized by doubt in one’s own compe- prerelease anxiety state anxiety experienced
tence and efficacy, and a positive internal work- by an individual about to leave an institutional
ing model of attachment of others, characterized setting and reenter the everyday world. For ex-
by one’s trust in the ability and dependability of ample, prison inmates may fear having to com-
others. Individuals with preoccupied attach- pete in the real world again.
ment are presumed to seek others’ help when preschool program an educational curricu-
distressed. Compare dismissive attachment; lum for children who are below the required
fearful attachment; secure attachment. minimum age for participation in regular class-
preoedipal adj. 1. in psychoanalytic theory, room work. Preschool programs for intellectu-
pertaining to the first stages of psychosexual ally or emotionally challenged children are
development, before the development of the designed to develop social skills and provide
oedipus complex during the phallic stage. stimulation at levels appropriate for each child.
During this phase the mother is the exclusive prescribing n. 1. in psychotherapy and medi-
love object of both sexes and the father is not yet cine, advising or telling a patient what to do in
449
prescribing psychology
specific situations. 2. ordering the use of a medi- rounding RxP, many universities and independ-
cation. ent training facilities are seeking to establish ap-
prescribing psychology an emerging area of propriate postdoctoral training programs that
clinical psychology in which licensed, meet the criteria contained within the American
appropriately trained practitioners are legally Psychological Association’s Recommended Post-
authorized to prescribe medications for the treat- doctoral Training in Psychopharmacology for
ment of emotional and mental disorders (see Prescription Privilege. Additionally, the affili-
psychoactive drug). This integration of mediated College of Professional Psychology has de-
cation management with psychological practice veloped the Psychopharmacology Examination
is controversial—within the United States, only for Psychologists for use by U.S. and Canadian li-
New Mexico and Louisiana have enacted laws censing boards. See also prescribing psychol-
permitting it, the former in 2002 and the latter ogy.
in 2004. In addition to fulfilling all other re- prescriptive eclectic psychotherapy see
quirements required for professional licensure as eclectic psychotherapy.
a practicing clinician, prescribing psychologists presenile dementia dementia with an onset
in these states must complete a postdoctoral before the age of 65.
psychopharmacology training program and pass
a national certification exam. New Mexico also
presenile dementia of the Alzheimer’s
requires a supervised 400-hour, 100-patient
type (PDAT) an older name for dementia of
the Alzheimer’s type with onset before age 65.
practicum. Also called medical psychology.
See also alzheimer’s disease.
See prescriptive authority.
presenility n. 1. dementia that occurs prior to
prescription privilege the legal right to pre-
old age (typically, prior to age 65). 2. the period
scribe drugs and other medications necessary for
of life immediately preceding dementia in old
the treatment of medical or mental health disor-
age.
ders.
presentation n. 1. in interpersonal relations
prescriptive authority (RxP) the legally rec-
and social interaction, the way in which an indi-
ognized right of specially trained psychologists
vidual behaves or expresses himself or herself. 2.
to dispense psychoactive drugs to their cli-
in psychoanalytic theory, the means or vehicle
ents. The practice is highly controversial, both
through which an instinct is expressed. Also
within the United States and abroad. Indeed,
called instinct representation. —present
of the several states that have introduced RxP
vb.
legislation, only New Mexico and Louisiana
have passed it. Those who oppose RxP cite con- presenting symptom a symptom or problem
cerns that psychologists, not having attended that is offered by a client or a patient as the rea-
medical school, do not have the requisite knowl- son for seeking treatment. In psychotherapy, a
edge and training to be able to prescribe safely. client may present with depression, anxiety,
For example, they worry that psychologists with panic, anger, chronic pain, or family or marital
P RxP may not screen clients carefully for health problems, for example; such symptoms may be-
concerns or may mistakenly attribute symptoms come the focus of treatment or may represent a
of medical conditions to mental disorders and different, underlying problem that is not recog-
thus inadvertently prescribe an inappropriate nized or regarded by the client as requiring help.
medicine. Opponents also fear that psycholo- Also called presenting problem.
gists trained in psychopharmacology will aban- Present State Examination (PSE) a struc-
don emotional, interpersonal, and behavioral tured interview comprising about 400 items,
interventions in favor of medication manage- including a wide range of symptoms likely to
ment, rather than incorporating the one with be manifested during an acute episode of one
the other. Those in favor of RxP, however, say of the functional psychoses. The PSE was
not only that it can be done safely, but also that developed for the WHO-sponsored interna-
it will enable psychologists to provide improved tional pilot study of schizophrenia.
care at a reduced cost because they can combine presolution variability the variability ob-
their communication skills and understanding served in behavior prior to arriving at a success-
of behavior with advanced training in the bio- ful solution to a difficult problem.
logical bases and treatments of mental illness.
Supporters also cite such benefits as enhancing press n. in the personology of U.S. psychologist
the quality and accessibility of health care for Henry Alexander Murray (1893–1988), an envi-
those in rural and other underserved communi- ronmental stimulus, such as a person or situa-
ties; facilitating more frequent and thorough tion, that arouses a need. Examples are the birth
communication between psychologists and pri- of a sibling, parental discord, feelings of social
mary care providers; reducing multiple medi- inferiority, or the sight of food when hungry. See
cations and better utilizing those that are need–press theory.
necessary through knowledge of alternative psy- pressure n. in psychology, excessive or stressful
chological treatments; and improving manage- demands, imagined or real, made on an individ-
ment of the psychological concomitants of ual by another individual or group to think, feel,
health care issues. Despite the heated debate sur- or act in particular ways. The experience of pres-
450
primacy effect
sure is often the source of cognitive and affective tection and early treatment of conditions and
discomfort or disorder, as well as of maladaptive generally including routine physical examina-
coping strategies, the correction of which may tion, immunizations, and well-person care. See
be a mediate or end goal in psychotherapy. also prevention; primary prevention.
pressured speech accelerated and sometimes preventive counseling counseling that aims
uncontrolled speech that often occurs in the to prevent anticipated problems or conflicts. It is
context of a hypomanic episode or a manic epi- most useful when individuals may be exposed to
sode. Also called pressure of speech. increased stress (e.g., during adolescence or prior
pressure of activity compulsive and occasion- to an important exam or commitment) or are at
ally uncontrolled activity and psychomotor risk from high levels of stress.
agitation, usually occurring in the context of a preventive stress management an inter-
manic episode. vention involving a session or series of sessions
pressure of ideas a characteristic symptom of prior to the occurrence of anticipated stressful
mania in which there is increased spontaneity situations during which information on stress-
and productivity of thought: Numerous, widely ors, coping strategies, and opportunities to prac-
varied ideas arise quickly and pass through the tice these strategies are provided. See also pri-
mind rapidly. It is usually manifested as pres- mary prevention; stress management.
sured speech or pressure of activity. Also preverbal adj. before the acquisition of lan-
called thought pressure. guage. Preverbal children communicate using
pressure of speech see pressured speech. nonword sounds and gestures.
prestige suggestion a method of supportive, prevocational training programs designed
symptomatic treatment that relies on the to help individuals prepare to enter a competi-
prestige of the therapist in the eyes of the pa- tive work situation and workplace environment.
tient. The so-called omnipotent therapist may Training is not career- or position-specific but
be able to abolish undesirable symptoms, at least rather focuses on helping individuals develop
temporarily, by suggestion. good work habits and gain the basic skills and
pretest 1. n. a preliminary test or trial run to fa- abilities essential for employment in any field,
miliarize the person or group tested with the such as following directions and being punctual.
content and nature of a particular test. It may be Prevocational training may be provided to any
given in conjunction with a posttest. 2. n. a individual who has not had actual work experi-
trial run administered before the application of ence in a competitive job market, such as a col-
an intervention or control condition. 3. vb. to lege student nearing graduation or an adult
administer a pretest. entering the workforce late in life, but is typi-
cally offered to adolescents and adults with dis-
pretest counseling a type of genetic coun- abilities.
seling undertaken before deciding whether to
undergo genetic testing. Pretest counseling in- priapism n. 1. persistent penile erection that
cludes educating individuals about the contribu- occurs independently of sexual arousal or that P
tion of genetics to the etiology of disease, taking continues long after orgasm has occurred and
a family history and creating a pedigree, esti- sexual activity ceased. The condition is associ-
mating risk, and discussing the risks, benefits, ated with leukemia and sickle-cell anemia and is
and limitations of genetic testing. usually painful. Immediate causes may be
thrombosis, cancer, hemorrhage, inflammation,
pretest–posttest design see before–after lesions involving nerve tracts between the brain
design. and the urethra, or overdose of drugs injected
prevalence n. the total number of cases (e.g., of into the penis to treat erectile dysfunction.
a disease or disorder) existing in a given popula- 2. another name for satyriasis. Priapism is
tion at a given time (point prevalence) or during named for Priapus, the Greco-Roman god of pro-
a specified period (period prevalence). See also creation and of the generative force in nature,
incidence. who was the basis of a cult that worshiped the
prevention n. behavioral, biological, or social phallus.
interventions intended to reduce the risk of dis- pride n. a self-conscious emotion that occurs
orders, diseases, or social problems for both indi- when a goal has been attained and one’s
viduals and entire populations. See primary achievement has been recognized and approved
prevention; secondary prevention; terti- by others. It differs from joy and happiness in
ary prevention. that these emotions do not require the approval
prevention research research directed toward of others for their existence. Pride also has ex-
finding interventions to reduce the likelihood of pressive reactions that differ from joy, such as
future pathology. Such research is often concen- puffing up of the chest and directing attention
trated on individuals or populations considered to others or an audience. Pride can become anti-
to be particularly at risk of developing a condi- social if the sense of accomplishment is not de-
tion, disease, or disorder. served or the reaction is excessive. See also
preventive care care that aims to prevent dis- hubris. —proud adj.
ease or its consequences, emphasizing early de- primacy effect the tendency for facts, impres-
451
primal anxiety
sions, or items that are presented first to be ceived little scientific validation and is not advo-
better learned or remembered than material pre- cated by most psychotherapists or counselors.
sented later in the sequence. This can occur in [developed in the 1960s and 1970s by U.S. psy-
both formal learning situations and social con- chologist Arthur Janov (1924– )]
texts. For example, it can result in a first- primal trauma in psychoanalytic theory, a
impression bias, in which the first information painful situation to which an individual was
gained about a person has an inordinate influ- subjected in early life that is presumed to be the
ence on later impressions and evaluations of that basis of a neurosis in later life. The primal trauma
person. Also called law of primacy; principle is considered by some in psychoanalysis to be
of primacy. Compare recency effect. the birth trauma. See also primal anxiety.
primal anxiety in psychoanalytic theory, the primary ability any of the seven unitary fac-
most basic form of anxiety, first experienced tors revealed by factor analysis to be essential
when the infant is separated from the mother components of intelligence. There are seven pri-
at birth and suddenly has to cope with the flood mary abilities: verbal ability (V), word fluency
of new stimuli. See also birth trauma; primal (WF), numerical ability (N), spatial intelligence
trauma. (S), memory (M), perceptual speed (P), and rea-
primal depression an obsolescent name for soning (R). These factors are measured by the
depression that occurs in early childhood and is Primary Mental Abilities Test. Also called pri-
theoretically attributed to absent or distant par- mary mental ability. [proposed around 1936
ents. by Louis L. thurstone]
primal fantasy in psychoanalytic theory, any primary aging changes associated with normal
of a range of fantasies employed by children to aging that are inevitable and caused by intrinsic
fill gaps in their knowledge of sexual experience, biological or genetic factors. Examples include
especially one about conception and birth (see the appearance of gray hair and skin wrinkles.
cloacal theory), parental intercourse, or cas- However, some age-related diseases have genetic
tration. influences, making the distinction between pri-
primal father the head of a hypothetical primi- mary aging and secondary aging imprecise.
tive tribe who is slain and devoured by his sons primary amenorrhea see amenorrhea.
(or other younger men) and later revered as a primary anxiety in psychoanalytic theory,
god, as described by Sigmund freud in 1913 in anxiety experienced as a spontaneous response
Totem and Taboo. The crime has a tragic effect on to trauma or in response to dissolution of the
the son or sons who kill the dominant male and ego. Also called automatic anxiety. Compare
becomes enshrined in the culture of the tribe as a signal anxiety.
totem. See also primal-horde theory.
primary appraisal in the cognitive ap-
primal-horde theory Sigmund freud’s spec- praisal theory of emotions, evaluation of the
ulative reconstruction in Totem and Taboo (1913) relevance of an event to one’s goals, one’s moral
P of the original human family, which comprised norms, and one’s personal preferences. It is fol-
a dominant male (the primal father) holding lowed by secondary appraisal. See also core
sway over a subordinate group of females and relational themes. [proposed by U.S. psychol-
younger men or sons. Freud used the theory to ogist Richard S. Lazarus (1922–2002)]
account for the origin of the incest taboo,
guilt, and totemism (see totem). primary behavior disorder any of various
behavior problems in children and adolescents,
primal repression see primary repression. including habit disturbances (e.g., nail biting,
primal sadism in psychoanalytic theory, an as- temper tantrums), bed-wetting, conduct disor-
pect of the death instinct that is identical with ders (e.g., vandalism, fire setting, alcohol or drug
masochism and remains within the person, use, sex offenses, stealing), and school-centered
partly as a component of the libido and partly difficulties (e.g., truancy, school phobia, disrup-
with the self as an object. tive behavior).
primal scene in psychoanalytic theory, the primary care the basic or general health care a
child’s first observation, in reality or fantasy, of patient receives when he or she first seeks assis-
parental intercourse or seduction, which is inter- tance from a health care system. General prac-
preted by the child as an act of violence (see titioners, family practitioners, internists, obstetri-
phallic sadism). See also primal fantasy. cians, and pediatricians are known as primary
primal therapy a therapeutic technique used care providers (PCPs). Also called primary
to release deep-seated feelings and emotional health care. Compare secondary care; ter-
frustration by crying, screaming, and hitting ob- tiary care.
jects. The client is encouraged to reexperience primary care provider (PCP) a physician
traumatic early childhood (even peri- and prena- who provides primary care services and may
tal) experiences and react vocally and physically act as the gatekeeper controlling patients’ ac-
to release the psychic pain associated with them. cess to the rest of the health care system through
The technique, sometimes popularly and errone- referrals. PCPs are usually generalist physicians
ously known as primal scream therapy, has re- (e.g., internists, pediatricians, family physicians,
452
primary hypersomnia
and general practitioners) and occasionally ob- response to social pressure, but if they continue
stetricians and gynecologists. Also called pri- to violate social norms (secondary deviance)
mary physician. other people may label them as deviant. See also
primary care psychology a specialty disci- labeling theory.
pline within health, clinical, and counseling primary drive an innate drive, which may be
psychology that involves providing psychologi- universal or species-specific, that is created by
cal preventive and treatment services under the deprivation of a needed substance (e.g., food) or
auspices of medical professionals in such set- by the need to engage in a specific activity (e.g.,
tings as clinics, hospitals, and private practices, nest building in birds). Compare secondary
either on site or on a consultation basis. drive.
primary caretaker standard a standard of primary dysmenorrhea see dysmenorrhea.
evaluation used in child custody disputes that primary emotion any one of a limited set
awards custody of the child to the parent who of emotions that typically are manifested and
has previously assumed the most responsibility recognized universally across cultures. They in-
for and spent the most time with the child. clude fear, anger, joy, sadness, disgust, con-
primary cause a condition or event that predis- tempt, and surprise; some theorists also
poses an individual to a particular disorder, include shame, shyness, and guilt. Also called
which probably would not have occurred in the basic emotion. Compare secondary emo-
absence of that condition or event. Sexual con- tion.
tact, for example, is a common primary cause of primary empathy an approach to client-
a sexually transmitted disease. centered therapy in which the therapist ac-
primary consciousness sensory experience. tively tries to experience the client’s situation as
The descriptor implies that sensory experience is the client has and then tries to restate the client’s
an early stage in the evolution of consciousness. thoughts, feelings, and experiences from the cli-
primary control behavior that is aimed at pro- ent’s point of view.
ducing a sense of control through an individ- primary environment an environment that
ual’s direct alteration of the environment. is central in a person’s life and in which personal
Compare secondary control. See locus of or family interactions can be sustained, for ex-
control. ample, a workplace or home. Compare second-
primary coping a stress-management strategy ary environment.
in which a person actively seeks to alter objective primary erectile dysfunction a male sexual
conditions, including environmental events and dysfunction in which the man has never been
other people’s behavior, to bring them into line able to achieve penile erection sufficient for sex-
with his or her wishes. Primary coping encom- ual intercourse. Also called primary impo-
passes a variety of different actions, such as seek- tence. See erectile dysfunction; impotence;
ing support, obtaining information, expressing male erectile disorder. Compare secondary
one’s emotions, or regulating one’s emotions. It erectile dysfunction. P
is a dynamic, approach-oriented coping strat- primary gain in psychoanalytic theory, any of
egy that provides an important sense of control the basic psychological benefits derived from
over environmental circumstances. Also called possessing neurotic symptoms, essentially relief
primary control coping. Compare second- from anxiety generated by conflicting impulses
ary coping. [identified in 1982 by Fred M. or threatening experiences. Also called para-
Rothbaum (1949–2011) and John R. Weisz nosic gain. Compare secondary gain.
(1945– ), U.S. clinical and developmental psy-
chologists, and Samuel S. Snyder, U.S. develop- primary group any of the small, long-term
mental psychologist] groups characterized by face-to-face interaction
and high levels of cohesion, solidarity, and
primary degenerative dementia in DSM– group identification. These groups are pri-
III, dementia of subtle onset with a gradually mary in the sense that they are the initial social-
progressive course but no specific cause, usually izers of the individual members, providing them
starting after the age of 65 (senile onset) but in with the foundation for attitudes, values, and a
some cases before this age (presenile onset). Sub- social orientation. Families, partnerships, and
types with delirium, delusions, or depression long-term psychotherapy groups are examples of
were also specified. This diagnostic category has such groups. Compare secondary group.
been removed from DSM–IV–TR, since the cur-
rent definition of dementia is based on symptom primary health care see primary care.
pattern and does not carry the historical implica- primary homosexuality same-sex sexual ori-
tion of progressively worsening or irreversible entation in which the individual has never expe-
course. rienced sexual arousal or activity with a person
primary deviance in theories of deviance and of the opposite sex.
identity, an initial rule-breaking act (such as primary hypersomnia in DSM–IV–TR, a sleep
nonconformity or disobedience) performed by disorder characterized by excessive sleepiness
an otherwise socially compliant individual. In (evidenced by prolonged episodes of sleep, day-
most cases individuals amend their behaviors in time episodes of sleep on an almost daily basis,
453
primary identification
or both), the severity and persistence of which cedes sharply. The back of the head is flat, and
cause clinically significant distress or impairment the vertex often is pointed. Mental retardation
in functioning. The disorder is not caused by a and spasticity of limbs occur as neurological def-
general medical condition and is not an aspect of icits. Compare pure microcephaly.
another sleep disorder or mental disorder. See primary mood disorder a mood disorder
dyssomnia. See also disorders of excessive that does not occur in the context of another dis-
somnolence. Compare primary insomnia. order.
primary identification in psychoanalytic primary motivation motivation created by
theory, the first and most basic form of identifi- the presence of a primary need. Compare sec-
cation, which occurs during the oral stage of ondary motivation.
development when the infant experiences the
primary narcissism in psychoanalytic theory,
mother as part of himself or herself. After wean-
the earliest type of narcissism, in which the in-
ing, the infant begins to differentiate between
fant’s libido is directed toward his or her own
the self and external reality and then becomes
body and its satisfaction rather than toward the
capable of secondary identification. Primary
environment or objects. At this stage the child
identification is closely tied to oral incorpora-
forms a narcissistic ego-ideal stemming from
tion. Also called primary narcissistic iden-
his or her sense of omnipotence. See also body
tification.
narcissism.
primary impotence see primary erectile primary narcissistic identification see
dysfunction.
primary identification.
primary insomnia in DSM–IV–TR, a sleep dis- primary need an innate need that arises out
order characterized by difficulty in initiating or of biological processes and leads to physical sat-
maintaining a restorative sleep to a degree in isfaction, for example, the need for water and
which the severity and persistence of the sleep sleep. See also physiological need; viscero-
disturbance causes clinically significant distress, genic need.
impairment in a significant area of functioning,
or both. The disorder is not caused by a general primary orgasmic dysfunction a female
medical condition or the effects of a substance sexual dysfunction in which the woman has
and is not exclusively an aspect of another sleep never been able to achieve an orgasm with any
disorder or mental disorder. See dyssomnia. See type of stimulation, with or without a partner.
also insomnia. Compare primary hypersom- Studies have found that 10–15% of sexually ac-
nia. tive women in the United States fall into this cat-
egory. Rates in other cultures are related to how
primary masochism in psychoanalytic the- positive or negative the culture is toward female
ory, the portion of the death instinct or ag- sexuality.
gressive instinct that is directed toward the
self after the libido has absorbed it emotionally primary personality 1. the original personal-
and directed a large portion of it toward the ex- ity, as opposed to a secondary personality or
P ternal world. Also called erotogenic masoch- secondary personalities, of an individual with
ism. dissociative identity disorder. 2. see pre-
morbid personality.
primary maternal preoccupation in the
primary physician see primary care pro-
object relations theory of British psycho-
vider.
analyst Donald Winnicott (1896–1971), a state
immediately following childbirth in which a primary prevention research and programs,
mother becomes preoccupied with her infant to designed for and directed to nonclinical popula-
the exclusion of everything else, which permits a tions or populations at risk, that seek to promote
heightened sensitivity to the child’s needs. and lay a firm foundation for mental, behav-
ioral, or physical health so that psychological
primary memory (PM) memory that retains a disorders, illness, or disease will not develop.
few items for only several seconds, in contrast
Compare secondary prevention; tertiary
to secondary memory. The term was used in
prevention.
dual-store models of memory before being
replaced by short-term memory. [introduced primary process in psychoanalytic theory, un-
by William james] conscious mental activity in which there is free,
uninhibited flow of psychic energy from one
Primary Mental Abilities Test see primary idea to another. Such thinking operates without
ability. regard for logic or reality, is dominated by the
primary mental deficiency below average pleasure principle, and provides hallucinatory
intelligence due to genetic factors. fulfillment of wishes. Examples are the dreams,
primary microcephaly a congenital disorder fantasies, and magical thinking of young chil-
in which microcephaly is the primary, and dren. These processes are posited to predominate
usually the only, evidence of anomalous fetal de- in the id. Also called primary-process think-
velopment. The most common characteristic is a ing. See also prelogical thinking.
normal-size face combined with a small cra- primary reinforcement 1. in operant con-
nium. The forehead is low and narrow but re- ditioning, the process in which presentation of
454
privacy
a stimulus or circumstance following a response priming-the-pump technique see double

increases the future probability of that response, technique.
without the need for special experience with primitive defense mechanism in psychoan-
the stimulus or circumstance. That is, the stimu- alytic theory, any defense mechanism that pro-
lus or circumstance, known as an unconditioned tects against anxiety associated with the death
primary reinforcer, functions as effective re- instinct. Primitive defense mechanisms in-
inforcement without any special experience or clude denial, splitting, projection, and ide-
training. 2. the contingent occurrence of such a alization.
stimulus or circumstance after a response. Also
primitive superego in object relations the-
called unconditioned reinforcement.
ory, an early superego that is formed in the
primary relationship a person’s closest rela- pregenital phase by the introjection of espe-
tionship, in terms of the time, energy, and pri- cially harsh and terrifying bad objects. [first
ority given to it. A primary relationship will used in 1934 by British psychoanalyst James
typically include high degrees of intimacy, at- Strachey (1887–1967)]
traction, and commitment.
primitivization n. in psychoanalytic theory,
primary repression in psychoanalytic theory, the regression of higher ego functions, such as
the first phase of repression, in which ideas as- objective thinking, reality testing, and purpose-
sociated with instinctual wishes are screened out ful behavior, with a return to primitive stages of
and prevented from becoming conscious. Pri- development characterized by magical thinking
mary repression contrasts with repression (e.g., wish-fulfilling fantasies and hallucina-
proper, in which the repressed material has al- tions), helplessness, and emotional dependence.
ready been in the realm of consciousness. Also Primitivization occurs primarily in traumatic
called primal repression. neuroses, in which higher functions are blocked
primary sexual dysfunction any failure in by the overwhelming task of meeting the emer-
sexual functioning that has always been present gency, and in advanced schizophrenia, in which
in the person and happens in all sexual situ- the ego breaks down and psychic energy is
ations. See sexual dysfunction. Compare sec- withdrawn from external reality and concen-
ondary sexual dysfunction. trated on a narcissistic fantasy life. [first used in
1950 by Austrian psychoanalyst Ernst Kris
primary sleep disorder see sleep disorder. (1900–1957)]
primary stuttering dysfluency in the speech primordial image see archetype.
of young children without accompanying signs
of awareness, stress, or emotion. This simple, principle of constancy in psychoanalytic
nonanxiety-producing stage is not accepted as theory, the idea that all mental processes tend
true stuttering by some speech and language pa- toward a state of equilibrium and the stability of
thologists. Compare secondary stuttering. the inorganic state. Also called constancy law;
law of constancy. See also death instinct;
primary symptoms 1. see fundamental nirvana principle; principle of inertia.
symptoms. 2. symptoms that are a direct result P
principle of inertia in psychoanalytic theory,
of a disorder and essential for its diagnosis.
the tendency of the organism to expend mini-
3. symptoms that appear in the initial stage of
mum energy by preferring unconscious auto-
a disorder. Compare secondary symptoms.
matic actions to conscious ones. This principle is
primary thought disorder a disturbance of posited to be the mechanism that underlies the
cognition, observed primarily in schizophrenia, repetition compulsion and is one type of id
characterized by incoherent and irrelevant intel- resistance. Also called inertia principle. See
lectual functions and peculiar language patterns also death instinct; nirvana principle.
(including bizarre syntax, neologisms, and prison psychosis a severe emotional distur-
word salad). See schizophrenic thinking. bance precipitated by actual or anticipated incar-
primidone n. a barbiturate anticonvulsant ceration. The types of disturbance vary; in many
drug whose primary metabolic product is phe- cases they result from long-standing tendencies
nobarbital. It is appropriate for the treatment toward schizophrenia or are paranoid reactions
of partial and tonic–clonic seizures but has been released by the stress of imprisonment. Symp-
largely supplanted by newer, safer agents. U.S. toms include delusions of innocence, pardon,
trade name: Mysoline. ill treatment, or persecution; periods of excite-
priming n. in cognitive psychology, the effect in ment; or rage and destructiveness. See ganser
which recent experience of a stimulus facilitates syndrome.
or inhibits later processing of the same or a simi- privacy n. 1. the state in which an individual’s or
lar stimulus. In repetition priming, presentation a group’s desired level of social interaction is not
of a particular sensory stimulus increases the exceeded. 2. the right to control (psychologi-
likelihood that participants will identify the cally and physically) others’ access to one’s per-
same or a similar stimulus later in the test. In se- sonal world, for example by regulating others’
mantic priming, presentation of a word or sign input through use of physical or other barriers
influences the way in which participants inter- (e.g., doors, partitions) and by regulating one’s
pret a subsequent word or sign. —prime vb. own output in the form of communication with
455
private mental hospital
others. 3. the right of patients and others (e.g., probability sample a sample chosen from a
consumers) to control the amount and disposi- population in such a way that the likelihood of
tion of the information they divulge about each unit in the population being selected is
themselves. See privileged communication. known in advance of the sampling. See random
—private adj. sampling.
private mental hospital a hospital for pa- probability theory a branch of mathematics
tients with mental disorders that is organized concerned with the study of probabilistic phe-
and run by a group of health care professionals nomena.
(e.g., psychiatrists, psychologists). A private men- proband n. the family member whose possible
tal hospital is typically considerably smaller genetic disease or disorder forms the center of
than a public mental hospital, usually has a the investigation into the extent of the illness in
higher doctor–patient ratio, and generally offers the family. He or she is the person around whom
specialized, intensive treatment rather than a pedigree is drawn and from whom the infor-
chronic care. mation about other family members is obtained.
private practice 1. the practice of a medical or Also called index case.
mental health care professional who operates as
probing n. in psychotherapy, the use of direct
a self-employed individual. 2. in the United
questions intended to stimulate additional dis-
Kingdom, any medical practice outside the Na-
cussion, in the hope of uncovering relevant in-
tional Health Service.
formation or helping the client come to a
private self the part of the self that is known particular realization or achieve a particular in-
mainly to oneself, such as one’s inner feelings sight.
and self-concept. The private self is distin-
problem behavior any conduct that is
guished from the public self and the collec-
maladaptive, destructive, or antisocial.
tive self.
problem checklist a type of self-report scale
private self-consciousness see self-con-
listing various personal, social, educational, or
sciousness.
vocational problems. The participant indicates
private speech spontaneous self-directed talk the items that apply to his or her situation.
in which a person “thinks aloud,” particularly as
problem drinking see alcohol abuse; alpha
a means of regulating cognitive processes and
alcoholism.
guiding behavior. In the theorizing of Russian
psychologist Lev Semenovich Vygotsky (1896– problem-focused coping a stress-manage-
1934), private speech is considered equivalent to ment strategy in which a person directly con-
egocentric speech. fronts a stressor in an attempt to decrease or
eliminate it. This may involve seeking informa-
privilege n. the legal right of an individual to
tion, generating possible solutions to a problem,
confidentiality of personal information ob-
confronting others who are responsible for or
tained by a professional in the course of their re-
otherwise associated with the stressor, and other
P lationship, as between a patient and a health
forms of instrumental action. For example, a stu-
care professional during the course of treatment
dent who is anxious about an upcoming exami-
or diagnosis. See privileged communication.
nation might cope by studying more, attending
privileged communication confidential in- every class, and attending special review sessions
formation, especially as provided by an individ- to ensure he or she fully understands the course
ual to a professional in the course of their material. It has been proposed that problem-
relationship, that may not be divulged to a third focused coping is used primarily when a person
party without the knowledge and consent of appraises a stressor as within his or her capacity
that individual. This protection applies to com- to change. Compare emotion-focused coping.
munications not only between patients and [identified in 1984 by Richard S. Lazarus (1922–
physicians, clinical psychologists, psychiatrists, 2002) and Susan Folkman (1938– ), U.S. psy-
or other health care professionals, but also be- chologists]
tween clients and attorneys, confessors and
priests, and spouses. problem-oriented record (POR) a form of
patient-care record that has four components:
probability (symbol: p) n. the degree to which (a) a database (standardized information on his-
an event is likely to occur. —probabilistic adj. tory, physical examination, mental status, etc.);
probability curve a graphic representation of (b) a problem list, based on the database; (c)
the expected frequency of occurrence of a vari- a treatment plan for each problem; and (d) prog-
able. ress notes as related to the problems and
probability distribution a curve that speci- to the patient’s response to each treatment.
fies, by the areas below it, the probability that a Also called problem-oriented medical rec-
random variable occurs at a particular point. The ord (POMR).
best known example is the bell-shaped normal problem representation a scheme, often a
distribution; others include the chi-square drawing, that represents the relations among el-
distribution, Student’s t distribution, and ements of a problem. For example, a table might
the f distribution. be used to express the relations among two sets
456
prochlorperazine
of items or a flow chart might be used to express processing-efficiency theory a theory that
the series of steps to be followed in solving a attempts to explain the relationship between
problem. anxiety and performance (see arousal–perfor-
problems in living concrete problems with mance relationship). It suggests that anxiety
which patients with chronic mental illness (e.g., serves two functions: (a) It increases worry and
schizophrenia) frequently struggle (e.g., inabil- takes part of the attentional resources, and
ity to keep a job or a place of residence), which (b) the worry created serves a monitoring func-
are believed to be the most useful next focus of tion by identifying the task as important, so that
treatment after symptoms stabilize with medica- the individual increases the effort, which over-
tion. Problems in living are often addressed in comes the depleted attentional capacity.
day treatment or in aftercare following hospital- Processing Speed Index an index from the
ization. [proposed by Hungarian-born U.S. psy- wechsler adult intelligence scale and
chiatrist Thomas S. Szasz (1920– )] other Wechsler tests that measures the speed of
problem solving the process by which individ- nonverbal processing.
uals attempt to overcome difficulties, achieve process–reactive adj. relating to a disease
plans that move them from a starting situation model of schizophrenia based on the distinction
to a desired goal, or reach conclusions through between gradual and acute onset of symptoms.
the use of higher mental functions, such as rea- process schizophrenia is marked by a long-
soning and creative thinking. Problem solv- term gradual deterioration before the disease is
ing is seen in animals in laboratory studies manifest, whereas reactive schizophrenia is
involving mazes and other tests as well as in nat- associated with a rapid onset of symptoms after a
ural settings to obtain hidden foods. Many ani- relatively normal premorbid period.
mals display problem-solving strategies, which process research the study of various psycho-
allow an animal to solve a new problem quickly, logical mechanisms or processes of psychother-
based on whether the first response was success- apy as they influence the outcome of treatment
ful or unsuccessful. In terms of conditioning, or the reactions that the therapist or client may
problem solving involves engaging in behavior have. A basic goal of such research is to identify
that results in the production of discriminative therapeutic methods and processes that are most
stimuli in situations involving new contingen- effective in bringing about positive change, as
cies. well as inadequacies and other limitations. See
problem space the set of all possible paths to also psychotherapy research.
the solution of a given problem. process schizophrenia a form of schizophre-
procedural memory long-term memory for nia that begins early in life, develops gradually,
the skills involved in particular tasks. Procedural is believed to be due to endogenous (biological
memory is demonstrated by skilled performance or physiological) rather than environmental fac-
and is often separate from the ability to verbalize tors, and has a poor prognosis. Psychosocial de-
this knowledge (see declarative memory). velopment before the onset of the disorder is
Knowing how to type or skate, for example, re- poor; individuals are withdrawn, are socially in- P
quires procedural memory. Also called sen- adequate, and indulge in excessive fantasies.
sorimotor memory. This term is often used interchangeably with nu-
process analysis in psychotherapy, the exami- clear schizophrenia. Also called poor pre-
nation of the interaction between the therapist morbid schizophrenia. Compare reactive
and the client and of their evolving relationship, schizophrenia. [proposed in 1959 by U.S. psy-
as opposed to the content of their discussions. chologists Norman Garmezy (1918–2009) and
Eliot H. Rodnick (1911–1999)]
process evaluation in evaluation research, an
in-house function in which the evaluator process study any investigation undertaken to
quickly moves into the situation to be evaluated, assess the mechanisms and variables that con-
conducts the evaluation, feeds back findings to tribute to and influence the outcome of a partic-
the program administrator for immediate pro- ular activity. For example, a process study of
gram modification (if necessary), then repeats group therapy sessions may seek to determine
the process. See also formative evaluation. characteristics of the therapeutic interaction
that are associated with positive, neutral, or neg-
process experiential psychotherapy an ative changes individually and across the group.
approach to psychotherapy that focuses on the See also process research.
client’s moment-to-moment experience and
guides the client’s cognitive and affective pro- process variable 1. an interpersonal, affective,
cessing in the direction of client-defined goals. cognitive, or behavioral factor that is operative
The therapeutic alliance, internal patterns of during the course of psychotherapy or counsel-
viewing the self and others, and an emphasis on ing and influences the progress or the course of
therapeutic process over content are core ele- behavior. 2. any set of psychological factors
ments of this therapy. See also client-centered that has an effect on the development or modifi-
therapy; gestalt therapy; humanistic ther- cation of a process over time.
apy. [proposed by South African-born Canadian prochlorperazine n. a low-potency pheno-
psychologist Leslie Greenberg (1945– )] thiazine used for the treatment of nausea and
457
procreative sex
vomiting and, occasionally, for the control of ual relations with a patient under his or her care.
anxiety. It was formerly used as an antipsychotic See also professional ethics.
agent. U.S. trade name (among others): Com- professional ethics rules of acceptable con-
pazine. duct that members of a given profession are ex-
procreative sex sexual activity that can result pected to follow. See boundary issues; code
in pregnancy. In some cultures and religions this of ethics; ethics; professional standards;
is regarded as the basis for what is considered to standards of practice.
be normal sex, as opposed to deviant or sinful professional licensing the imposition of
sexual activity. state-regulated minimal standards for legal em-
procyclidine n. an anticholinergic drug ployment as a member of a given profession.
that is used in the treatment of Parkinson’s dis- Professional licensing usually consists of three
ease and drug-induced extrapyramidal symp- parts: provisional certification, full certification,
toms. U.S. trade name: Kemadrin. and recertification. See license.
prodromal syndrome a set of traits, symp- professional standards the levels of perfor-
toms, or neurological deficits that may predis- mance and conduct required or expected in a
pose an individual to developing a psychological particular profession. See also code of ethics;
or neurological disorder. professional ethics; standards of practice.
prodrome n. an early symptom or symptoms of profile of a disorder a drawn or mechanically
a mental or physical disorder. A prodrome fre- generated outline, often a graph, representing
quently serves as a warning or premonitory sign the symptoms and characteristics of a disorder.
that may, in some cases, enable preventive mea- Profile of Mood States (POMS) a brief self-
sures to be taken. Examples are the auras that report instrument measuring six dimensions of
often precede epileptic seizures or migraine transient and fluctuating mood states over time:
headaches and the headache, fatigue, dizziness, tension or anxiety, depression or dejection,
and insidious impairment of ability that often anger or hostility, vigor or activity, fatigue or in-
precede a stroke. Also called prodromic phase. ertia, and confusion or bewilderment. Partici-
—prodromic adj. —prodromal adj. pants indicate on a 5-point scale ranging from
prodrug n. a drug that is either biologically inert “not at all” to “extremely” whether each of the
or of limited activity until metabolized to a more 65 adjectives (e.g., confused, spiteful, energetic,
active derivative. good-natured) listed is descriptive of themselves
within the specified time frame. A mentally
productive love in psychoanalytic theory, the healthy profile on the POMS is known as the ice-
capacity of healthy individuals to establish close, berg profile. [originally developed in 1971 by
interdependent relationships without abridging U.S. psychologist Douglas M. McNair (1927–
their individuality. Respect, care, responsibility, 2008), U.S. psychometrician Maurice Lorr
and knowledge of the other are essential compo- (1910–1998), and U.S. psychologist Leo F.
P nents. According to Erich fromm, productive Droppleman (1936–2009)]
love is accomplished through active effort and is
an aspect of the productive orientation. profound mental retardation a diagnostic
category for those with IQs below 20, compris-
productive orientation in psychoanalytic ing about 1% of people with mental retarda-
theory, a personality pattern in which the indi- tion. It is due to sensorimotor abnormalities as
vidual is able to develop and apply his or her po- well as intellectual factors; typical developmen-
tentialities without being unduly dependent on tal attainments include rudimentary speech and
outside control. Such an individual is highly ac- limited self-care, and affected individuals require
tive in feeling, thinking, and relating to others, lifelong, highly structured environments with
and at the same time retains the separateness constant aid and supervision.
and integrity of his or her own self. [introduced
by Erich fromm]
progesterone n. a hormone, secreted mainly by
the corpus luteum in the ovary, that stimulates
productive thinking in the theory of Erich proliferation of the endometrium (lining) of the
fromm, thinking in which a given question or uterus required for implantation of an embryo.
issue is considered with objectivity as well as re- If implantation occurs, progesterone continues
spect and concern for the problem as a whole. It to be secreted—first by the corpus luteum and
is a feature of the productive orientation. then by the placenta—maintaining the pregnant
product–moment correlation (symbol: r) a uterus and preventing further release of egg cells
statistic that indexes the degree of linear rela- from the ovary. It also stimulates development
tionship between two variables. Invented by of milk-secreting cells in the breasts.
British statistician Karl Pearson (1857–1936), it is progestin n. see progestogens.
often known as the Pearson product–moment progestogens pl. n. steroids that include the
correlation (Pearson’s r). natural hormone progesterone and synthetic
professional–client sexual relations a steroids (known as progestins) with physiologi-
boundary violation (see boundary issues) in cal effects similar to those of progesterone.
which a health care professional engages in sex- Progestins may be derived from progesterone or
458
prolactin
testosterone. While progesterone has an anti- flicted over expressing anger to change “I hate
estrogenic action, progestins may have different him” to “He hates me.” Such defensive patterns
effects, such as proestrogenic activity. They are are often used to justify prejudice or evade re-
used in oral contraceptives, hormone replace- sponsibility; in more severe cases, they may de-
ment therapy, and medications for menstrual velop into paranoid delusions in which, for
disorders. example, an individual who blames others for
prognosis n. in general medicine and mental his or her problems may come to believe that
health science, a prediction of the future course, those others are plotting against him or her. In
duration, severity, and outcome of a condition, classical psychoanalytic theory, projection per-
disease, or disorder. Prognosis may be given mits the individual to avoid seeing his or her
whether or not treatment is undertaken, in order own faults, but modern usage has largely aban-
to give the client an opportunity to weigh the doned the requirement that the projected trait
benefits of different treatment options. —prog- remain unknown in the self. —project vb.
nostic adj. projective identification 1. in psychoanaly-
program efficacy conclusions drawn about sis, a defense mechanism in which the individ-
program outcomes from testing an interven- ual projects qualities that are unacceptable to the
tion under closely controlled scientific condi- self onto another individual and that person—
tions, which may narrowly define the type of through unconscious or conscious interpersonal
patients treated, nature of services offered, and pressure—internalizes the projected qualities
so forth. Because this method involves the provi- and believes himself or herself to be character-
sion of services under conditions that are very ized by them appropriately and justifiably. See
different from everyday real-world service deliv- projection. 2. in the object relations theory of
ery, there are dangers that it may not achieve a Melanie klein, a defense mechanism in which a
high degree of external validity. person fantasizes that part of his or her ego is
program integrity the extent to which an in- split off and projected into the object in order
tended program is actually delivered. Also called to control or harm it, thus allowing the individ-
treatment integrity; treatment validity. ual to maintain a belief in his or her omnipotent
control. Projective identification is a key feature
program outcome any or all of the effects that of Klein’s paranoid-schizoid position.
arise from the implementation of a program.
Also called program output. projective method see projective tech-
nique.
progressive relaxation a technique in which
the individual is trained to relax the entire body projective play a variation of play therapy in
by becoming aware of tensions in various muscle which dolls and other toys are used by children
groups and then relaxing one muscle group at a to express their feelings, which can be helpful in
time. In some cases, the individual consciously diagnosing mental disturbances.
tenses specific muscles or muscle groups and projective psychotherapy a treatment pro-
then releases tension to achieve relaxation cedure in psychotherapy in which selected re-
throughout the body. Also called Jacobson responses on various projective tests are fed back
P
laxation method. [developed by U.S. physi- to the client, who associates with them in much
cian Edmund Jacobson (1888–1983)] the same way that psychoanalytic patients make
progressive teleologic regression the pur- free associations to dreams. [developed by
posive return of a person with schizophrenia U.S. psychologist Molly Harrower (1906–1999)]
to the primary process level, in an attempt projective technique any personality assess-
to avoid tension, stress and anxiety, and a self- ment procedure that consists of a fixed series of
image that has become bizarre, threatening, and relatively ambiguous stimuli designed to elicit
frightening. The regression is progressive because unique, sometimes highly idiosyncratic, re-
it fails to accomplish its purpose and becomes sponses. Examples of this type of procedure are
more extreme. [first described by Italian-born the rorschach inkblot test, the thematic
U.S. psychiatrist Silvano Arieti (1914–1982)] apperception test, and various sentence com-
projected jealousy a type of behavior in which pletion and word association tests. Projective
individuals who are unfaithful, or who repress techniques are quite controversial, with opin-
impulses to be unfaithful, accuse their partners ions ranging from the belief that personality as-
of being unfaithful, thereby projecting their own sessment is incomplete without data from at
impulses. See projection. least one or more of these procedures to the view
projection n. in psychoanalytic and psycho- that such techniques lack reliability and validity
dynamic theories, the process by which one at- and that interpretations of personality organiza-
tributes one’s own individual positive or negative tion and functioning derived from them are
characteristics, affects, and impulses to another completely hypothetical and unscientific. Also
person or group. This is often a defense mecha- called projective method.
nism in which unpleasant or unacceptable im- prolactin n. a peptide hormone both synthe-
pulses, stressors, ideas, affects, or responsibilities sized and released into the bloodstream by spe-
are attributed to others. For example, the defense cialized cells in the anterior pituitary gland
mechanism of projection enables a person con- called lactotrophs. Although generally known
459
Prolixin
for its originally described role in initiating and to habituate clients to the traumatic event so
maintaining lactation—prolactin levels rise sig- that it no longer evokes the excessive anxiety,
nificantly in women during pregnancy, stimu- fear, and other distressing emotions that it previ-
lating the mammary glands to grow and ously did. [developed in the 1980s by U.S. psy-
subsequently produce milk—prolactin also per- chologist Edna B. Foa (1937– ) and colleagues]
forms hundreds of other essential reproductive, promethazine n. a phenothiazine used for the
homeostatic, and behavioral functions in both treatment of nausea, motion sickness, and aller-
sexes. These include such activities as preserving gies and as a sedative. Its mechanism of action
the corpus luteum and enhancing its secretion of includes blockade of H1 histamine receptors
progesterone, modulating sexual arousal and and of dopamine receptors in the mesolimbic
the orgasmic refractory phase, influencing system. U.S. trade name: Phenergan.
spermatogenesis, regulating prostate gland de-
velopment, regulating the response of the im- promiscuity n. transient, casual sexual relations
mune system, regulating water and electrolyte with a variety of partners. In humans, this type
concentrations (osmoregulation), and inhibit- of behavior is generally regarded unfavorably;
ing fat metabolism. Prolactin also is associated however, it has been argued that there can be
with mammalian and avian parental behavior, healthy promiscuity in the simple enjoyment of
with prolactin variation possibly explaining in- casual, consensual, nonexploitative relation-
dividual differences in parental decision making ships. In bonobos (pygmy chimpanzees) sexual
and the initiation of parental interactions. Given activity occurs frequently both between and
such versatility of action, it is not surprising that within sexes in exchange for resources (e.g.,
prolactin receptors are found throughout the food) or to calm tensions. In many species fe-
body, including within the hypothalamus, males appear to display promiscuity to prevent
hippocampus, amygdala, and other areas of certainty of paternity but often mate with the
the central nervous system; the thymus and most dominant or successful male at the time
lymphocytes of the immune system; and the when conception is most likely. —promiscu-
liver, kidney, prostate, testis, ovary, uterus, ous adj.
mammary glands, and numerous other organs. prompting n. in psychotherapy, suggesting or
Also called lactogenic hormone; lacto- hinting at topics by the therapist to encourage
tropic hormone; lactotropin; luteotropic the client to discuss certain issues. Prompting
hormone (LTH); luteotropin. may include reminding the client of previously
discussed material, tying previously discussed
Prolixin n. a trade name for fluphenazine. topics together, or finishing a sentence or
prolonged exposure therapy a form of cog- thought for the client to aid in his or her under-
nitive-behavior therapy for posttraumatic standing of an issue.
stress disorder in adults. Based on emotional pronoun reversal a speech phenomenon ob-
processing theory, it is a brief treatment, in- served in children with autistic disorder, in
volving 9–12 sessions of 60–90 minutes each which the child refers to him- or herself in the
P conducted once or twice weekly. The first two second or third person (e.g., you, him, she) while
sessions are devoted to information gathering, identifying others by first-person pronouns (e.g.,
explanation of treatment rationale, treatment me). Also called pronominal reversal.
planning, and breathing retraining. During propanediols pl. n. a group of chemically re-
the remaining sessions, clients relive their trau- lated compounds derived from propyl alcohol
matic experiences by imagining them as vividly and originally developed as antianxiety drugs.
as possible and describing them aloud in the Their pharmacological actions include muscle
present tense (i.e., imaginal exposure), includ- relaxation, depression of the central nervous sys-
ing their thoughts, feelings, and physical sensa- tem, and a calming effect through interference
tions at the time. These narratives are recorded, with autonomic reactions. The prototype of the
and clients are instructed to listen to the record- group is meprobamate. Due to their toxicity in
ings as homework. They are also instructed to overdose, propanediols have largely been sup-
confront, as homework, situations and stimuli planted as anxiolytics by benzodiazepines and
that trigger distressing memories and thoughts other sedative-hypnotics; carisoprodol, a pre-
and thus have been avoided (i.e., in vivo expo- cursor of meprobamate, is currently used as a
sure). The homework assignments and imaginal muscle relaxant.
exposure are reviewed in session: Clients discuss
their emotions, cognitions, and other responses prophylactic maintenance see mainte-
to the activity, while the therapist uses non- nance therapy.
directive statements to validate and normalize prophylactic surgery the removal of an
the clients’ experiences and reactions. The expo- organ prior to the expected onset of cancer in
sure exercises are intended to teach clients that that organ, usually because the individual has a
trauma memories are in fact not harmful and positive family history of the disease or is a car-
that they can cope with them; the in-session dis- rier of a predisposing genetic mutation (e.g.,
cussion seeks to help clients change their errone- women who carry mutations in genes BRCA1
ous beliefs about the trauma and reevaluate their and BRCA2 are at a greatly increased risk of
feelings about it. Ultimately, this method aims breast cancer).
460
protected relationships
prophylaxis n. the use of methods or proce- extension, rational thinking, self-image, pro-
dures designed to avoid or prevent mental or priate striving, and knowing.
physical disease or disorder. —prophylactic prosocial adj. denoting or exhibiting behavior
adj., n. that benefits one or more other people, such as
propoxyphene n. a synthetic opioid anal- providing assistance to an older adult crossing
gesic that has approximately half the pain- the street. Compare antisocial.
control efficacy of codeine. It is generally mar- prosocial behavior any act that is socially
keted in combination with a nonsteroidal anti- constructive or in some way beneficial to an-
inflammatory agent, such as aspirin, for the other person or group. A broad range of behavior
management of moderate pain. In 2010, pro- can be described as prosocial, including simple
poxyphene was withdrawn from the U.S. mar- everyday acts, such as providing assistance to an
ket. Former U.S. trade names: Darvon; Darvocet elderly person crossing the street. Compare an-
(in combination with acetaminophen). tisocial behavior. See altruistic behavior;
helping.
propranolol n. a beta blocker used primarily to
treat hypertension. In low doses it is used as an ProSom n. a trade name for estazolam.
adjunctive agent in the treatment of certain prospective research research that is planned
forms of social phobia, such as fear of public before the data have been collected; that is, re-
speaking or performance, predominantly due to search that starts with the present and follows
its ability to control certain peripheral symp- subjects forward in time, as in randomized ex-
toms of anxiety, such as tremor and vocal qua- periments and in longitudinal research. Com-
vering. Because it produces a nonspecific pare retrospective research.
blockade of beta-adrenergic receptors, it prospect theory a theory of decision making
should not be taken by individuals with asthma that attempts to explain how people’s decisions
or reactive airway disease, due to its ability to are influenced by their attitudes toward risk, un-
constrict bronchial smooth musculature and certainty, loss, and gain. In general, it finds that
thereby induce breathing difficulties. U.S. trade people are motivated more strongly by the fear
name: Inderal. of loss than the prospect of making the equiva-
propriate striving the final stage in the devel- lent gain. See anticipatory regret. [formu-
opment of the proprium. According to Gordon lated by Israeli-born U.S. psychologists Daniel
W. allport, who originated the concept, pro- Kahneman (1934– ) and Amos Tversky (1937–
priate striving emerges in adolescence with the 1996)]
search for identity and includes the experimen- prostaglandin (PG) n. any of a group of chemi-
tation common to adolescents before making cally related substances that act as local hor-
long-range commitments. Because Allport be- mones in animal tissue and cause a variety of
lieved in the independence of adult motivation, physiological effects. There are several basic
in contrast to childhood motivation, adoles- types, designated by capital letters with subscript
cence is considered especially significant as the numbers indicating the degree of saturation of P
time when conscious intentions and future- fatty acid side chains (e.g., PGE2, PGH2). Among
oriented planning begin to motivate the person- their many activities, they influence blood pres-
ality. See functional autonomy. sure, cause stimulation of smooth muscle, and
proprietary drug any chemical used for me- promote inflammation.
dicinal purposes that is formulated or manufac- prosthesis n. (pl. prostheses) an artificial re-
tured under a name that is protected from placement for a missing or dysfunctional body
competition by trademark or patent. The in- part that is attached to or implanted in the body.
gredients, however, may be components of ge- Prostheses include artificial limbs, artificial
neric drugs that have the same or similar effects. joints, and plastic heart valves. Also called pros-
thetic device. —prosthetic adj.
propriety standards the legal and ethical re-
quirements of an evaluation research study. Prostigmin n. a trade name for neostigmine.
These standards include having formal or writ- prostitution n. a sex service that is based on the
ten agreements between parties in the study, payment of money or the exchange of other
protecting the rights of participants, avoiding property or valuables. Prostitution may involve
conflicts of interest by both program evaluators heterosexual or same-sex services provided by
and participants, conducting complete and fair male or female prostitutes. The sex service may
program assessments, fully reporting all find- be simple coitus, other common sexual acts (e.g.,
ings, and maintaining fiscal soundness. See also fellatio, cunnilingus, masturbation), or acts lead-
accuracy standards; feasibility standards; ing to gratification of paraphilias.
utility standards. protagonist n. in psychodrama, the person se-
proprium n. a concept of the self, or that which lected as the central character in the drama or
is consistent, unique, and central in the individ- role play.
ual, that was developed by Gordon W. allport. protected relationships professional pro-
According to Allport, the proprium incorporates vider–client contacts that are subject to ethical
body sense, self-identity, self-esteem, self- standards regarding confidentiality of records
461
protective factor
and other information provided by the client, the process. 2. a case history and work-up. 3. a
information about sessions, and the existence of treatment plan.
the professional relationship itself. prototypal approach to classification the
protective factor a variable or clearly defined process of classifying abnormal behavior on the
behavior that promotes relative healthiness and assumption that there are combinations of char-
well-being because it is associated with a de- acteristics (prototypes of behavior disorders)
creased probability that a particular disease or that tend to occur together regularly. The proto-
disorder will develop or because it reduces the se- typal approach recognizes that the ideal combi-
verity of an existing pathological condition. For nation of traits does not exist in reality and that
example, exercising regularly can serve as a pro- prototypes with similar characteristics can blend
tective factor by decreasing the likelihood or se- into one another.
verity of coronary heart disease, hypertension, prototype n. 1. in concept formation, the
and depression. Likewise, supportive social net- best or average exemplar of a category. For exam-
works and positive coping skills are examples of ple, the prototypical bird is some kind of mental
protective factors that help alleviate depression average of all the different kinds of birds of
and anxiety and enhance mental health gener- which a person has knowledge or with which
ally. a person has had experience. Also called cogni-
protective reflex the reflex withdrawal of the tive prototype. 2. more generally, an object,
body or a body part away from painful or an- event, or person that is held to be typical of a cat-
noying stimulation. Also called protective re- egory and comes to represent or stand for
sponse. that category. 3. an early model of something
that represents or demonstrates its final form.
protein n. a molecule that consists of a long- —prototypal, prototypical, or prototypic
chain polymer of amino acids. Proteins are in- adj.
volved in virtually every function performed by
protriptyline n. see tricyclic antidepres-
a cell; they are the principal building blocks
sant.
of living organisms and, in the form of enzymes,
the basic tools for construction, repair, and provider n. a health care professional or facility,
maintenance. Proteins play an essential role in such as a psychologist, psychiatrist, physician,
human nutrition, including the provision of all hospital, or skilled nursing or intensive care fa-
of the essential amino acids that humans cannot cility, that provides health care services to pa-
produce themselves. protein deficiency leads tients. See primary care provider. See also
to a variety of symptoms and conditions. Excess ppo; preferred provider arrangement.
protein can cause overreaction of the immune Provigil n. a trade name for modafinil.
system and liver dysfunction and is implicated
provocative testing any type of testing in
in obesity. See also peptide.
which symptoms of a condition are intention-
protein deficiency lack of a normal quantity ally caused or reproduced in a patient or other
P of proteins, particularly complete proteins, in person presenting for evaluation. This can be
the diet or body tissues. Complete proteins condone in order to test the effectiveness of treat-
tain the essential amino acids, which must be ments for the condition, to rule in or rule out the
acquired from the external environment in possibility of a similar diagnosis, or, in the case
meals since they cannot be synthesized by the of psychogenic disorders, to test the veracity
body’s own chemistry. In addition to being re- of the condition. For example, provocative test-
quired for basic structural and functional pro- ing has been used somewhat controversially in
cesses, several amino acids, including glutamic distinguishing nonepileptic seizures from
acid, lysine, and cystine, are needed for learning neurologically based epileptic seizures.
and other mental activities. Protein deficiency proximate cause the most direct or immediate
may lead to fatigue, retarded growth, loss of cause of an event. In a causal chain, it is the one
muscle mass, hair loss, insulin resistance, and that directly produces the effect. For example the
hormonal irregularities. It may occur as a result proximate cause of Smith’s aggression may be an
of a lack of carbohydrates or fats in the diet, a insult, but the remote cause may be Smith’s
condition that causes the body to consume its early childhood experiences. In law, proximate
own proteins as a source of energy. If this self- cause is important in liability cases where it must
digestion process is not controlled, irreversible be determined whether the actions of the defen-
damage to vital organs results. See also kwashi- dant are sufficiently related to the outcome to be
orkor; marasmus. considered causal, or if the action set in motion a
protensity n. the temporal attribute (i.e., dura- chain of events that led to an outcome that
tion spread) of a mental process or of conscious- could have been reasonably foreseen.
ness. Prozac n. a trade name for fluoxetine.
protocol n. 1. the original notes of a study or ex- prudence n. farsighted and deliberate concern
periment recorded during or immediately after for the consequences of one’s actions and deci-
a particular session or trial, particularly as re- sions. It is a form of practical reasoning and self-
corded from participant’s verbalizations during management that resists the impulse to satisfy
462
pseudologia fantastica
short-term pleasures at the expense of long-term without penetration and sometimes while
goals. —prudent adj. clothed, with or without orgasm occurring.
prudery n. the quality of being excessively mod- pseudocyesis n. a condition in which a woman
est or priggish, particularly in having a negative shows many or all of the usual signs of preg-
view of sexual matters. —prude n. —prudish nancy when conception has not taken place. In
adj. some cases the condition is psychogenic,
whereas in others it is due to a medical condition
pruritus n. itching that may result from physio-
(e.g., a tumor or an endocrine disorder). Also
logical or psychological conditions. See also psy-
called false pregnancy; pseudopregnancy.
chogenic pruritus. —pruritic adj.
pseudodementia n. 1. deterioration or impair-
PSE abbreviation for present state examina-
ment of cognitive functions in the absence of
tion.
neurological disorder or disease (compare de-
pseudoephedrine (pseudephedrine) n. see mentia). The condition may occur, reversibly,
ephedra. in a major depressive episode—particularly
pseudoangina n. 1. chest pain that resembles among older adults, in which case the preferred
the pain (angina pectoris) of a heart attack but term is dementia syndrome of depression—or as
for which there is no clinical evidence of heart a psychological symptom of factitious disor-
disease. 2. chest pain that resembles angina der. 2. see ganser syndrome.
pectoris but originates from damage to the spi- pseudoepilepsy n. see nonepileptic seizure.
nal roots in the neck (cervical) region. Compres- pseudohallucination n. a vivid hallucination,
sion of the root of the seventh cervical nerve by a usually visual, that the individual recognizes as
prolapsed intervertebral disk (slipped disk) is hallucinatory.
commonly identified as the cause. Also called
cervical angina. See noncardiac chest pain. pseudohermaphroditism n. a congenital ab-
normality in which the gonads (ovaries or tes-
pseudoasthma n. a physical condition with ticles) are of one sex, but one or more
symptoms and findings that suggest asthma, al- contradictions exist in the morphological cri-
though no organic basis can be found. Differ- teria of sex. In female pseudohermaphrodit-
ences between pseudoasthma and true asthma ism, the individual is a genetic and gonadal fe-
are detected during physical examination. For male with partial masculinization, such as an en-
example, the patient generally has difficulty larged clitoris resembling a penis and labia
breathing in rather than breathing out, the respi- majora resembling a scrotum. In male pseudo-
ratory attack is resolved quickly rather than hermaphroditism, the individual is a genetic and
gradually, and the severity of the attack de- gonadal male with incomplete masculinization,
creases in the presence of distraction rather than including a small penis, perineal hypospadias,
remaining constant. Also called nonorganic and a scrotum that lacks testes. —pseudo-
acute upper airway obstruction; vocal hermaphrodite n.
cord dysfunction.
pseudohypoparathyroidism n. a condition P
pseudocommunication n. distorted attempts that resembles hypoparathyroidism (deficiency
at communication or vestiges of communication of parathyroid hormone) but fails to respond to
in the form of fragments of words, apparently parathyroid hormone treatment. Patients have a
meaningless sounds, and unfathomable ges- round face and thick-set figure and seem to have
tures. The condition is sometimes observed in impaired senses of smell and taste. In most cases
individuals with different types of schizophre- they have mild to moderate mental retardation.
nia. The disease is believed to be due to a genetic de-
pseudocommunity n. a group of real or imag- fect that blocks normal response to parathyroid
ined persons believed, in a persecutory delusion, hormone by receptor tissues.
to be organized for the purpose of conspiring pseudoidentification n. a defense mecha-
against, threatening, harassing, or otherwise nism in which individuals adopt or identify with
negatively focusing upon one. Also called para- the opinions, values, or orientations of others in
noid pseudocommunity. [first described by order to protect themselves against attack or crit-
20th-century U.S. psychiatrist and clinical psy- icism.
chologist Norman A. Cameron]
pseudoinsomnia n. insomnia reported by an
pseudoconvulsion n. an older name for a type individual who actually sleeps an adequate num-
of nonepileptic seizure in which the person ber of hours. The reason for reporting the com-
collapses and experiences muscular contrac- plaint is often obscure and may involve a subtle
tions, although other signs (e.g., pupillary signs, misperception of sleep, dreaming of a sleepless
loss of consciousness, and amnesia) are not ob- night, or the use of the complaint as a symptom
served. when the individual is anxious or depressed.
pseudocopulation n. 1. bodily contact be- pseudologia fantastica a clinical syndrome
tween a man and a woman with ejaculation characterized by elaborate fabrications, which
but without actual penetration. 2. sexual activ- are usually concocted to impress others, to get
ity in which a couple rub their genitals together, out of an awkward situation, or to give the indi-
463
pseudomemory
vidual an ego boost. Unlike the fictions of con- pseudoparkinsonism n. see parkinsonism.
fabulation, these fantasies are believed only pseudopersonality n. a fictitious characteriza-
momentarily and are dropped as soon as they are tion contrived by an individual in an effort to
contradicted by evidence. Typical examples are conceal facts about his or her true self from oth-
the “tall tales” told by people with antisocial per- ers.
sonality disorder, although the syndrome is also
found among malingerers and individuals with pseudopregnancy n. see pseudocyesis.
factitious disorders, neuroses, and psychoses. See pseudopsychology n. an approach to under-
also pathological lying. standing or analyzing the mind or behavior that
pseudomemory n. a fake memory, such as a utilizes unscientific or fraudulent methods.
spurious recollection of events that never took Examples include phrenology and physio-
place, as opposed to a memory that is merely in- gnomy. See pseudoscience. —pseudopsy-
accurate (see false memory). Pseudomemory is chological adj.
a cause of particular concern when using hypno- pseudopsychopathic schizophrenia a dis-
sis to help eyewitnesses retrieve memories (see order in which psychotic tendencies characteris-
hypermnesia). It was formerly called pseudo- tic of schizophrenia are masked or overlaid by
mnesia. See also confabulation; recovered antisocial tendencies, such as pathological lying,
memory. sexual deviations, and violent or other uninhib-
pseudomotivation n. a reason created by a ited behavior. Pseudopsychopathic schizophre-
person, particularly one with schizophrenia, to nia is primarily considered to be a personality
justify earlier behavior. The individual may or disorder rather than a type of schizophrenia;
may not be aware of the inconsistencies in the in DSM–IV–TR, such individuals are diagnosed
excuse or may be indifferent to them. [first de- with schizotypal personality disorder or
scribed by Swiss psychiatrist Eugen Bleuler borderline personality disorder.
(1857–1939)] pseudoretardation n. retarded intellectual de-
pseudomutuality n. a family relationship that velopment, usually consistent with mild men-
has a superficial appearance of mutuality, open- tal retardation, due to adverse cultural or
ness, and understanding although in fact the re- psychological conditions rather than congenital
lationship is rigid and depersonalizing. Family factors. Among these conditions are maternal
theories of schizophrenia and other forms deprivation, intellectual impoverishment, se-
of major psychopathology have identified vere emotional disturbance, and perceptual defi-
pseudomutuality as a critical etiological factor. cits. The term may be a misnomer as it can
be applied to individuals whose performance
pseudoneurological adj. suggesting a neuro-
is consistent with mental retardation that may
logical condition. The term is generally used in
not be alleviated by educational intervention.
reference to somatization disorder: Accord-
Also called psychosocial mental retarda-
ing to dsm–iv–tr, at least one pseudoneuro-
tion; psychosocial mental developmental
logical symptom must be present in order to
P diagnose this disorder.
delay.
pseudoneurotic schizophrenia a disorder pseudoscience n. a system of theories and

characterized by all-pervasive anxiety and a wide methods that has some resemblance to a genu-
variety of neurotic symptoms (persistent and ir- ine science but that cannot be considered such.
rational fears, obsessive thoughts, compulsive Examples range from astrology, numerology,
acts, dissociative states), with underlying psy- and esoteric magic to such modern phenomena
chotic tendencies (delusions, hallucinations, as Scientology. Various criteria for distinguish-
disorganized speech, thought, or behavior) ing pseudosciences from true sciences have been
that at times emerge very briefly, typically proposed, one of the most influential being that
in response to stress (see micropsychosis). of falsifiability. On this basis, certain approaches
Pseudoneurotic schizophrenia is primarily con- to psychology and psychoanalysis have some-
sidered to be a personality disorder rather than times been criticized as pseudoscientific, as they
a type of schizophrenia; in DSM–IV–TR, such in- involve theories or other constructs that cannot
dividuals are diagnosed with schizotypal be directly or definitively tested by observation.
personality disorder or borderline person- —pseudoscientific adj.
ality disorder. [described in 1949 by German- pseudoseizure n. see nonepileptic seizure.
born U.S. psychiatrist Paul H. Hoch (1902–1964) pseudosenility n. an acute, reversible con-
and psychiatrist Phillip Polatin (1905–1980) and fusional state or severe cognitive impairment in
used in clinical practice and research for the next an older adult resulting from such factors as drug
25 years] effects, malnutrition, depression, diminished
pseudonomania n. an abnormal urge to lie or cardiac output, fever, alcoholism, intracranial
to falsify information. tumor, a fall, or a metabolic disturbance. This
pseudoparalysis n. loss of limb movement or state is often confused with the irreversible state
limb power due to pain, with no identifiable of dementia.
structural or functional etiology within the ner- pseudotrisomy 18 a congenital disorder, be-
vous system. lieved to be due to an autosomal recessive trait,
464
psychiatric nursing
marked by the same general anomalies found pled with reclassification of these drugs as ille-
in patients with chromosome-18 trisomy (e.g., gal, ended for a time the use of such agents in
a short neck with webbing, congenital heart dis- psychotherapy. More recently, MDMA has been
ease). However, studies have failed to show signs studied for a potential role in the treatment of
of chromosome-18 trisomy, chromosomal trans- posttraumatic stress disorder and ibogaine
location, or other abnormalities. All affected indi- for the treatment of substance dependence and
viduals observed have evidenced mental retarda- withdrawal symptoms.
tion. psychiatric classification the grouping of
PSI abbreviation for parenting stress index. mental disorders and other psychological prob-
psilocin n. an indolealkylamine hallucinogen lems into diagnostic categories, as in the Diag-
that is the principal psychoactive compound in nostic and Statistical Manual of Mental Disorders
“magic mushrooms” of the genus Psilocybe, (see dsm–iv–tr). Classification serves the pur-
which were used by the Aztecs for religious and pose of organizing symptomatic states and ab-
ceremonial purposes. Psilocybin, first isolated in normal functioning to enhance the treatment of
1958, differs from psilocin only in having an ad- disorders and research aimed at understanding
ditional phosphate group; it is rapidly metabo- causes. Also called psychiatric nosology.
lized in the body and converted to psilocin. Like psychiatric diagnosis the diagnosis of mental
other indolealkylamine hallucinogens (e.g., lsd, disorders as currently based on the dsm–iv–tr.
dmt), psilocin is active at various serotonin re- See clinical diagnosis.
ceptors: Agonism at 5-HT1A and 5-HT2A recep- psychiatric disability chronic loss or impair-
tors in the cerebral cortex of the brain appears to ment of function due to a mental disorder, re-
be responsible for the psychoactive effects of sulting in severe difficulties in meeting the
these drugs. demands of life.
psilocybin n. see psilocin. psychiatric disorder see mental disorder.
psychache n. intense psychological pain that is psychiatric hospital a public or private insti-
sometimes thought to be a risk factor for suicide. tution providing a wide range of diagnostic tech-
psychagogy n. a method of reeducation that niques and treatment to individuals with mental
emphasizes the relationship of the client to the disorders on an inpatient basis. Also called men-
environment, particularly the social environ- tal hospital. See also private mental hospi-
ment. tal; psychiatric unit; public mental hospital.
psychasthenia n. an archaic name for any of psychiatric illness see mental disorder.
the anxiety disorders. It is primarily still in psychiatric nosology see psychiatric clas-
use as an axis on the minnesota multiphasic sification.
personality inventory. psychiatric nursing a specialty within the
psyche n. in psychology, the mind in its totality, field of nursing that provides holistic care to in-
as distinguished from the physical organism. dividuals with mental disorders or behavioral
The term, which earlier had come to refer to the problems so as to promote their physical and P
soul or the very essence of life, derives from the psychosocial well-being. It emphasizes the use
character of Psyche in Greek mythology, a beau- of interpersonal relationships as a therapeutic
tiful princess who, at the behest of her divine agent and considers the environmental factors
lover, Eros, son of Aphrodite, is made immortal that influence mental health. Thus, psychiatric
by Zeus. nurses not only provide physical care but also
psychedelic drug a name for any of the hallu- socialize and communicate with their patients to
cinogens (from Greek, literally: “mind- create a safe, comfortable environment that pro-
manifesting”), proposed in 1956 by Humphry motes positive change and responsible decision
Osmond (1917–2004). Also called psychedelic. making. Their specific responsibilities often
include assisting patients with activities of
psychedelic experience see hallucinogen; daily living, administering psychotropic medi-
hallucinogen intoxication. cation and managing side effects, assisting with
psychedelic therapy the use of hallu- crisis management, observing patients to evalu-
cinogens (or psychedelics; so-called mind- ate their progress, offering guidance and other
expanding or mind-enhancing drugs) in the forms of interpersonal support to patients, par-
treatment of some types of mental or physical ill- ticipating in recreational activities with patients,
ness. lsd was used in the 1950s and 1960s in educating patients and their families about men-
combination with psychotherapy to assist pa- tal health issues and lifestyle choices, and
tients in enhancing their awareness of cognitive conducting group therapy. Registered nurses
and psychological processes; it was also used in wishing to become psychiatric nurses complete
the management of a number of significant con- additional training in pharmacology and the be-
ditions, such as schizophrenia and alcoholism. havioral and social sciences. They practice in a
mdma was similarly used in the 1980s. However, variety of settings—including general and psy-
various studies revealed no lasting benefit; in- chiatric hospitals, nursing homes, assisted-living
deed, some patients claimed to have been facilities, physicians’ offices, correctional facili-
harmed by such treatments. These findings, cou- ties, long-term care centers, community mental
465
psychiatric unit
health centers, rehabilitation centers, and pri- term is also applied to any putative powers,
vate homes (see home care)—in conjunction forces, or faculties associated with such phenom-
with psychiatrists, psychologists, social workers, ena. 3. n. a person with alleged paranormal abili-
and other mental health professionals. Psychiat- ties.
ric nurses are distinct from psychiatric nurse psychic apparatus in psychoanalytic theory,
practitioners, who have obtained master’s or mental structures and mechanisms. Sigmund
doctoral degrees and more advanced training to freud initially (1900) divided these into uncon-
practice privately and perform additional assess- scious, preconscious, and conscious areas or sys-
ment, diagnostic, and therapeutic functions, in- tems and later (1923) into the id, ego, and
cluding conducting individual psychotherapy superego: The id is described as unconscious,
and prescribing medication. Also called mental and the ego and superego as partly conscious,
health nursing. partly preconscious, and partly unconscious.
psychiatric unit a unit of a general hospital or- Also called mental apparatus. See also struc-
ganized for treatment of acutely disturbed psy- tural model; topographic model.
chiatric patients on an inpatient basis. Such psychic blindness see functional blindness.
units usually include provision for emergency
psychic conflict see intrapsychic conflict.
coverage and admission; treatment with psy-
chotropic drugs or electroconvulsive therapy; psychic energizer a drug that has an antide-
group therapy; psychological examinations; and pressant effect. The name, now rarely used, was
adjunctive modalities, such as social work ser- introduced in the late 1950s by U.S. psychiatrist
vices, occupational therapy, art therapy, move- Nathan S. Kline (1916–1983) to identify mono-
ment therapy, music therapy, and discussion amine oxidase inhibitors derived from iproni-
groups. azid, which had been developed for control of
tuberculosis. Iproniazid was discontinued as a
psychiatrist n. a physician who specializes in
tuberculosis drug because of its powerful effects
the diagnosis, treatment, prevention, and study
on the central nervous system.
of mental and emotional disorders. In the
United States, education for this profession con- psychic energy in psychoanalytic theory, the
sists of 4 years of premedical training in college; dynamic force behind all mental processes. Ac-
a 4-year course in medical school, the final 2 cording to Sigmund freud, the basic sources of
years of which are spent in clerkships studying this energy are the instincts or drives that are
with physicians in at least five specialty areas; located in the id and seek immediate gratifica-
and a 4-year residency in a hospital or agency ap- tion according to the pleasure principle. Carl
proved by the American Medical Association. jung also believed that there is a reservoir of psy-
One year of the residency is spent as a hospital chic energy, but he objected to Freud’s emphasis
intern, and the final 3 in psychiatric residency, on the pleasurable gratification of biological in-
learning diagnosis and treatment as well as the stincts and emphasized the means by which this
use of psychiatric medicines and other treatment energy is channeled into the development of the
modes. After completing residency, most psychi- personality and the expression of cultural and
P spiritual values. Also called mental energy. See
atrists take a voluntary examination for certifica-
tion by the American Board of Psychiatry and also libido.
Neurology. psychic healing the treatment of physical or
psychiatry n. the medical specialty concerned mental illness by parapsychological or spiritual-
with the study, diagnosis, treatment, and pre- istic means. See also crystal healing; faith
vention of personality, behavioral, and mental healing.
disorders. As a medical specialty, psychiatry is psychic numbing a posttraumatic symptom
based on the premise that biological causes are at pattern in which the individual feels incapable
the root of mental and emotional problems, al- of emotional expression, love, or closeness to
though some psychiatrists do not adhere exclu- others. See alexithymia.
sively to the biological model and additionally psychic pain intolerable pain caused by intense
treat problems as social and behavioral ills. psychological suffering (rather than organic dys-
Training for psychiatry includes the study of function). At its extreme, prolonged psychic
psychopathology, biochemistry, psychopharma- pain can lead to suicide attempts. See also algo-
cology, neurology, neuropathology, psychology, psychalia.
psychoanalysis, genetics, social science, and
psychic reality the internal reality of fantasies,
community mental health, as well as the many
wishes, fears, dreams, memories, and anticipa-
theories and approaches advanced in the field it-
tions, as distinguished from the external reality
self. —psychiatric adj.
of actual events and experiences.
psychic 1. adj. denoting phenomena associated
psychic resilience see resilience.
with the mind. Ivan pavlov referred to condi-
tioned responses as “psychic reflexes” because psychic seizure a type of complex partial sei-
the idea of the physical stimulus evoked the re- zure marked by psychological disturbances,
flexive response. 2. adj. denoting a class of phe- such as illusions, hallucinations, affective expe-
nomena, such as telepathy and clairvoyance, riences, or cognitive alterations (e.g., déjà vu).
that appear to defy scientific explanation. The psychic suicide a purported form of self-
466
psychobiography
destruction in which the individual decides to Also called Freudian approach; Freudian-
die and actually does so without resorting to a ism. —psychoanalytic adj.
physical agency. See also voodoo death.
psychoanalyst n. a therapist who has under-
psychic tension a sense of emotional strain ex- gone special training in psychoanalytic theory
perienced in emergencies or other situations and practice and who applies the techniques de-
that generate inner conflict or anxiety. See veloped by Sigmund freud to the treatment of
stress; tension. mental disorders. In the United States, psycho-
analysts are usually trained first as psychiatrists
psychic trauma an experience that inflicts or clinical psychologists and then undergo ex-
damage on the psyche, often of a lasting nature. tensive training at a psychoanalytic institute;
Examples are sexual assault and child abuse. See European institutes permit so-called lay analy-
trauma. sis and accept other interested and qualified
psychic vaginismus a painful vaginal spasm professionals for psychoanalytic training. All
that makes intercourse painful and in some cases recognized training centers, however, require a
impossible. The corresponding DSM–IV–TR des- thorough study of the works of Freud and others
ignation is functional vaginismus. in the field, supervised clinical training, a train-
ing analysis, and a personal program of psy-
psychoactive drug a group of drugs that have choanalysis. See also analyst.
significant effects on psychological processes,
such as thinking, perception, and emotion. Psy- psychoanalytic group psychotherapy
choactive drugs include those deliberately taken group therapy in which basic psychoanalytic
to produce an altered state of consciousness concepts and methods, such as free associa-
(e.g., hallucinogens, opioids, inhalants, can- tion, analysis of resistances and defenses, and
nabis) and therapeutic agents designed to ame- dream analysis, are used in modified form. The
liorate a mental condition; these include anti- most prominent exponent of such therapy was
depressants, mood stabilizers, sedatives, British psychoanalyst Wilfred Bion (1897–1979).
hypnotics, and anxiolytics (which are CNS psychoanalytic play technique a method
depressants), and antipsychotics. Psychoac- of child analysis developed by Melanie klein
tive drugs are often referred to as psychotropic during the 1920s, in which play activity is inter-
drugs (or psychotropics) in clinical contexts. preted as symbolic of underlying fantasies and
conflicts and substitutes for free association.
psychoanalysis n. an approach to the mind,
The therapist provides toys for the child and en-
psychological disorders, and psychological treat-
courages free, imaginative play in order to reveal
ment originally developed by Sigmund freud at
the child’s unconscious wishes and conflicts.
the beginning of the 20th century. The hallmark
of psychoanalysis is the assumption that much psychoanalytic psychotherapy therapy
of mental activity is unconscious and, conse- conducted in the form of classical psychoanal-
quently, that understanding people requires in- ysis or in one of the generally shorter forms of
terpreting the unconscious meaning underlying treatment that evolved from the classical form, P
their overt, or manifest, behavior. Psychoanaly- such as psychodynamic psychotherapy. Gen-
sis (often shortened to analysis) focuses primar- erally, it involves a systematic one-on-one inter-
ily, then, on the influence of such unconscious action between a therapist and a client that
forces as repressed impulses, internal conflicts, emphasizes the importance of unconscious mo-
and childhood traumas on the mental life and tives and conflicts as determinants of human
adjustment of the individual. The foundations behavior while helping the client overcome ab-
on which classic psychoanalysis rests are: (a) normal behavior or adjust to the problems of
the concept of infantile sexuality; (b) the life. The use of free association and therapist
oedipus complex; (c) the theory of instincts; interpretation, as well as the development of
(d) the pleasure principle and the reality a therapeutic alliance, are common tech-
principle; (e) the threefold division of the psy- niques.
che into id, ego, and superego; and (f) the
psychoanalytic theory the diverse complex
central importance of anxiety and defense
of assumptions and constructs underlying the
mechanisms in neurotic reactions. Psychoanal-
approach known as psychoanalysis. Clas-
ysis as a form of therapy is directed primarily to
sically—and properly—the term focuses spec-
psychoneuroses, which it seeks to eliminate by
ifically on the formulations of Austrian
bringing about basic modifications in the per-
psychiatrist Sigmund Freud (1856–1939), but it
sonality. This is done by establishing a construc-
may also be taken to include such subsequent
tive therapeutic relationship, or transference,
offshoots and counterapproaches as analytic
with the analyst, which enables him or her to
psychology, individual psychology, object
elicit and interpret the unconscious conflicts
relations theory, and others that are based on
that have produced the neurosis. The specific
psychodynamic theory.
methods used to achieve this goal are free as-
sociation, dream analysis, analysis of resis- psychobiography n. a form of biographical lit-
tances and defenses, and working through erature that offers a psychological profile or
the feelings revealed in the transference process. analysis of an individual’s personality in addi-
467
psychobiological factors
tion to the usual account of his or her life and ex- action. Various special techniques are used to ad-
periences. —psychobiographical adj. vance the therapy, among them role reversal,
psychobiological factors the multiple deter- soliloquy, doubling (see double), and future ex-
minants of personality and behavior—biologi- ploration. See also hypnodrama; sociodrama;
cal, psychological, and sociological—that are theater of spontaneity. [developed in the
cited in the holistic, multidisciplinary approach 1920s by Romanian-born U.S. psychiatrist Jacob
of psychobiology. Levi Moreno (1889–1974)]
psychobiology n. 1. a school of thought in the psychodynamic approach the psychological
mental health professions in which the individ- and psychiatric approach that views human
ual is viewed as a holistic unit and both normal behavior from the standpoint of unconscious
and abnormal behavior are explained in terms motives that mold the personality, influence at-
of the interaction of biological, sociological, titudes, and produce emotional disorder. The
and psychological determinants. Also called psychodynamic approach is interested in affect
ergasiology. [developed by Swiss-born U.S. rather than cognition and rejects introspective
psychiatrist Adolf Meyer (1866–1950)] 2. a rare methods in favor of clinical material as a basis
synonym for biological psychology. —psy- for inference. The emphasis is on tracing behav-
chobiological adj. ior to its origins, as contrasted with the system-
atic approach (see topographic model) and
psychochemistry n. the study of the relation- the nosological approach, which concen-
ships between chemicals, behavior (including trate on overt events, personality characteristics,
the genetic or metabolic aspects of behavior), and symptoms. See psychodynamic psycho-
and psychological processes. therapy.
psychocultural stress psychological tension Psychodynamic Diagnostic Manual (PDM)
or anxiety and, in many cases, mental illness a handbook for the diagnosis and treatment of
generated by cultural and sociocultural fac- mental health disorders that attempts to charac-
tors (e.g., racial discrimination, rapid techno- terize an individual’s personality and the full
logical advance). range of his or her emotional, social, and inter-
psychocutaneous disorder any skin (der- personal functioning. Published in 2006, by a
matological) disorder in which psychological task force of the American Psychoanalytic Asso-
factors are believed to play an important role ciation, the International Psychoanalytic Associ-
(see psychosomatic disorder). In some cases ation, Division 39 (Psychoanalysis) of the
(e.g., hives, psychogenic pruritus) the disor- American Psychological Association, the Ameri-
der appears to be caused or exacerbated by psy- can Academy of Psychoanalysts and the Dy-
chological factors; in others (e.g., acne, psoriasis, namic Psychiatry, and the National Membership
eczema, dermatitis) there is a predisposition to Committee on Psychoanalysis in Clinical Social
the condition, which is precipitated by stress fac- Work, the PDM is meant to serve as a comple-
tors (see diathesis–stress model). ment to the Diagnostic and Statistical Manual of
P psychodiagnosis n. 1. any procedure designed Mental Disorders (see dsm–iv–tr) and the ICD
to discover the underlying factors that account (see international classification of diseases).
for behavior, especially disordered behavior. Although based on current neuroscience and
2. diagnosis of mental disorders through psy- treatment outcome research the classification
chological methods and tests. adapts many concepts from classical psychoan-
alytic psychotherapy. The diagnostic frame-
psychodrama n. a method of psychotherapy in
work describes (a) healthy and disordered
which clients enact their concerns to achieve
personality functioning; (b) individual profiles
new insight about themselves and others. Its
of mental functioning, including patterns of re-
central premise is that spontaneity and creativ-
lating, comprehending, and expressing emo-
ity are crucial for the balanced, integrated per-
tions, coping with stress and anxiety, self-
sonality and that humans are all improvising
observation of emotions and behaviors, and
actors on the stage of life. Clients may role play
forming moral judgments; and (c) symptom pat-
in a variety of scenes either lived or imagined.
terns, including differences in each individual’s
The process involves: (a) a protagonist, the cli-
experience of his or her symptoms.
ent or central figure in the drama; (b) a direc-
tor, or therapist, who guides this process and psychodynamic group psychotherapy
assists the client to alternative enactment and psychodynamic psychotherapy conducted in
interpretation; and (c) auxiliary egos, thera- a group that focuses on insight, with group
peutic actors or stand-ins for absentees, who as- members providing support and modeling for
sist the protagonist in completing his or her gaining awareness of previously disregarded as-
interaction with significant others. When psy- pects of their personality and behavior.
chodrama is used in a group, the members be- psychodynamic psychotherapy those
come therapeutic agents by sharing common forms of psychotherapy, falling within or deriv-
themes or experiences touched on in the drama. ing from the psychoanalytic tradition, that view
It can also be employed as individual treatment, individuals as reacting to unconscious forces
with the protagonist taking the needed roles, (e.g., motivation, drive), that focus on processes
though some therapists become involved in the of change and development, and that place a
468
psychogenic nonepileptic seizure
premium on self-understanding and making sion disorder). In psychology and psychiatry,

meaning of what is unconscious. Most psy- psychogenic disorders are improperly consid-
chodynamic approaches have certain shared fea- ered equivalent to functional disorders.
tures, such as emphasis on dealing with the psychogenic amnesia see dissociative am-
unconscious in treatment, emphasis on the role nesia.
of analyzing transference, and the use of
dream analysis and interpretation. Also called psychogenic cardiovascular disorder any
dynamic psychotherapy. disorder of the heart or circulation that cannot
be accounted for by any identifiable organic dys-
psychodynamics n. 1. any system or perspec-
function or a general medical condition and is
tive emphasizing the development, changes,
thought to be related to psychological factors. It
and interaction of mental and emotional pro-
can include chest pain, racing heart, and tight-
cesses, motivation, and drives. 2. the pattern of
ness in the chest.
motivational forces, conscious or unconscious,
that gives rise to a particular psychological event psychogenic disorder any disorder that can-
or state, such as an attitude, action, symptom, not be accounted for by any identifiable organic
or mental disorder. These forces include drives, dysfunction and is believed to be due to psycho-
wishes, emotions, and defense mechanisms, logical factors, such as emotional conflict or
as well as biological needs (e.g., hunger and sex). stress. Psychogenic disorders include anxiety dis-
—psychodynamic adj. orders, somatoform disorders, personality disor-
psychodynamic theory a constellation of ders, and functional psychoses. In psychology
theories of human functioning that are based on and psychiatry, psychogenic disorders are im-
the interplay of drives and other forces within properly considered equivalent to functional
the person, especially (and originating in) the disorders.
psychoanalytic theories developed by Sigmund psychogenic fugue see dissociative fugue.
freud and his colleagues and successors, such as
psychogenic hallucination a hallucina-
Anna freud, Carl jung, and Melanie klein.
tion arising from psychological factors, such as
Later psychodynamic theories, while retaining
a need to enhance self-esteem or obtain relief
concepts of the interworking of drives and mo-
from a sense of guilt, as opposed to hallucina-
tives to varying degrees, moved toward the con-
tions produced primarily by physiological con-
temporary approach, which emphasizes the
ditions, such as intoxication.
process of change and incorporates inter-
personal and transactional perspectives of per- psychogenic hypersomnia episodes of sleep
sonality development. See psychodynamic or sleep of excessive duration precipitated by
approach; psychodynamics. psychological factors, such as a wish to escape
psychoeducational diagnostician a spe- from a threatening or other anxiety-provoking
cialist trained in the diagnosis and assessment of situation. Also called somnolent detach-
children with learning disabilities. ment. See also hypersomnia.
psychoendocrinology n. the study of the hor- psychogenic mutism loss of speech due to P
monal system in order to discover sites and pro- psychological rather than physical factors. See
cesses that underlie and influence biological, also mutism.
behavioral, and psychological processes. It is psychogenic need in the personology of U.S.
often concerned with identifying biochemical psychologist Henry Alexander Murray (1893–
abnormalities that may play a significant role in 1988), a need that is concerned with emotional
the production of mental disorders. satisfaction as opposed to biological satisfaction.
psychogender n. a less common name for gen- The psychogenic needs defined by Murray in-
der identity or gender self-identity, used to clude the affiliative need (see affiliation), the
distinguish between psychological sex identifi- dominance need, and the seclusion need. Com-
cation and biological sex in the treatment of pare viscerogenic need.
intersexuality and gender identity disor- psychogenic nocturnal polydipsia exces-
der. sive nighttime thirst with a psychological rather
psychogenesis n. 1. the origin and develop- than organic or physical basis. It is most
ment of personality, behavior, and mental and often seen in patients with schizophrenia and is
psychic processes. 2. the origin of a particular recognized as a dangerous and potentially life-
psychic event in an individual. See psycho- threatening disorder, because chronic over-
genic. —psychogenetic adj. consumption of substantial amounts of water
psychogenetics n. the study of the inheritance can fatally damage the body’s fluid balance.
of psychological attributes. —psychogenetic psychogenic nonepileptic seizure (PNES)
adj. a behavioral or emotional manifestation of psy-
psychogenic adj. resulting from mental factors. chological distress, conflict, or trauma that re-
The term is used particularly to denote or refer to sembles an epileptic seizure but is not produced
a disorder that cannot be accounted for by any by abnormal electrical activity in the brain. Most
identifiable organic dysfunction and is believed PNESs are conversion nonepileptic seizures,
to be due to psychological factors (e.g., a conver- but they may also be associated with factitious
469
psychogenic pain disorder
disorder or malingering. Also called psycho- psychological autopsy an analysis that is

genic seizure. conducted following a person’s death in order to
psychogenic pain disorder see pain disor- determine his or her mental state prior to death.
der. Psychological autopsies are often performed
when a death occurs in a complex or ambiguous
psychogenic pruritus a psychosomatic skin
manner and are frequently used to determine if a
disorder characterized by a functional itching
death was the result of natural causes, accident,
that resists treatment. Psychogenic pruritus
homicide, or suicide. Attention is given to the
often occurs in individuals with anxiety, depres-
total course of the individual’s life in order to re-
sion, or obsessive-compulsive disorder.
construct the facts, motivations, and meanings
psychogenic purpura see gardner–diamond associated with the death. [pioneered in the
syndrome. 1970s by psychologists Edwin S. Shneidman and
psychogenic seizure see psychogenic non- Norman L. Farberow and medical examiner The-
epileptic seizure. odore J. Murphy at the Los Angeles Suicide Pre-
psychogenic torticollis see torticollis. vention Center]
psychogenic vertigo an unpleasant, illusory psychological counseling interaction with a
sensation of movement of oneself or the envi- client for the purpose of exploring and, particu-
ronment that cannot be accounted for fully by larly, offering direct advice about affective, cog-
any identifiable neurological or other organic nitive, or behavioral problems and reaching
dysfunction and is thought to be related to psy- solutions. See also counseling psychology.
chological factors. Psychogenic vertigo is com- psychological deficit cognitive, behavioral,
mon in a number of psychological disorders, or emotional performance of any individual at a
including panic disorder, agoraphobia, schizo- level that is significantly below, or less adept
phrenia, and somatoform disorder. than, that of a typical person.
psychography n. 1. the natural history and de- psychological dependence dependence on a
scription of mental phenomena, as in psycho- psychoactive substance for the reinforcement it
analysis. 2. the art of literary characterization of provides. It is signaled by a high rate of drug use,
an individual—real or fictional—making free use drug craving, and the tendency to relapse after
of psychological categories and theories. 3. a cessation of use. Many believe reinforcement is
psychological biography or character descrip- the driving force behind drug addiction, and
tion. See also psychobiography; psycho- that tolerance and physical dependence are
history. related phenomena that sometimes occur but
psychohistory n. the application of psychoana- are probably not central to the development of
lytic theory to the study of historical figures, dependency-inducing patterns of drug use.
events, and movements. Also called historical psychological disorder see mental disor-
psychoanalysis. der; psychopathology.
psycholepsy n. the sudden onset of a major de- psychological distress a set of psychological
P pressive episode, often occurring in the context and physical symptoms of both anxiety and de-
of a bipolar disorder. pression that occur in individuals who do not
psychological abuse see emotional abuse. meet the criteria for any particular psychological
disorder. It is thought to be what is assessed by
psychological anaphylaxis a psychological
many putative self-report measures of depres-
hypersensitivity resulting from a previous dis-
sion. Psychological distress likely reflects normal
turbing or traumatic event. Exposure to circum-
fluctuations of mood in most people but may in-
stances or events that are similar to the one that
dicate the beginning of a major depressive epi-
produced the original sensitivity may result in a
sode in individuals with a history of major
reappearance of the earlier psychological symp-
depressive disorder.
toms.
psychological dysfunction impaired or ab-
psychological assessment the gathering and
normal mental functioning and patterns of be-
integration of data in order to evaluate a person’s
havior.
behavior, abilities, and other characteristics, par-
ticularly for the purposes of making a diagnosis psychological examination examination of
or treatment recommendation. Psychologists as- a patient by means of interviews, observations of
sess diverse psychiatric problems (e.g., anxiety, behavior, and administration of psychological
substance abuse) and nonpsychiatric concerns tests in order to evaluate personality, adjust-
(e.g., intelligence, career interests) across a range ment, abilities, interests, and functioning in
of areas, including clinical, educational, organi- important areas of life. The purpose of the exam-
zational, health, and forensic settings. Assess- ination may be to assess the patient’s needs, dif-
ment data may be gathered through various ficulties, and problems and contribute to the
methods, such as interviews, observation, pro- diagnosis of mental disorder and determination
jective techniques, standardized tests, physio- of the type of treatment required.
logical or psychophysiological measurement psychological factors functional factors—as
devices, or other specialized procedures and ap- opposed to organic (constitutional, hereditary)
paratuses. factors—that contribute to the development of
470
psychology
personality, the maintenance of health and well- als in their typical ways of thinking, affective
being, and the etiology of mental and behavioral responses, and behaviors.
disorder. A few examples of psychological factors psychological rehabilitation the develop-
are the nature of significant childhood and adult ment or restoration of an effective, adaptive
relationships, the experience of ease or stress in identity in an individual with a congenital or
social environments (e.g., school, work), and the acquired physical impairment (e.g., through
experience of trauma. accident, injury, or surgery) through such psy-
psychological factors affecting medical chological approaches as individual or group
condition in DSM–IV–TR, a clinical category, therapy, counseling, ability assessment, and psy-
classified under “Other Conditions,” comprising chopharmacology. The object is to help the indi-
psychological and behavioral factors that ad- vidual to improve or regain his or her self-image,
versely affect the course, treatment, or outcome ability to cope with emotional problems, compe-
of a general medical condition (e.g., by exac- tence, and autonomy.
erbating symptoms or delaying recovery). The psychological resilience see resilience.
factors include mental disorders and psychologi-
psychological time the subjective estimation
cal symptoms (e.g., major depressive disorder,
or experience of time. This is mainly dependent
anxiety), personality traits (e.g., hostile, deny-
upon the processing and interpretation by the
ing), physiological response to stress, and be-
brain of time-related internal or external stimuli
havior patterns detrimental to health (e.g.,
but can be influenced by other factors. In gen-
overeating, excessive alcohol consumption). A
eral, time is experienced as passing more slowly
wide range of medical conditions can be affected
when one is bored or inactive and more rapidly
by psychological factors: cardiovascular, gastro-
when one is engaged in an absorbing activity.
intestinal, neurological, and rheumatological
Certain peak experiences can produce a sense
disorders; cancers and many others.
of time dissolving or being suspended (see time-
psychological field in the social psychology less moment). Drugs and hypnosis can also be
of Kurt lewin, the individual’s life space or en- used to alter the perception of time.
vironment as he or she perceives it at any given psychological treatment various forms of
moment. See also field theory. treatment and psychoeducation—including psy-
psychological intervention see interven- chotherapy, clinical intervention, and behavior
tion. modification, among others—aimed at increas-
psychological kidnapping depriving a pering the client’s adaptive and independent func-
son of the free functioning of his or her personal- tioning. Psychological treatment is the specific
ity. The term is commonly used to describe the purview of trained mental health professionals
psychological mind control attributed to cults. and incorporates a wide array of diverse theories
Compare brainwashing. and techniques for producing healthy and adap-
tive change in a client’s actions, thoughts, and
psychological masquerade a medical condi- feelings. The term is sometimes used in contrast
tion that can present as a psychological disorder. to treatment through the use of medication, P
Examples include epilepsy, multiple sclerosis, although medication is sometimes used as an
Alzheimer’s disease, and brain tumors. adjunct to various forms of psychological treat-
psychological moment 1. the best possible ment (see adjunctive therapy).
moment for producing a particular effect on an- psychological tremor see tremor.
other person or other people, as in He put in his
psychologist n. an individual who is profession-
counteroffer at the psychological moment. 2. the
ally trained in the research, practice, or teaching
lived present as it is experienced. See timeless
(or all three) of one or more branches or sub-
moment.
fields of psychology. Training is obtained at a
psychological need any need that is essential university or a school of professional psychol-
to mental health or that is otherwise not a bio- ogy, leading to a doctoral degree in philosophy
logical necessity. It may be generated entirely in- (PhD), psychology (PsyD), or education (EdD).
ternally, as in the need for pleasure, or it may be Psychologists work in a variety of settings, in-
generated by interactions between the individ- cluding laboratories, schools, colleges, univer-
ual and the environment, as in the need for sities, social agencies, hospitals, clinics, the
social approval, justice, or job satisfaction. Psy- military, industry and business, prisons, the gov-
chological needs comprise the four higher levels ernment, and private practice. The professional
of maslow’s motivational hierarchy. Com- activities of psychologists are also varied but can
pare physiological need. include psychological counseling, health care
psychological rapport 1. Carl jung’s term for services, educational testing and assessment,
transference, which he defined as an intensi- research, teaching, and business and organiza-
fied tie to the analyst that acts as a compensation tional consulting. Formal certification or
for the patient’s defective relationship to his or professional licensing is required in order to
her present reality. Jung saw this as an inevitable practice independently in many of these settings
feature of every analysis. 2. more generally, a and activities.
kind of agreement or affinity between individu- psychology n. 1. the study of the mind and be-
471
psychometrician
havior. Historically, psychology was an area of pulling or rubbing clothing and other objects
philosophy. It is now a diverse scientific disci- and is a common symptom of both major de-
pline comprising several major branches of repressive episodes and manic episodes. Also
search (e.g., experimental psychology, biological called psychomotor excitement.
psychology, cognitive psychology, developmen- psychomotor disorder 1. a disturbance in the
tal psychology, personality, and social psychol- psychological control of movement. 2. a motor
ogy), as well as several subareas of research and disorder precipitated by psychological factors.
applied psychology (e.g., clinical psychology, in- Examples include epileptic seizures brought on
dustrial/organizational psychology, school and by stress, psychomotor retardation associ-
educational psychology, human factors, health ated with depression, and hyperactivity exhib-
psychology, neuropsychology, cross-cultural ited during a manic episode.
psychology). Research in psychology involves
psychomotor excitement see psycho-
observation, experimentation, testing, and anal-
motor agitation.
ysis to explore the biological, cognitive, emo-
tional, personal, and social processes or stimuli psychomotor hallucination the sensation
underlying human and animal behavior. The that parts of the body are being moved to differ-
practice of psychology involves the use of psy- ent areas of the body.
chological knowledge for any of several psychomotor retardation a slowing down
purposes: to understand and treat mental, emo- or inhibition of mental and physical activity,
tional, physical, and social dysfunction; to un- manifest as slow speech with long pauses before
derstand and enhance behavior in various answers, slowness in thinking, and slow body
settings of human activity (e.g., school, work- movements. Psychomotor retardation is a com-
place, courtroom, sports arena, battlefield, etc.); mon symptom of major depressive episodes.
and to improve machine and building design for psychomotor skill any ability (e.g., handwrit-
human use. 2. the supposed collection of behaving, drawing, or driving a car) whose perfor-
iors, traits, attitudes, and so forth that character- mance draws on a combined and coordinated set
ize an individual or a group (e.g., the psychology of cognitive and motor processes.
of women). —psychological adj. psychomotor test a test requiring a coordina-
psychometrician n. an individual who is tion of cognitive and motor activities, as in the
trained to administer psychological tests and in- trail making test.
terpret their results, working under the supervi- psychoneuroendocrinology n. the study of
sion of a licensed psychologist. Also called the relations among psychological factors, the
psychometrist. nervous system, and the endocrine system in
psychometrics n. 1. the psychological theory determining behavior and health. It includes the
and technique (e.g., the science and process) of effects of psychological stress on neuroendo-
mental measurement. 2. the branch of psychol- crine systems (see neuroendocrinology) and
ogy dealing with measurable factors. Also called how changes in these systems affect behavior in
P psychometric psychology; psychometry. normal and psychopathological states.
Psychometric Society a nonprofit profes- psychoneuroimmunology n. the study of
sional organization founded in 1935 to promote how the brain and behavior affect immune re-
the advancement of quantitative measurement sponses. [originated by U.S. psychologist Robert
practices in psychology, education, and the so- Ader (1932–2011)] —psychoneuroimmuno-
cial sciences. It publishes the journal Psycho- logical adj.
metrika. psychoneurosis n. see neurosis.
psychomimetic adj., n. see psychotomimetic. psychonosology n. the systematic classifica-
psychomimic syndrome a condition in tion of mental disorders. See psychiatric clas-
which an individual who lacks organic evidence sification.
of an illness develops symptoms of an illness suf- psychooncology n. the study of psychological,
fered by another person, who may have died behavioral, and psychosocial factors involved in
of the disorder. The symptoms usually occur the risk, detection, course, treatment, and out-
around the anniversary of the death of the other come (in terms of survival) of cancer. The field
person. See also anniversary event; anniver- examines responses to cancer on the part of pa-
sary reaction. tients, families, and caregivers at all stages of the
psychomotility n. a motor action or habit that disease. —psychooncological adj. —psycho-
is influenced or controlled by a mental process oncologist n.
(e.g., a tic, handwriting, gait, stammering, or psychopath n. a former name for an individual
dysarthria), which may be an indicator of with antisocial personality disorder. —psy-
psychomotor disturbance. chopathic adj.
psychomotor adj. relating to movements or psychopathia sexualis the name for sexual
motor effects that result from mental activity. deviance coined by German psychiatrist Rich-
psychomotor agitation restless physical and ard von Krafft-Ebing (1840–1902) and used as
mental activity that is inappropriate for its con- the title of his classic work on the subject, first
text. It includes pacing, hand wringing, and published in 1886.
472
psychosis
psychopathic personality a former name for physiological psychology. —psychophysio-

antisocial personality disorder. logical adj. —psychophysiologist n.
psychopathology n. 1. the scientific study of psychopoetry n. see poetry therapy.
mental disorders, including theory, etiology, psychoscience n. any science that deals with
progression, symptomatology, diagnosis, and the mind and mental behavior, with mental dis-
treatment. This broad field of study may involve eases and disorders, and with their treatment
psychology, biochemistry, pharmacology, psy- and cure. In particular, it refers to psychology,
chiatry, neurology, endocrinology, and other re- psychiatry, and cognitive science.
lated subjects. The term in this sense is
psychosexual adj. relating to or denoting any
sometimes used synonymously with abnormal
aspects of human sexuality that are based on or
psychology. 2. the behavioral or cognitive
influenced by psychological factors, as opposed
manifestations of such disorders. The term in
to genetic, chemical, and other biologically
this sense is sometimes considered synonymous
based (organic) aspects.
with mental disorder itself. —psychopatho-
logical adj. —psychopathologist n. psychosexual development in the classic
psychoanalytic theory of Sigmund freud, the
psychopathy n. 1. a former term for a personal-
step-by-step growth of sexual life as it affects per-
ity trait marked by egocentricity, impulsivity,
sonality development. Freud posited that the
and lack of such emotions as guilt and remorse,
impetus for psychosexual development stems
which is particularly prevalent among repeat of-
from a single energy source, the libido, which is
fenders diagnosed with antisocial personal-
concentrated in different organs throughout in-
ity disorder. 2. formerly, any psychological
fancy and produces the various psychosexual
disorder or mental disease. —psychopathic adj.
stages: the oral stage, anal stage, phallic
psychopharmacological drugs any medica- stage, latency stage, and genital stage.
tions used in the treatment of mental or behav- Each stage gives rise to its own characteristic
ioral disorders. erotic activities (e.g., sucking and biting in the
psychopharmacology n. the study of the oral stage) and the early expressions may lead to
influence of drugs on mental, emotional, and “perverse” activities later in life, such as sadism,
behavioral processes. Psychopharmacology is masochism, voyeurism, and exhibitionism.
concerned primarily with the mode of action Moreover, the different stages leave their mark
of various substances that affect different areas on the individual’s character and personality, es-
of the brain and nervous system, including drugs pecially if sexual development is arrested in a
of abuse. See also clinical psychopharma- fixation at one particular stage. Also called
cology; geriatric psychopharmacology; libidinal development.
pediatric psychopharmacology; preclinical psychosexual disorders in DSM–III, a group
psychopharmacology. —psychopharmaco- of disorders of sexuality stemming from psycho-
logical adj. —psychopharmacologist n. logical rather than organic factors. In DSM–IV–
psychopharmacotherapy n. the use of phar- TR the category of sexual and gender iden- P
macological agents in the treatment of mental tity disorders is used for these problems.
disorders. For example, acute or chronic schizo- psychosexual disorders not elsewhere
phrenia is treated by administration of antipsy- classified in DSM–III, a residual category com-
chotic drugs or other agents. Although such drugs prising psychological sexual disturbances not
do not cure mental disorders, they may—when covered by the specific diagnostic categories. In
used appropriately—produce significant relief DSM–IV–TR this category is termed sexual dis-
from symptoms. orders not otherwise specified.
psychophysics n. a branch of psychology that psychosexual dysfunction in DSM–III, a cat-
studies the relationship between the objective egory of sexual disorders that in DSM–IV–TR is
physical characteristics of a stimulus (e.g., its termed sexual dysfunction.
measured intensity) and the subjective percep- psychosexual stages see psychosexual de-
tion of that stimulus (e.g., its apparent bright- velopment.
ness).
psychosexual trauma a frightening, degrad-
psychophysiological assessment the use of ing, or otherwise traumatic sexual experience in
physiological measures via electroencephalo- earlier life that is related to current emotional
graphy, electrocardiography, electromyography, problems. Examples include incest or other
and electrooculography to infer psychological forms of child sexual abuse, sexual assault,
processes and emotion. Also called psycho- and date rape.
physiological monitoring.
psychosis n. 1. an abnormal mental state involv-
psychophysiological monitoring see ing significant problems with reality testing
psychophysiological assessment. and characterized by serious impairments or dis-
psychophysiology n. the study of the relation ruptions in the most fundamental higher brain
between the chemical and physical functions of functions—perception, cognition and cognitive
organisms (physiology) and cognitive processes, processing, and emotions or affect—as mani-
emotions, and behavior (psychology). Also called fested in behavioral phenomena, such as delu-
473
psychosis with mental retardation
sions, hallucinations, and significantly disorgan- psychosomatic adj. characterizing an approach

ized speech. See psychotic disorder. 2. histori- based on the belief that the mind (psyche) plays
cally, any severe mental disorder that signifi- a role in all the diseases affecting the various
cantly interferes with functioning and ability to bodily systems (soma).
perform activities essential to daily living. psychosomatic disorder a type of disorder in
psychosis with mental retardation epi- which psychological factors are believed to play
sodes of excitement, depression, hallucinations, an important role in the origin or course (or
or paranoia that occur occasionally in people both) of the disease. See also psychological
with mental retardation. Such episodes are usu- factors affecting medical condition.
ally mild and may recur, either regularly or un- psychosomatic medicine a field of study that
predictably. They must be distinguished from emphasizes the role of psychological factors in
emotional or behavioral characteristics consis- causing and treating disease.
tent with the intellectual, social, and develop-
psychostimulant n. see cns stimulant.
mental status of the person.
psychosurgery n. the treatment of a mental dis-
psychosocial adj. describing the intersection
order by surgical removal or destruction of selec-
and interaction of social and cultural influences
tive brain areas. The most well-known example
on mental health, personality development, and
of psychosurgery is prefrontal lobotomy, his-
behavior.
torically used particularly for schizophrenia but
psychosocial deprivation lack of adequate also a variety of other disorders. Psychosurgery
opportunity for social and intellectual stimula- was most popular from 1935 to 1960 and is
tion. It may be a significant factor in emotional among the most controversial of all psychiatric
disturbance and delayed mental development treatments ever introduced. Contemporary psy-
or mental retardation in children. Also called chosurgery approaches (e.g., cingulotomy) are
sociocultural deprivation. See pseudo- far more precisely targeted and confined in ex-
retardation. tent than the early techniques, employing high-
psychosocial factors social, cultural, and en- tech imaging and a variety of highly controllable
vironmental phenomena and influences that af- methods of producing minute lesions. Addi-
fect the mental health and behavior of the tionally, they are used only as a last resort and only
individual and of groups. Such influences infor a handful of specific psychiatric disorders—
clude social situations, relationships, and pres- major depressive disorder, bipolar disorder,
sures, such as competition for and access to obsessive-compulsive disorder, and general-
education, health care, and other social re- ized anxiety disorder—that have been resistant
sources; rapid technological change; work dead- to other available therapies.
lines; and changes in the roles and status of psychosynthesis n. in psychoanalysis, an at-
women and minority groups. tempt to unify the various components of the
psychosocial mental retardation (psycho- unconscious, such as dreams, fantasies, and in-
social mental developmental delay) see stinctual strivings, with the rest of the personal-
P pseudoretardation. ity. This “constructive approach” was advocated
psychosocial rehabilitation the process of by Carl jung, who contrasted it with what he
restoring normal psychological, behavioral, and saw as Sigmund freud’s “reductive approach.”
social skills to individuals after mental illness, —psychosynthetic adj.
often with assistance from specialized profes- psychotechnics n. 1. the practical application
sionals using focused programs and techniques. of psychological principles, as in economics, so-
It aims to help individuals who have been resid- ciology, and business. 2. the application of psy-
ing in mental institutions or other facilities (e.g., chological principles to alter or control behavior
prisons) to reenter the community. of an individual.
psychosocial stressor a life situation that cre- psychotherapeutic process whatever occurs
ates an unusual or intense level of stress that between and within the client and psychothera-
may contribute to the development or aggrava- pist during the course of psychotherapy. This in-
tion of mental disorder, illness, or maladaptive cludes the experiences, attitudes, emotions, and
behavior. Examples of psychosocial stressors in- behavior of both client and therapist, as well as
clude divorce, the death of a child, prolonged ill- the dynamic, or interaction, between them. See
ness, unwanted change of residence, a natural also process research.
catastrophe, or a highly competitive work situa- psychotherapy n. any psychological service
tion. provided by a trained professional that primarily
psychosocial therapy psychological treat- uses forms of communication and interaction to
ment with a strong emphasis on interpersonal assess, diagnose, and treat dsyfunctional emo-
aspects of problem situations, which is designed tional reactions, ways of thinking, and behavior
to help an individual with emotional or behav- patterns of an individual, family (see family
ioral disturbances adjust to situations that re- therapy), or group (see group therapy). There
quire social interaction with other members of are many types of psychotherapy, but generally
the family, work group, community, or any they fall into four major categories: psycho-
other social unit. dynamic psychotherapy, cognitive therapy
474
public health approach
or behavior therapy, humanistic therapy, major depressive episode, manic episode, or

and integrative psychotherapy. The psycho- mixed episode. See mood-congruent psy-
therapist is an individual who has been profes- chotic features; mood-incongruent psy-
sionally trained and licensed (in the United chotic features.
States by a state board) to treat mental, emo- psychoticism n. a dimension of personality in
tional, and behavioral disorders by psychologi- eysenck’s typology characterized by aggres-
cal means. He or she may be a clinical sion, impulsivity, aloofness, and antisocial be-
psychologist (see clinical psychology), psy- havior, indicating a susceptibility to psychosis
chiatrist, counselor (see counseling psy- and psychopathic disorders (see antisocial
chology), social worker, or psychiatric nurse. personality disorder). It was originally devel-
Also called therapy; talk therapy. —psycho- oped as a factor for distinguishing between nor-
therapeutic adj. mal individuals and those with schizophrenia or
psychotherapy by reciprocal inhibition bipolar disorders, using tests of judgment of spa-
a type of behavior therapy in which emphasis tial distance, reading speed, level of proficiency
is placed on the weakening of the bond between in mirror drawing, and adding rows of numbers.
anxiety responses and anxiety-provoking stim- psychotic mannerism a frequently repeated
uli by conditioning the anxiety-provoking re- complex movement that appears to be related to
sponse to an incompatible response, such as or affected by psychosis (e.g., hand wringing,
muscle relaxation. See reciprocal inhibition; stroking one’s hair).
systematic desensitization.
psychotogenic 1. adj. describing a drug-
psychotherapy integration see integra- induced state resembling psychosis, marked,
tive psychotherapy. for example, by sensory illusions or distortions,
psychotherapy matching see matching pa- hallucinations, delusions, and behavioral and
tients. emotional disturbances. 2. n. an agent, such as a
hallucinogen, that induces such a state. Also
psychotherapy research the use of scientific
called psychotogen.
methods to describe, explain, and evaluate psy-
chotherapy techniques, processes, and effective- psychotomimetic 1. adj. tending to induce
ness. hallucinations, delusions, or other symptoms of
psychosis. 2. n. one of a group of drugs originally
psychotic adj. of, relating to, or affected by psy-
used in laboratory experiments to determine if
chosis or a psychotic disorder.
they could induce psychoses, or states mimick-
psychotic disorder any one of a number of se- ing psychoses, on the basis of their effects. The
vere mental disorders, regardless of etiology, group includes lsd and amphetamines. Also
characterized by gross impairment in reality called psychomimetic.
testing. The accuracy of perceptions and
psychotoxic adj. denoting or relating to agents
thoughts is incorrectly evaluated, and incorrect
that cause brain damage, such as excess alcohol,
inferences are made about external reality, even
certain drugs and heavy metals, volatile sol- P
in the face of contrary evidence. Specific symp-
vents, and pesticides.
toms indicative of psychotic disorders are
delusions, hallucinations, and markedly disorga- psychotropic drug see psychoactive drug.
nized speech, thought, or behavior; individuals PT abbreviation for physical therapy.
may have little or no insight into their symp- PTSD abbreviation for posttraumatic stress
toms. In DSM–IV–TR, the psychotic disorders in- disorder.
clude schizophrenia, schizophreniform
disorder, schizoaffective disorder, delu- puberty n. the stage of development when the
sional disorder, brief psychotic disorder, genital organs reach maturity and secondary sex
shared psychotic disorder, psychotic disor- characteristics begin to appear, signaling the
der due to a general medical condition, sub- start of adolescence. It is marked by ejacula-
stance-induced psychotic disorder, and tion of sperm in the male, onset of menstruation
psychotic disorder not otherwise specified. and development of breasts in the female, and,
in both males and females, growth of pubic hair
psychotic disorder not otherwise speci- and increasing sexual interest. See also preco-
fied in DSM–IV–TR, a category that includes dis- cious puberty; persistent puberism. —pu-
orders with psychotic symptoms (e.g., delusions, bertal adj.
hallucinations, disorganized speech or behavior)
that do not meet the criteria for any specific psy- public health approach a community-based
chotic disorder. An example is postpartum psy- approach to mental and physical health in
chosis. which agencies and organizations focus on en-
hancing and maintaining the well-being of indi-
psychotic episode a period during which an viduals by ensuring the existence of the
individual exhibits psychotic symptoms, such conditions necessary for them to lead healthy
as hallucinations, delusions, and disorganized lives. The approach involves such activities as
speech. See also acute psychotic episode. monitoring community health status; identify-
psychotic features in mood disorders, delu- ing and investigating health problems and
sions or hallucinations that occur during a threats to community health; ensuring the com-
475
public health nurse
petency of health care providers and personnel; puer aeternus the archetype of eternal youth.
disseminating accurate information and educat- [Latin, “eternal boy”; introduced by Carl jung]
ing individuals about health issues; developing, puerilism n. immature, childish behavior.
modifying, and enforcing policies and other reg-
ulatory measures that support community puerperal disorder a medical or psychological
health and safety; and ensuring the accessibility disorder occurring in a woman during the
of quality health services. The approach involves puerperium, which extends from the termina-
various levels of disease and disorder prevention tion of labor to the return of the uterus to its nor-
(primary, secondary, tertiary), the expansion mal condition. Puerperal disorders include
and appropriate use of the scientific knowledge psychotic and depressive reactions and, oc-
base, and the development and utilization of casionally, manic episodes or delirious states
partnerships within and among communities. precipitated by biological, psychosocial, or envi-
ronmental factors. See postpartum depres-
public health nurse a registered nurse or sion; postpartum emotional disturbance;
nurse practitioner who has received addi- postpartum psychosis.
tional training in social and public health sci-
ences and services. Public health nurses are Puerto Rican syndrome see mal de pelea.
usually employed by government health depart- pull model a psychological theory emphasizing
ments and engaged in educational, informa- how positive experience draws a person to estab-
tional, and preventive activities. lish meaning or to set goals. Compare push
public health services 1. services intended to model.
protect and improve community health. 2. in puppetry therapy the use of puppets as a pro-
some countries, health services provided by the jective form of play therapy. See also projec-
state and financed mainly by general taxation. tive play.
public mental hospital a hospital for pa- pure consciousness awareness without con-
tients with mental disorders that is organized tent.
and run by the state, the county, or the U.S. De- pure microcephaly a condition marked by an
partment of Veterans Affairs. Compare private abnormally small cranium (see microcephaly)
mental hospital. in the absence of other congenital anomalies. Af-
public residential facility any residential fected individuals usually have a face of normal
setting directly operated by state or local govern- size and show mental retardation. They may be
ment. Although generally referring to large insti- smaller than average in height and in many
tutions, such as developmental centers (formerly cases are affected by spasticity of the limbs.
called training schools or state schools), the Compare primary microcephaly.
number of smaller residential settings, such as
purging n. the activity of expelling food that has
community residences, that are publicly oper-
just been ingested, usually by vomiting or the
ated now greatly exceeds the number of remain-
use of laxatives. Purging often occurs in conjunc-
ing large public facilities.
P tion with an eating binge in anorexia nervosa
public self information about the self, or an in- or bulimia nervosa; its purpose is to eliminate
tegrated view of the self, that is conveyed to oth- or reduce real or imagined weight gain.
ers in actions, self-descriptions, appearance, and
social interactions. An individual’s public self
purpose n. 1. the reason for which something is
done or for which something exists. 2. a mental
will vary with the people who constitute the tar-
goal or aim that directs a person’s actions or be-
get or audience of such impressions. The public
havior. 3. persistence or resolution in pursuing
self is often contrasted with the private self.
such a goal.
See also collective self; social self.
public self-consciousness see self-con- purposeful behavior behavior with a specific
sciousness. goal, as opposed to aimless or random behavior.
See goal-directed behavior.
public service psychology an area of psy-
chology defined by the activities of psycholo- purpose in life (PIL) the internal, mental sense
gists employed by public sector agencies (e.g., in of a goal or aim in the process of living or in ex-
community mental health centers, state hospi- istence itself. This concept is of special signifi-
tals, correctional facilities, police and public cance in existential psychotherapy, in which
safety agencies) and the psychological condition it is considered to be central to the development
of people served by these agencies. Particular in- and treatment of anxiety, depression, and re-
terests include advocacy, access to services, edu- lated emotional states. Having a clear purpose in
cation and training, public policy formulation, life reduces negative states.
research and program evaluation, and preven- purposeless hyperactivity a symptom of cer-
tion efforts. tain brain or mental disorders characterized by
public-speaking anxiety fear of giving a prolonged periods of excessive activity that has
speech or presentation in public in the expecta- no purpose.
tion of being negatively evaluated or humiliated purposive accident an apparent accident that
by others. This is a common fear, associated with in fact was caused deliberately. It may have been
social phobia. motivated by psychological factors, such as un-
476
pyromania
acknowledged wishes or needs. Also called in- Greek mythology, in which Pygmalion fell in
tentional accident. See parapraxis. love with a statue of Aphrodite that he had
push model a psychological theory emphasiz- sculpted.
ing how negative experience impels a person to pyknodysostosis n. see pycnodysostosis.
establish meaning or to set goals. Compare pull pyridostigmine n. an anticholinesterase (see
model. anticholinergic drug) used in the treatment
putamen n. a part of the lenticular nucleus in of myasthenia gravis. U.S. trade name (among
the basal ganglia of the brain. It receives input others): Mestinon.
from the motor cortex and is involved in control pyrolagnia n. the arousal of sexual excitement
of movements. by large fires or conflagrations. Also called
p-value n. see significance level. erotic pyromania.
PVS abbreviation for persistent vegetative pyromania n. an impulse-control disorder
state. characterized by (a) repeated failure to resist
impulses to set fires and watch them burn,
PWS abbreviation for prader–willi syndrome. without monetary, social, political, or other
pycnodysostosis (pyknodysostosis) n. an motivations; (b) an extreme interest in fire and
autosomal recessive syndrome characterized by things associated with fire; and (c) a sense of in-
dense but defective bones, open skull sutures, creased tension before starting the fire and in-
and short stature. Affected individuals rarely tense pleasure, gratification, or release while
reach an adult height of 5 ft (1.5 m), and about committing the act. In DSM–IV–TR pyromania
20% are likely to show mental retardation. is included in the category impulse-control
pygmalionism n. the act of falling in love with disorders not elsewhere classified. An older
one’s own creation. The term is derived from name is incendiarism.
477
Qq
QALYs acronym for quality adjusted life qualitative data can often be expressed
years. quantitatively through a coding process. See
qat n. see khat. qualitative research.
Q data questionnaire data: information about an qualitative research a method of research
individual gathered from the observations, judg- that produces descriptive (nonnumerical) data,
ments, and evaluations of that person as pro- such as observations of behavior or personal ac-
vided via subjective self-report inventories—and counts of experiences. The goal of gathering this
therefore also known as S data (self data)—or qualitative data is to examine how individu-
questionnaires. See also l data; o data; t data. als can perceive the world from different vantage
points. A variety of techniques are subsumed
qi n. see chi. under qualitative research, including content
qigong n. a Chinese health maintenance and analyses of narratives, in-depth interviews, focus
self-healing practice that consists of coordina- groups, and case studies, often conducted in
tion of specific breathing patterns with a variety naturalistic settings. Also called qualitative
of postures and body movements. Various forms design; qualitative inquiry; qualitative
are often taught as an auxiliary to Chinese mar- method; qualitative study.
tial arts.
quality adjusted life years (QALYs) a mea-
Q sort a data-collection procedure, often used in sure that combines the quantity of life, ex-
personality measurement, in which a participant pressed in terms of survival or life expectancy,
or independent rater sorts a broad set of stimuli with the quality of life. The value of a year of per-
into categories using a specific instruction set. fect health is taken as 1; a year of ill health is
The stimuli are often short descriptive state- worth less than 1; death is taken as 0. The mea-
ments (e.g., of personal traits) printed on cards. sure provides a method to assess the benefits to
Examples of the instruction set are: “describe be gained from medical procedures and inter-
yourself”; “describe this child”; “describe your ventions.
friend.” In the classic Q sort, raters are con-
quality assurance in health administration or
strained to use a predetermined number of stim-
other areas of service delivery, a systematic pro-
uli in each category.
cess that is used to monitor and provide continu-
Quaalude n. see methaqualone. ous improvement in the quality of health care
quack 1. n. an unqualified person who makes services. It involves not only evaluating the ser-
false claims about, or misrepresents his or her vices in terms of effectiveness, appropriateness,
ability or credentials in, medical diagnosis and and acceptability, but also offering feedback and
treatment. 2. adj. describing a treatment for which implementing solutions to correct any identified
false or exaggerated claims are made. —quack- deficiencies and assessing the results.
ery n. quality of care the extent to which health ser-
quadrangular therapy marital therapy in- vices are consistent with professional standards
volving the married couple and each spouse’s and increase the likelihood of desired outcomes.
individual therapist working together (see cou- quality of life the extent to which a person ob-
ples therapy). Each spouse may meet with his tains satisfaction from life. The following are im-
or her therapist separately and then come to- portant for a good quality of life: emotional,
gether as a group. material, and physical well-being; engagement
quale n. (pl. qualia) 1. the characteristic or qual- in interpersonal relations; opportunities for per-
ity that determines the nature of a mental expe- sonal (e.g., skill) development; exercising rights
rience (sensation or perception) and makes it and making self-determining lifestyle choices;
distinguishable from other such experiences, so and participation in society. Enhancing quality
that (for example) the experiencer differentiates of life is a particular concern for those with
between the sensations of heat and cold. 2. the chronic disease or developmental and other dis-
phenomenal, conscious state or feeling specific abilities and for those undergoing medical or
to each emotion. The ineffable phenomenal states psychological treatment.
of anger, happiness, fear, sadness, and so on are quantitative approach Sigmund freud’s
qualia of affect. theory that mental processes, such as tensions,
qualitative data data that are not expressed obsessions, pleasure, and unpleasure, differ in
numerically, such as descriptions of behavior, the quantity as well as quality of psychic en-
thoughts, attitudes, and experiences. If desired, ergy associated with them. Even though the
478
quetiapine
amounts cannot be measured as exactly as in the of the ego: feeling, thinking, intuiting, and sen-
physical sciences, they nevertheless are posited sing (see functional types). For Jung, the
to exist: For example, the amount of tension ex- quaternity is an archetype exemplified in myr-
isting in the psyche at one time can be compared iad ways, such as the four points of the compass
with the amount at another time. See also eco- and the four points of the cross.
nomic model. quazepam n. a benzodiazepine used as a hyp-
quantitative data data expressed numerically, notic agent. It is of medium potency and is
such as test scores or measurements of length or highly lipid soluble, enabling rapid penetration
width. These data may or may not have a real of the blood–brain barrier resulting in rapid
zero but they have order and often equal inter- onset of effects. Because its metabolic products
vals. Compare qualitative data. are eliminated slowly, quazepam may accumu-
late in the body, leading to unwanted daytime
quantitative genetics the field of genetics sedation. U.S. trade name: Doral.
that studies traits that differ in degree rather
than in kind. queer adj., n. controversial slang, in the main pe-
jorative, referring (in both the adjectival and
quantitative research a method of research noun senses) to gays and lesbians or relating to
that relies on measuring variables using a nu- same-sex sexual orientation. The original and
merical system, analyzing these measurements still common use of the word, to describe any-
using any of a variety of statistical models, and thing that is unusual in an odd or strange way,
reporting relationships and associations among was extended to refer to gays in the late 19th and
the studied variables. For example, these vari- throughout much of the 20th century, when it
ables may be test scores or measurements of re- acquired a predominantly negative, derogatory
action time. The goal of gathering this quanti- connotation. During the late 1960s and onward
tative data is to understand, describe, and pre- (see sexual revolution), it was appropriated
dict the nature of a phenomenon, particularly by some members within the gay community as
through the development of models and theo- a term of identification that carried no negative
ries. Quantitative research techniques include connotation and, indeed, took on the role of a
experiments and surveys. Also called quantita- label of pride and self-respect. This usage is not
tive design; quantitative method. embraced, however, by all members of the gay
quasi-experimental research research in community.
which the investigator cannot randomly assign querulent adj. quarrelsome, complaining,
units or participants to conditions, cannot gen- irritable, and suspicious. These qualities are fre-
erally control or manipulate the independent quently associated with a paranoid state and a
variable, and cannot limit the influence of tendency toward litigiousness. See also liti-
extraneous variables. field research typically gious paranoia.
takes the form of quasi-experimental research. quetiapine n. an atypical antipsychotic
Examples of such research are studies that inves-
used for the management of psychosis and
tigate the responses of large groups to natural di-
schizophrenia. Like the conventional antipsy-
sasters or widespread changes in social policy.
chotics, its therapeutic effects are in part related
Also called nonexperimental research; non-
to its ability to block D2 dopamine receptors (see Q
randomized research.
dopamine-receptor antagonists); however, it
quasineed in the social psychology of Kurt differs from the older agents in its ability to
lewin, a tension state that initiates goal-directed also block 5-HT2 serotonin receptors. Seda-
activity with an origin in intent or purpose tion is a common adverse effect; thyroid dys-
rather than a biological deficit. function, weight gain, and electrocardio-
quaternity n. Carl jung’s fourfold concept of graphic effects are more rarely observed. U.S.
personality, in which there are four functions trade name: Seroquel.
479
Rr
racial memory thought patterns, feelings, and stimuli. See behavior analysis; descriptive
traces of experiences held to be transmitted from behaviorism.
generation to generation and to have a basic in- radical psychiatry a variant of radical ther-
fluence on individual minds and behavior. Carl apy proposing that the psychological problems
jung and Sigmund freud both embraced the of individuals are the result of their victimiza-
concept of a phylogenetic heritage (see phylog- tion by the social, economic, and political sys-
eny), but focused on different examples. Freud tem in which they live. As such, it is the system,
cited religious rituals designed to relieve feelings not the individual, that should be the target of
of anxiety and guilt, which he explained in intervention and change. This view was most se-
terms of the oedipus complex and his primal- riously considered during the 1970s and 1980s.
horde theory. Jung cited images, symbols, and
personifications that spontaneously appear in radical therapy any clinical intervention that
different cultures, which he explained in terms focuses on the harmful psychological effects of
of the archetypes of the collective uncon- social problems on individuals and that encour-
scious. Also called racial unconscious. ages individuals to help themselves by changing
society. This approach was actively advanced by
racial unconscious see racial memory. some psychologists in the 1970s and 1980s.
radiation n. 1. energy transmitted in the form rage n. intense, typically uncontrolled anger. It is
of waves, such as electromagnetic radiation (e.g., usually differentiated from hostility in that it
heat, light, microwaves, short radio waves, ultra- is not necessarily accompanied by destructive
violet rays, or X-rays), or in the form of a stream actions but rather by excessive expressions. In
of nuclear particles (e.g., alpha particles, beta animals, rage appears to be a late stage of ag-
particles, gamma rays, electrons, neutrons, or gression when normal deterrents to physical
protons). Such waves or particles are used for di- attack, such as submissive signals, are no longer
agnostic, therapeutic, or experimental purposes effective. It generally includes rapid respiration;
(see radiation therapy). 2. in neuroscience, thrusting and jerking of limbs; and clawing, bit-
the spread of excitation to adjacent neurons. ing, and snarling.
radiation therapy the use of radiation (e.g., rage disorder any disturbance characterized by
X-rays) in the treatment of diseases. Radiother- one or more episodes of extreme anger and ag-
apy is used mainly in the destruction of cancer gression, such as incidents of road rage, or any
cells by implanting radioactive isotopes in the clinical disorder in which episodes of rage are a
body of the patient or delivering a known dose primary symptom, such as intermittent explo-
of radiation to a specific tissue area. Side effects sive disorder.
may include fatigue, soreness and redness of the
irradiated area, nausea and vomiting, loss of ap- random adj. without order or predictability.
petite, and a decreased white blood cell count. random assignment see randomize.
Also called radiotherapy.
random error an error due to chance alone.
radical behaviorism the view that behavior, Random errors are nonsystematic (occurring ar-
rather than consciousness and its contents, bitrarily) and they are generally assumed to form
should be the proper topic for study in psycho- a normal distribution around a true score.
logical science. This term is often used to distin- Also called variable error. See also absolute
guish classical behaviorism, as originally error; constant error.
formulated in 1913 by John B. watson, from
randomize vb. to assign participants or other
more moderate forms of neobehaviorism.
sampling units to the conditions of an experi-
However, it has evolved to denote as well the
ment at random, that is, in such a way that each
form of behaviorism later proposed by B. F. skin-
participant or sampling unit has an equal chance
ner, which emphasized the importance of rein-
of being assigned to any particular condition.
forcement and its relationship to behavior (i.e.,
—randomization n.
the environmental determinants of behavior).
Skinner conceded the existence of private randomized clinical trial an experimental
events, such as thinking, feeling, and imagining, design in which patients are randomly assigned
but believed them to be irrelevant, viewing them to either a group that will receive an experi-
not as causes of behavior but as more behavior in mental treatment or one that will receive a com-
need of explanation or as private stimuli that parison treatment or placebo. There may be
function according to the same laws as public multiple experimental and comparison groups,
480
ratio data
but each patient is assigned to only a single posttraumatic stress disorder (PTSD) expe-
group. rienced by an individual who has been sexually
random observation any observation that is assaulted (the term was coined prior to the wide
made spontaneously or by chance, is uncon- acceptance and use of the more inclusive con-
trolled, or is not part of a schedule or pattern of cept of PTSD). The symptoms, which may in-
organized observation. clude fear of being alone, phobic attitudes
toward sex, vaginismus, male impotence, or re-
random sampling a process for selecting indi-
peated washing of the body, may persist for a
viduals for a study from a larger potential group
year or more after the rape. They may be aggra-
of individuals in such a way that each is selected
vated by an attitude of others that the victim
with a fixed probability of inclusion. This se-
“invited” rape by dressing in a certain way or
lected group of individuals is called a random
other behavior.
sample.
rapid cycling mood disturbance that fluctuates
random selection the procedure used for ran-
over a short period, most commonly between
dom sampling.
manic and depressive symptoms. A rapid-
random variable a variable whose value de- cycling bipolar disorder is characterized by
pends upon the outcome of chance. Also called four or more mood episodes over a 12-month pe-
stochastic variable. riod; the episodes must be separated by symp-
range n. in statistics, a measure of dispersion, tom-free periods of at least 2 months or must
obtained by subtracting the lowest score from be delimited by switching to an episode of oppo-
the highest score in a distribution. site polarity (e.g., a major depressive episode
rank 1. n. a particular position along an ordered switches to a manic, mixed, or hypomanic epi-
continuum. See rank order. 2. vb. to arrange sode).
items in a graded order, for example, from high- rapid eye movement (REM) the rapid, jerky,
est to lowest value. but coordinated movement of the eyes behind
rank correlation coefficient a numerical closed lids, observed during dreaming sleep. See
index reflecting the degree of relationship be- dream state; rem sleep.
tween two variables that have each been ar- rapid neuroleptization see megadose
ranged in ascending or descending order of pharmacotherapy.
magnitude (i.e., ranked). It is an assessment not rapid sequential visual presentation
of the association between the actual values of (RSVP) in psychophysical testing, a methodol-
the variables but rather of the association be- ogy in which a series of visual stimuli, such as
tween their rankings. Among the most com- shapes or words, are presented in a very short
monly used is the Spearman rank correlation time span, often just a few milliseconds per item.
coefficient (Spearman’s rho, symbolized by ρ),
appropriate when the variables being compared rapport n. a warm, relaxed relationship of
do not follow the normal distribution. Also mutual understanding, acceptance, and sympa-
called rank order correlation coefficient. thetic compatibility between or among indi-
viduals. The establishment of rapport with the
Rankian therapy see will therapy. client in psychotherapy is frequently a signifi-
rank order the arrangement of a series of items cant mediate goal for the therapist in order to fa-
(e.g., scores or individuals) in order of magni- cilitate and deepen the therapeutic experience
tude. and promote optimal progress and improve- R
rape n. the nonconsensual oral, anal, or vaginal ment in the client.
penetration of an individual by another person rapprochement n. 1. generally, a state of cor-
with a part of the body or an object, using force dial relations between individuals or groups. 2.
or threats of bodily harm, or by taking advantage in the theory of separation–individuation of
of someone incapable of giving consent. U.S. Austrian child psychoanalyst Margaret Mahler
laws defining rape vary by state, but in contrast (1897–1985), the phase, after about 18 months
to older definitions the crime of rape is no longer of age, in which the child makes active ap-
limited to female victims, to vaginal penetration proaches to the mother. This contrasts with the
alone, or to forcible situations only, and the ex- preceding stage in which the child was relatively
clusion of spouses as possible perpetrators of oblivious to the mother.
rape has been dropped.
ratio data numerical values that indicate mag-
rape counseling provision of guidance and nitude and have a true, meaningful zero point.
support for victims of rape and sexual assault. Ratio data represent exact quantities of the vari-
Rape crisis centers offer expert counseling for ables under consideration, and when arranged
the psychological trauma that individuals typi- consecutively have equal differences among ad-
cally experience following a sexual attack; both jacent values (regardless of the specific values se-
the affected individuals and their families are lected) that correspond to genuine differences
counseled. Community education and preven- between the physical quantities being measured.
tion outreach programs are increasingly part of Income provides an example: the difference be-
the purview of this area of counseling. tween an income of $40,000 and $50,000 is the
rape-trauma syndrome the symptoms of same as the difference between $110,000 and
481
ratio IQ
$120,000, and an income of $0 indicates a com- psychotherapy, rationalization is considered

plete and genuine absence of earnings. Ratio counterproductive to deep exploration and con-
data are continuous in nature (i.e., able to take frontation of the client’s thoughts and feelings
on any of an infinite variety of amounts) and of and of how they affect behavior. —rationalize
the highest measurement level, surpassing nom- vb.
inal data, ordinal data, and interval data rationally suicidal having suicidal idea-
in precision and complexity. tion or intent that could be considered an un-
ratio IQ iq as determined by the ratio of mental derstandable response to an untenable situation.
age to chronological age, multiplied by 100. rational psychotherapy see rational emo-
Compare deviation iq. tive behavior therapy.
rational adj. 1. pertaining to reasoning or, rational type in the analytic psychology of
more broadly, to higher thought processes. 2. Carl jung, one of the two major categories of
based on, in accordance with, or justifiable by functional type: It comprises the thinking
accepted principles of reasoning or logic. Com- type and the feeling type. Compare irratio-
pare irrational. 3. capable of or exhibiting rea- nal type.
son. 4. influenced by reasoning rather than by
emotion. —rationally adv. ratio scale a measurement scale having a true
zero (i.e., zero on the scale indicates an absence
rational emotive behavior therapy of the measured attribute) and a constant ratio of
(REBT) a form of cognitive behavior ther- values. Thus, on a ratio scale an increase from 3
apy based on the concept that an individual’s ir- to 4 (for example) is the same as an increase from
rational or self-defeating beliefs and feelings 7 to 8. The existence of a true zero point is what
influence and cause his or her undesirable be- distinguishes a ratio scale from an interval
haviors and damaging self-concept. Originally scale.
called rational emotive therapy (RET), it became
known as rational emotive behavior therapy Rat Man a landmark case of Sigmund freud’s,
during the 1990s. The therapy teaches the indi- which he described in “Notes Upon a Case of
vidual, through a variety of cognitive, emotive, Obsessional Neurosis” (1909). The name was ap-
and behavioral techniques, to modify and re- plied to a patient of Freud’s, a 30-year-old lawyer
place self-defeating thoughts to achieve new and whose obsessional fear of rats was traced to re-
more effective ways of feeling and behaving. In pressed death wishes toward his father generated
the process of the therapy, the irrational beliefs by oedipal conflicts. One example of the pa-
and feelings are first unmasked then altered by tient’s obsession was his belief that a rat that ap-
(a) showing how the beliefs and feelings produce peared to come out of his father’s grave had
the individual’s problems and (b) indicating eaten the corpse; another was a fantasy that a rat
how they can be changed through behavior had been placed in his father’s anus and had
therapy. Also called rational psychotherapy. eaten through his intestines. Freud’s analysis of
See also abcde technique; abc theory. [devel- these reactions laid the groundwork for the psy-
oped in 1955 by U.S. psychotherapist Albert Ellis choanalytic interpretation of obsessional neuro-
(1913–2007)] sis. See also oedipus complex.
rationality n. 1. the quality of being reasonable rauwolfia derivatives alkaloids obtained
or rational or of being acceptable to reason. from plants of the genus Rauwolfia, primarily R.
2. a rational action, belief, or desire. serpentina, the ancient Hindu snakeroot. They
R have sedative and antihypertensive actions, and
rationality of emotions the proposition that have been used in neuropsychopharmacology
emotions show an implacable logic, in that they since about 1000 bce by Hindu healers. The
follow from appraisals made by the individual genus was named for 16th-century German bot-
as inevitably as logical conclusions follow from anist Leonhard Rauwolf, who reported its tran-
axioms and premises. This view, which counters quilizing effect in 1575 while traveling in India.
the traditional idea that emotions and reason are The prototype drug of the group is reserpine,
in opposition to one another, is linked to the which acts by depleting stores of catecholamine
work of U.S. psychologist Richard S. Lazarus neurotransmitters in both central and peripheral
(1922–2002) and Swiss-born Canadian–British nervous systems. Rauwolfia derivatives were ini-
psychologist Ronald B. De Sousa (1940– ). tially used in the management of psychosis, but
rationalization n. in psychotherapy, an expla- were erroneously thought to induce depression
nation, or presentation, in which apparently and therefore abandoned for this use in the
logical reasons are given to justify unacceptable 1950s.
behavior that is motivated by unconscious in- RAVLT abbreviation for rey auditory verbal
stinctual impulses. In psychoanalytic theory, learning test.
such behavior is considered to be a defense
mechanism. Examples are: “Doesn’t everybody raw score an original score before it is converted
cheat?” or “You have to spank children to to other units or another form through statistical
toughen them up.” Rationalizations are used to analysis.
defend against feelings of guilt, to maintain self- Raynaud’s disease a disorder characterized by
respect, and to protect oneself from criticism. In episodes of painful vasoconstriction of the blood
482
reading disorder
vessels in the extremities, especially the fingers sponse to a given stimulus or situation. For ex-
and toes. The attacks, usually lasting up to 15 ample, a psychotic episode that is secondary to a
min, are precipitated by cold exposure or, in one traumatic or otherwise stressful event in the life
third of cases, by emotional stress. Raynaud’s of the individual would be considered reactive
phenomenon refers to similar symptoms caused and generally associated with a more favorable
by another disease—for example, rheumatic ar- prognosis than an endogenous episode unre-
thritis (see arthritis)—or by toxic agents, such lated to a specific happening.
as vinyl chloride. Drug therapy and behavioral reactive attachment disorder in DSM–IV–
treatment (with thermal biofeedback) have TR, a disorder of infancy and early childhood
proven effective in relieving the attacks. [identi- characterized by disturbed and developmentally
fied in 1854 by Maurice Raynaud (1834–1881), inappropriate patterns of social relating not re-
French physician] sulting from mental retardation or pervasive de-
RBD abbreviation for rem behavior disorder. velopmental disorder. It is evidenced either by
RDC abbreviation for research diagnostic cri- persistent failure to initiate or respond appropri-
teria. ately in social interactions (inhibited type) or by
reactance theory a model stating that in re- indiscriminate sociability without appropriate
sponse to a perceived threat to or loss of a be- selective attachments (disinhibited type). There
havioral freedom a person will experience psy- must also be evidence of inadequate care (e.g.,
chological reactance (or, more simply, reactance), ignoring the child’s basic physical or emotional
a motivational state characterized by distress, needs, frequent changes of primary caregiver),
anxiety, resistance, and the desire to restore that which is assumed to be responsible for the dis-
freedom. According to this model, when people turbed social relating. Also called attachment
feel coerced or forced into a certain behavior, disorder.
they will react against the coercion, often by reactive depression a major depressive epi-
demonstrating an increased preference for the sode that is apparently precipitated by a dis-
behavior that is restrained, and may perform the tressing event or situation, such as a career or
opposite behavior to that desired. [proposed in relationship setback. Also called exogenous de-
1966 by U.S. psychologist Jack W. Brehm (1928– pression. Compare endogenous depression.
2009)] reactive disorder an older name for a mental
reaction formation in psychoanalytic theory, disorder that is apparently precipitated by severe
a defense mechanism in which unacceptable or environmental pressure or a traumatic event.
threatening unconscious impulses are denied reactive mania a hypomanic episode or
and are replaced in consciousness with their op- manic episode that is precipitated by an exter-
posite. For example, to conceal an unconscious nal event.
prejudice an individual may preach tolerance; to
deny feelings of rejection, a mother may be over- reactive psychosis see situational psycho-
indulgent toward her child. Through the sym- sis.
bolic relationship between the unconscious wish reactive schizophrenia an acute form of
and its opposite, the outward behavior provides schizophrenia that clearly develops in response
a disguised outlet for the tendencies it seems to to predisposing or precipitating environmental
oppose. factors, such as extreme stress. The prognosis is
reaction time (RT) the time that elapses be- generally more favorable than for process
tween onset or presentation of a stimulus and schizophrenia. [proposed in 1959 by U.S. psy- R
occurrence of a response to that stimulus. Also chologists Norman Garmezy (1918–2009) and
called cognitive reaction time; response Eliot H. Rodnick (1911–1999)]
time. reading delay inability to read at the ability
reaction type 1. any of the categories into level typical for a given age.
which a psychiatric syndrome can be classified reading disability a reading ability that is
in terms of its predominant symptoms. For ex- below that expected for a child of a given age
ample, Swiss-born U.S. psychiatrist Adolf Meyer and stage of development. It is associated with
(1866–1950) distinguished affective, delirious, neurological damage or impairment, typically in
deteriorated, disguised-conflict, organic, and language processing and visual reasoning areas
paranoid reaction types. 2. in reaction-time ex- of the brain, that results in difficulty under-
periments, a particular type of set, or readiness standing the associations between letters and
of the participant or participants: motor (pre- sounds.
pared to respond), sensory (prepared to receive a
reading disorder in DSM–IV–TR, a learning
stimulus), or mixed.
disorder that is characterized by a level of read-
reactivation of memory the retrieval of a ing ability substantially below that expected for
memory, which may be triggered by stimuli or a child of a given age, intellectual ability, and
environmental conditions that were present educational experience. The reading difficulty,
when the memory was originally formed. See which involves faulty oral reading, slow oral and
also priming. silent reading, and often reduced comprehen-
reactive adj. associated with or originating in re- sion, interferes with achievement or everyday
483
reading span
life and is not attributable to neurological im- reality orientation in psychotherapy, a form
pairment, sensory impairment, mental retarda- of remotivation that aims to reduce a client’s
tion, or environmental deprivation. confusion about time, place, or person. The ther-
reading span 1. the amount of written or apist continually reminds the client who he or
printed material that a person can apprehend she is, what day it is, where he or she is, and what
during a single fixation of the eye during read- is happening or is about to take place.
ing. The greater the reading span, the fewer reality principle in psychoanalytic theory, the
times the eye needs to stop along a line of text. A regulatory mechanism that represents the de-
span of 7–10 characters is considered typical. mands of the external world and requires the
Also called eye span; recognition span. 2. in individual to forgo or modify instinctual gratifi-
memory tests, the number of words a person can cation or to postpone it to a more appropriate
remember on being asked to recall the last word time. In contrast to the pleasure principle,
of each sentence in a passage that he or she has which is posited to dominate the life of the in-
just read. fant and child and govern the id, or instinctual
readmission n. the admission to a hospital, impulses, the reality principle is posited to gov-
clinic, mental hospital, or other institution of a ern the ego, which controls impulses and en-
patient who has been admitted previously. Also ables people to deal rationally and effectively
called rehospitalization. See also revolving- with the situations of life.
door phenomenon. —readmit vb. reality testing any means by which an individ-
Real n. the realm of nature or reality: one of three ual determines and assesses his or her limitations
aspects of the psychoanalytic field defined by in the face of biological, physiological, social, or
French psychoanalyst Jacques Lacan (1901– environmental actualities or exigencies. It en-
1981). The Real is posited to be unknown and ables the individual to distinguish between self
unknowable—in effect, unreal—because all indi- and non-self and between fantasy and real life.
viduals ultimately possess are images and sym- Defective reality testing is the major criterion of
bols. The other realms are the imaginary and psychosis.
the symbolic. reality therapy treatment that focuses on pres-
real–ideal self congruence the degree to ent ineffective or maladaptive behavior and the
which the characteristics of a person’s ideal self development of the client’s ability to cope with
match his or her actual characteristics. The dis- the stresses of reality and take greater responsi-
crepancy between the two, when large enough, bility for the fulfillment of his or her needs (i.e.,
creates psychological pain; it is theorized to be a discover what he or she really wants and the op-
motivating force for entering treatment and is timal way of achieving it). To these ends, the
the focus of treatment in client-centered therapist plays an active role in examining the
therapy. In research studies it is measured by client’s daily activities, suggesting healthier,
having participants sort cards describing them- more adaptive ways for the client to behave. Re-
selves as they would like to be and as they are ality therapy tends to be of shorter duration than
(see self-ideal q sort). many other traditional psychotherapies (see
realistic anxiety anxiety in response to an brief psychotherapy). [developed by U.S. psy-
identifiable threat or danger. This type of anxi- chiatrist William Glasser (1925– )]
ety is considered a normal response to danger in real-life test a period during which people seek-
the real world and serves to mobilize resources in ing sex-reversal surgery (see transsexualism)
R order to protect the individual from harm. Also are required to live as the sex they wish to be-
called objective anxiety. come, for usually one or two years, before any
realistic thinking thinking that is based or fo- surgical procedures are performed. As well as a
cused on the objective qualities and require- name change, it involves changing clothing,
ments that pertain in different situations. hair, and other aspects of physical appearance to
Realistic thinking permits adjustment of those of the opposite sex. The real-life test is used
thoughts and behavior to the demands of a situ- to give the individual (and the professionals in-
ation; it depends on the ability to interpret exter- volved) an indication of whether he or she will
nal situations in a fairly consistent, accurate be able to cope with, and benefit from, a sex-
manner. This, in turn, involves the capacity to reversal operation.
distinguish fantasy and subjective experience real self the individual’s true wishes and feelings
from external reality. See also reality testing. and his or her potential for further growth and
reality awareness the perception of external development. See self. See also actual self;
objects as different from the self and from each true self. [defined by German-born U.S. psy-
other. Also called reality contact. choanalyst Karen D. Horney (1885–1952)]
reality confrontation an activity in which reason 1. n. consecutive thought, as in deduc-
the therapist raises the possibility that the pation or induction. Although at one time reason
tient has misconstrued events or the intentions was considered a mental faculty, this is typically
of others. The confrontation is thought to be not intended in current usage. See deductive
helpful in reducing maladaptive behaviors that reasoning; inductive reasoning. 2. n. in phi-
result from distorted thinking. losophy, the intellect regarded as the source of
484
recency effect
true knowledge. 3. n. soundness of mind. 4. n. a experience being born (e.g., through hypnotic
statement offered to justify an action or decision age regression) in order to resolve supposed pre-
or to explain the occurrence of an event. 5. vb. and perinatal conflicts and emotions and to de-
see reasoning. velop new and different outlooks on life.
reasonable accommodations adjustments rebound effect an increase in behavior or the
made within an employment or educational set- strength of a process following a period of sup-
ting that allow an individual with a physical, pression.
cognitive, or psychiatric disability to perform re- rebound insomnia a phenomenon associated
quired tasks and essential functions. This might with the use of hypnotic agents, particularly
include installing ramps in an office cafeteria for short-acting benzodiazepines, and character-
wheelchair accessibility, altering the format of a ized by a temporary worsening of insomnia fol-
test for a person with learning disabilities, or pro- lowing abrupt discontinuation of the drug or an
viding a sign language interpreter for a person inability to return to sleep after the initial effects
with hearing loss. Provisions for reasonable ac- of the drug have worn off. Rebound insomnia of
commodations must be made by employers and the latter type often makes administration of a
educators according to the 1990 Americans With second dose of the agent ineffective.
Disabilities Act and the 1973 Rehabilitation Act.
rebound phenomenon 1. an effect in which
reasonable doubt see beyond reasonable an activity or occurrence previously suppressed
doubt. or prevented temporarily increases once the re-
reasoning n. 1. thinking in which logical pro- strictions imposed on it are removed. The term is
cesses of an inductive or deductive character are used particularly to denote the temporary reap-
used to draw conclusions from facts or premises. pearance of symptoms following abrupt discon-
See deductive reasoning; inductive reason- tinuation of a medication used for treatment. An
ing. 2. the sequence of arguments or proofs used example is rebound insomnia, in which the dis-
to establish a conclusion in this way. —reason continuation of the use of hypnotic agents, par-
vb. ticularly short-acting benzodiazepines, results
reasoning mania a manic episode in which in a transitory return of insomnia, possibly of in-
judgment is not impaired and there are no psy- creased severity. 2. a test that demonstrates loss
chotic features. of the ability of the cerebellum to control coordi-
nated movement: If the individual extends the
reassociation n. in hypnoanalysis, a process forearm against resistance and the resistance is
of renewing or reviewing a forgotten or inhib- suddenly removed, the hand or fist will snap
ited traumatic event so that the experience will back toward the chest. Also called Holmes’s
be integrated with the individual’s personality phenomenon.
and consciousness.
reboxetine n. a drug that inhibits the reuptake
reassurance n. in psychotherapy and counsel- of norepinephrine but has little or no effect on
ing, a supportive approach that encourages neurotransmission of serotonin, dopamine, ace-
clients to believe in themselves and in the possi- tylcholine, or histamine. It was the first selective
bilities of improvement. The technique is com- norepinephrine reuptake inhibitor developed
mon and has widespread use across many forms for clinical use as an antidepressant. It is not
of psychotherapy. It is used frequently in sup- available for use in the United States.
portive psychotherapy and occasionally in
REBT abbreviation for rational emotive be-
reconstructive psychotherapy to encourage
havior therapy.
R
a client in the process of exploring new relation-
ships and feelings. Reassurance is also used to di- recall 1. vb. to transfer prior learning or past ex-
minish anxiety, for example, by explaining to a perience to current consciousness: that is, to re-
client that a period of heightened depression or trieve and reproduce information. 2. n. the
tension is temporary and not unexpected. Also process by which this occurs. See also free re-
called assurance. call.
rebirthing n. 1. the therapeutic use of continu- receiving hospital a health facility that is spe-
ous, focused breathing and reflection, initially cially equipped and staffed to handle new pa-
under the guidance of a rebirthing practitioner tients requiring diagnosis and preliminary
(a rebirther), to release tension, stress, and in- treatment, for example, people with suspected
tense emotions and attain a state of deep peace mental disorder.
and total relaxation that leads to personal recency effect a memory phenomenon in
growth and positive changes in health, con- which the most recently presented facts, impres-
sciousness, and self-esteem (i.e., a personal and sions, or items are learned or remembered better
spiritual “rebirth”). This type of therapy is in- than material presented earlier. This can occur in
creasingly being termed breathwork or re- both formal learning situations and social con-
birthing breathwork. [developed in the 1970s by texts. For example, it can result in inaccurate rat-
California-based New Age guru Leonard Orr] 2. a ings or impressions of a person’s abilities or
highly controversial form of therapy, now other characteristics due to the inordinate influ-
largely discredited (both scientifically and ethi- ence of the most recent information received
cally), in which an individual attempts to re- about that person. Also called law of recency;
485
receptive character
principle of recency; recency error. Com- who also influences them. This concept is associ-
pare primacy effect. ated with social learning theory.
receptive character in the psychoanalytic reciprocal inhibition 1. a technique in be-
theory of Erich fromm, a passive, dependent, havior therapy that aims to replace an unde-
and compliant, or conforming, personality type: sired response with one that is desired by
roughly equivalent to the oral-receptive per- counterconditioning. It relies on the gradual
sonality or the passive-dependent personality substitution of a response that is incompatible
(see dependent personality disorder) de- with the original one and is potent enough to
scribed by others. Such an individual is said to be neutralize the anxiety-evoking power of the
of a receptive orientation. stimulus. See also systematic desensitization.
receptor n. 1. the cell in a sensory system that is [devised by South African-born U.S. psychologist
responsible for stimulus transduction, the pro- Joseph Wolpe (1915–1997)] 2. in neuroscience,
cess by which one form of enegy is converted the inhibition of one spinal reflex when another
into another. Receptor cells are specialized to de- is elicited. [proposed by British neurophysi-
tect and respond to specific stimuli in the exter- ologist Charles Scott Sherrington (1857–1952)]
nal or internal environment. 2. a sense organ, 3. a neural mechanism that prevents opposing
such as the eye or the ear. 3. a molecule in a cell muscles from contracting at the same time. 4.
membrane that specifically binds a particular the inability to recall two associated ideas or
molecular messenger (e.g., a neurotransmitter, items because of their interference with each
hormone, or drug) and elicits a response in the other.
cell. Also called receptor molecule. See also reciprocal regulation recurring or mutual ad-
neuroreceptor. aptation of behavior of a person or people to
recessive allele the version of a gene (see al- changed conditions.
lele) whose effects are manifest only if it is car- reciprocity norm the social standard (norm)
ried on both members of a homologous pair of that people who help others will receive equiva-
chromosomes. Hence, the trait determined by a lent benefits from these others in return.
recessive allele (the recessive trait) is apparent recoding n. the translation of material held
only in the absence of another version of that in memory from one form into another. For
same gene (the dominant allele). The term example, a series of random digits (e.g.,
autosomal recessive is used to describe such pat- 239812389712) could be recoded as a series of
terns of inheritance in which characteristics are four-digit prices ($23.98, $12.38, $97.12),
conveyed by recessive alleles. Tay–Sachs disease thereby making the series much easier to recall.
is an example of autosomal recessive disorder. See chunking; elaboration. —recode vb.
recessive trait in genetics, a trait that is ex- Recognition Memory Test (RMT) a verbal
pressed only if its determining allele is carried and nonverbal memory test that is used to detect
on both members of a homologous pair of neuropsychological deficits. In the Recognition
chromosomes or on an unmatched sex chromo- Memory for Words subtest of the RMT, partici-
some. See recessive allele. Compare domi- pants are presented with 50 stimulus words, one
nant trait. every 3 s, and must respond whether they con-
recidivism n. relapse. The term typically de- sider each pleasant or unpleasant. Following the
notes the repetition of delinquent or criminal presentation of all 50 stimuli, each word is pre-
R behavior, especially in the case of a habitual sented again concurrently with a distractor item,
criminal, or repeat offender, who has been and participants must choose which of the two
convicted several times. —recidivist n., adj. words had been presented previously. The proce-
—recidivistic adj. dure is the same for the Recognition Memory
recidivism rate the frequency with which de- for Faces subtest, in which the stimuli used are
linquent or criminal behavior recurs or patients photographs of unfamiliar faces. Also called
relapse. It is sometimes used as a marker of the Warrington Recognition Memory Test.
effects of interventions; for example, the per- [originally developed in 1984 by British neuro-
centage of patients who are rearrested for rape psychologist Elizabeth Kerr Warrington]
following treatment intended to reduce the like- recombinant DNA a dna molecule containing
lihood of committing this crime would indicate a fragment that has been inserted by genetic
the effectiveness of the treatment. recombination or some similar process, for
reciprocal determinism a concept that op- example, using the techniques of genetic en-
poses the radical or exclusive emphasis on envi- gineering. Recombinant DNA laboratory tech-
ronmental determination of responses and niques involve the creation of novel or modified
asserts that a reciprocal relation exists among en- pieces of genetic material, which can then be in-
vironment, behavior, and the individual. That serted in the chromosomes of another species.
is, instead of conceptualizing the environment These techniques allow for the study of the ex-
as a one-way determinant of behavior, reciprocal pression of a particular gene or the development
determinism maintains that the environment of strains of bacteria that can produce natural
influences behavior, behavior influences the en- substances of therapeutic value.
vironment, and both influence the individual, recompensation n. an increase in the ability of
486
redintegration
an individual to adapt to the environment and surable return of abilities, skills, and functions
alleviate stressful situations. Compare compen- following illness or injury.
sation; decompensation. Recovery, Inc. a self-help group for individu-
reconditioning therapy a form of behavior als with serious mental health problems that fo-
therapy in which the client is conditioned to re- cuses on will-training techniques for controlling
place undesirable responses with desirable re- temperamental behavior and changing mem-
sponses. See also aversion therapy. bers’ attitudes toward their problems. Founded
in 1937 by U.S. neuropsychiatrist Abraham A.
reconstituted family see stepfamily. Low (1891–1954), it is one of the oldest self-help
reconstitution n. 1. revision of one’s attitudes organizations in the world.
or goals. 2. a mental or attitudinal outcome of recovery ratio see discharge rate.
the grieving process experienced by some pa-
recreational drug any substance that is used
tients with catastrophic illnesses resulting in dis-
in a nontherapeutic manner for its effects on
ability.
motor, sensory, or cognitive activities.
reconstruction n. 1. in psychoanalysis, the re- recreational therapy the use of individual-
vival and analytic interpretation of past experi- ized recreational activities (arts and crafts,
ences that have been instrumental in producing sports, games, group outings, etc.) as an integral
present emotional disturbance. 2. the logical re- part of the rehabilitation or therapeutic process
creation of an experience or event that has been for individuals with physical or psychological
only partially stored in memory. —reconstruct disabilities or illness. Also called therapeutic
vb. recreation.
reconstructive memory a form of remember- rectal administration the administration of
ing marked by the logical recreation of an experi- a drug by rectal insertion, usually in the form of
ence or event that has been only partially stored a suppository, for absorption via the rectal mu-
in memory. It draws on general knowledge and cosa.
schemas or on memory for what typically hap- recuperative theory a theory that the func-
pens in order to reconstruct the experience or tion of sleep is to allow the body to recuperate
event. from the rigors of waking, to regather resources,
reconstructive psychotherapy psychother- and to reestablish internal homeostasis.
apy directed toward basic and extensive modifi- recurrent adj. occurring repeatedly or reappear-
cation of an individual’s character structure, by ing after an interval of time or a period of remis-
enhancing his or her insight into personality de- sion: often applied to disorders marked by
velopment, unconscious conflicts, and adaptive chronicity, relapse, or repeated episodes (e.g., de-
responses. Examples are Freudian psychoanal- pressive symptoms).
ysis, Adlerian individual psychology, Jung-
recurrent depression major depressive dis-
ian analytic psychology, and the approaches
order in which there have been two or more
of German-born U.S. psychoanalyst Karen D.
major depressive episodes.
Horney (1885–1952) and U.S. psychiatrist Harry
Stack Sullivan (1892–1949). recurrent dream a dream that occurs repeat-
edly. Sigmund freud saw recurrent dreams as
record keeping an essential aspect of therapy, punishment, rather than wish-fulfillment,
in which clinical notes are preserved for future dreams and linked them to a masochistic need
reference, training purposes, or both. Clinical R
for self-criticism arising from fantasies of exces-
notes may be subpoenaed by the courts. The ex- sive ambition. Carl jung regarded recurrent
tent of detail in record keeping varies with the dreams as more revealing of the unconscious
situation, but some degree of record keeping is than single dreams, and found that in a dream
deemed standard procedure for clinicians. series the later dreams often throw light on the
recovered memory the subjective experience earlier ones (see serial interpretation). Other
of recalling details of a prior traumatic event, psychologists see them as an attempt to come to
such as sexual or physical abuse, that has previ- terms with disturbing experiences.
ously been unavailable to conscious recollec- recurring-phase theories the view that cer-
tion. Before recovering the memory, the person tain specific issues continually dominate group
may be unaware that the traumatic event has oc- interactions.
curred. The phenomenon is controversial: Be-
redintegration n. 1. the process of reorganiz-
cause such recoveries often occur while the
ing, or reintegrating, mental processes after they
person is undergoing therapy, there is debate
have been disorganized by psychological disor-
about their veracity vis-à-vis the role that the
der, particularly in psychoses. 2. more generally,
therapist may have played in suggesting or oth-
restoration to health or to normal condition and
erwise arousing them. Also called repressed
functioning. 3. the process of recovering or rec-
memory. See also dissociative barriers;
ollecting memories from partial cues or remind-
posttraumatic amnesia; pseudomemory.
ers, as in recalling an entire song when a few
recovery n. the period during which an individ- notes are played. 4. the elicitation of a response
ual exhibits consistent progress in terms of mea- by a part of the stimulus complex that was in-
487
red sage
volved in the initial learning. Also called reinte- ships through a form of nonreconstructive ther-
gration. —redintegrative adj. apy, such as relationship therapy, behavior
red sage a brushy shrub, Salvia miltiorrhiza, therapy, hypnotic suggestion (see hypno-
whose roots are known to Chinese herbalists as suggestion), counseling, persuasion ther-
dan shen and have traditionally been used (pow- apy, nonanalytic group therapy, or reality
dered or whole) to treat cardiac and vascular dis- therapy. Also called reeducative therapy.
orders, including heart attacks, stroke, and reenactment n. in some forms of psychother-
atherosclerosis. Indeed, red sage has been shown apy, the process of reliving traumatic events and
in some studies to decrease the clotting capabil- past experiences and relationships while reviv-
ity of blood; it should not be taken in combina- ing the original emotions associated with them.
tion with prescribed blood thinners, as bleeding See also abreaction.
problems may result. Other studies suggest red reentry n. 1. the return of a patient or client to
sage may interfere with the development of society after experiencing life in an institution
scarlike fibers in the liver (associated primarily (e.g., a psychiatric hospital) or being part of the
with chronic hepatitis and consumption of large relatively open and honest environment of an
quantities of alcohol) and may be effective in encounter group. 2. the return of a mental
preventing the growth of cancer cells and the health professional from a disaster experience in
replication of the HIV virus, but these potential which he or she dealt with many victims suffer-
uses have not been confirmed and require fur- ing from trauma and other forms of psychologi-
ther investigation. Side effects of red sage are cal stress. See also postvention.
mild and may include itching, stomach upset,
reevaluation counseling a therapeutic ap-
and decreased appetite. The active compounds
proach involving cocounseling between indi-
are miltirone and other diterpene quinones,
viduals. In the process, two people take turns in
which act as partial agonists at the benzodiaz-
counseling and being counseled. The process
epine–GABA receptor complex (see gabaa re-
starts with one individual (acting as counselor)
ceptor). Because red sage is a partial agonist, it
asking the other (acting as client) a provocative
may interact with and enhance the sedative ef-
question and continues with other steps, such as
fects of drugs that are full benzodiazepine
asking the individual acting as client to cite two
agonists—commonly used in the treatment of
or three minor upsets that have recently oc-
generalized anxiety and insomnia—leading to
curred. The client is encouraged to react emo-
extreme drowsiness.
tionally in his or her responses, to work through
reductionism n. the strategy of explaining or his or her emotions, and then to reverse roles
accounting for some phenomenon or construct and act as the counselor for the other person.
A by claiming that, when properly understood, it Also called reevaluation cocounseling. [de-
can be shown to be some other phenomenon or veloped in the 1950s by U.S. personal counselor
construct B, where B is seen to be simpler, more Harvey Jackins (1916–1999)]
basic, or more fundamental. The term is mainly
referenced cognitive test a test of cognitive
applied to those positions that attempt to under-
function that has been standardized and normed
stand human culture, society, or psychology in
so that performances can be compared across in-
terms of animal behavior or physical laws. In
dividuals.
psychology, a common form of reductionism is
that in which psychological phenomena are re- referential attitude an expectancy attitude
duced to biological phenomena, so that mental sometimes observed in certain individuals with
R schizophrenia or other forms of psychopath-
life is shown to be merely a function of biologi-
cal processes. Compare emergentism. See also ology who are seeking justification, via environ-
epiphenomenalism; identity theory; materi- mental aspects, for their ideas of reference or
alism. delusions of reference.
reduplicative paramnesia a disturbance of referral n. 1. the act of directing a patient to a
memory or confabulation characterized by therapist, physician, agency, or institution for
the subjective certainty that a familiar person or evaluation, consultation, or treatment. 2. the in-
place has been duplicated, such as the belief that dividual who is so referred. —refer vb.
the hospital where one is treated is duplicated reflected appraisals the evaluative feedback
and relocated to another site. It can be caused by that a person receives from others. Some theories
a variety of neurological disorders, but brain le- of self have treated reflected appraisals as the
sions commonly involve the frontal lobes, the most important basis for the self-concept,
right hemisphere, or both. See also capgras claiming that people learn about themselves
syndrome. chiefly from others. See symbolic inter-
reeducation n. 1. learning or training that fo- actionism.
cuses on replacing maladaptive cognitions, af- reflection of feeling a statement made by a
fects, or behaviors with healthier more adaptive therapist or counselor that is intended to high-
ones or on learning forgotten or otherwise lost light the feelings or attitudes implicitly expressed
skills anew. 2. a form of psychological treatment in a client’s communication. The statement re-
in which the client learns effective ways of han- flects and communicates the essence of the cli-
dling and coping with problems and relation- ent’s experience from the client’s point of view
488
regression analysis
so that hidden or obscured feelings can be ex- refractory adj. 1. resistant to control, as in a
posed for clarification. Also called reflection case of a disease or disorder that fails to respond
response. to previously effective therapy. 2. in neurophysi-
reflection response 1. in a rorschach ink- ology, describing a neuron or muscle cell that is
blot test, a response that the inkblot represents unable to respond to a stimulus. —refractori-
a bilateral reflection of one half of the card. That ness n.
is, the image is perceived not as a single entity refractory phase the period following orgasm
across both halves of the card but as two entities during which further sexual arousal or orgasm is
in the two halves, one entity being a mirror not possible. It occurs only in the male sexual-
image of the other. 2. see reflection of feel- response cycle; females can have immediate
ing. further arousal and multiple orgasm. The length
of the refractory phase increases with advancing
reflectivity–impulsivity n. a dimension of
age: Older men may not be capable of sexual ac-
cognitive style based on the observation that
tivity more than once per day.
some people approach tasks impulsively, prefer-
ring to act immediately on their first thoughts or reframing n. a process of reconceptualizing an
impressions, whereas others are more reflective, idea for the purpose of changing an attitude by
preferring to make a careful consideration of seeing it from a different perspective. In chang-
a range of alternatives before acting. This aspect ing the conceptual or emotional context of a
of cognitive style—conceptual tempo—can be problem, and placing it in a different frame that
assessed by means of the Matching Familiar Fig- fits the given facts equally well but changes its
ures Test. Also called reflection–impulsivity. entire meaning, perceptions of weakness or diffi-
[first described in 1963 by U.S. developmental culty in handling the problem may be changed
psychologist Jerome Kagan (1929– )] to strength and opportunity. In psychotherapy,
the manner in which a client frames behavior
reflex n. any of a number of automatic, un-
may be part of the problem. Part of the thera-
learned, relatively fixed responses to stimuli that
pist’s response might be to reframe thoughts or
do not require conscious effort and that often in-
feelings so as to provide alternative ways to eval-
volve a faster response than might be possible if
uate the situation or respond to others. Compare
a conscious evaluation of the input was required.
restatement.
Reflexes are innate in that they do not arise as a
result of any special experience. regimen n. a particular course of action designed
to achieve a specific goal. In medicine, it often
reflexive affect see affect. refers to a detailed treatment program for the
reflexive behavior responses to stimuli that regulation of diet, exercise, rest, medication, and
are involuntary or free from conscious control other therapeutic measures. Various forms of
(e.g., the salivation that occurs when food is pre- psychotherapy, such as cognitive behavior
sented) and therefore serve as the basis for therapy, may also make use of regimens during
pavlovian conditioning. Compare planned the course of treatment. Such programs typically
behavior; voluntary behavior. include a schedule and specify the components,
reflexology n. 1. a school of psychology based methods, and duration of the program.
on research dealing solely with the outwardly registered nurse (RN) a professional nurse
observed and fixed manifestations and reactions who has completed an accredited educational
of the human being. It is credited to Russian program and passed a required state licensing ex-
physiologist Vladimir M. Bekhterev (1857– amination. Registered nurses provide such ser- R
1927), who taught that all behavior could be vices as observing and recording patient
constructed from the simple reflex as the ele- symptoms and reactions, developing a treat-
mentary unit or building block. 2. the physio- ment plan in consultation with the attending
logical study of involuntary automatic responses physician, administering medication, and edu-
to stimuli, particularly as they affect the behav- cating the patient or family on self-care meth-
ior of humans and other animals. 3. a form of ods.
complementary and alternative medicine Regitine n. a trade name for phentolamine.
based on the principle that there are reflex
regression n. a return to a prior, lower state of
points or zones in the feet and hands that cor-
cognitive, emotional, or behavioral functioning.
respond to every part of the body and that ma-
This term is associated particularly with psycho-
nipulating and pressing on these points has
analytic theory, denoting a defense mechanism
beneficial health effects. —reflexologist n.
in which the individual reverts to immature be-
reflex strength the potential strength of a re- havior or to an earlier stage of psychosexual
sponse to a reflex stimulus (e.g., the potential for development when threatened with anxiety
a startle response if an organism is touched), caused by overwhelming external problems or
often measured by reflex latency. internal conflicts. —regress vb. —regressive
reformatory paranoia a type of megaloma- adj.
nia expressed as a personality trait in individuals regression analysis any of several statistical
who concoct plans to reform the world and try techniques that are designed to allow the predic-
to convince others to follow their ideas. tion of the score on one variable, the dependent
489
regression coefficient
variable, from the scores on one or more other sources, such as treatment or training, to enable
variables, the independent variables. Regres- such a person (e.g., one who has had a stroke) to
sion analysis is a subset of the general linear redevelop skills and abilities he or she had ac-
model. quired previously or to compensate for their loss.
regression coefficient the weight associated Compare habilitation.
with an independent (predictor) variable in a re- rehabilitation center a facility devoted to re-
gression analysis. storing individuals with mental or physical dis-
regression effect the tendency for individuals orders or impairments, including those with
scoring high or low on a test to score closer to the multiple problems, to an adequate level of func-
mean on a retest. tioning. Rehabilitation centers use such tech-
niques as vocational training, work in a
regression equation the mathematical ex- sheltered situation, occupational therapy, physi-
pression of the relationship between the de- cal therapy, educational therapy, social therapy,
pendent variable and one or more independent recreational therapy, and psychological therapy
variables that results from conducting a regres- and counseling.
sion analysis. It usually takes the form y = a + bx
+ e, in which y is the dependent variable, x is the rehabilitation counselor a professional
independent variable, a is the intercept, b is the worker trained and equipped to evaluate and
regression coefficient (a specific weight associ- guide individuals who have a physical, mental,
ated with x), and e is the error term. or emotional impairment in all major phases of
the rehabilitation process: vocational, educa-
regression in the service of the ego the tional, personal, psychological, social, and recre-
adaptive circumvention of normal ego function- ational. The rehabilitation counselor typically
ing in order to access primitive material (see pri- helps to coordinate the various services offered
mary process), often associated with the by the rehabilitation team and to focus them on
creative process. [first described by Swiss-born each individual’s needs.
U.S. psychoanalyst Ernst Kris (1900–1957)]
rehabilitation engineering a discipline that
regression therapy see reparenting. integrates multiple areas of research within vari-
regression toward the mean a phenome- ous fields to develop products, processes, and en-
non in which earlier measurements that were ex- vironments to improve the quality of life for
tremely deviant from a sample mean will tend, people with disabilities.
on retesting, to result in a value closer to the rehabilitation medicine the branch of medi-
sample mean than the original value. cine that specializes in the development of indi-
regressive electroshock therapy an obso- viduals to the fullest physical, psychological,
lete form of electroconvulsive therapy that cognitive, social, vocational, or educational po-
was administered several times a day to patients tential that is consistent with their physiological
with schizophrenia when other treatment meth- or anatomical impairment and environmental
ods failed and the prognosis was poor. The pa- limitations.
tients typically regressed to a point where they rehabilitation program the overall system
were incontinent, out of contact, and had to be of rehabilitation services provided in support
spoon-fed. Recovery from treatment took from a of an individual with an illness, injury, or physi-
week to a month. cal or mental disability, disorder, or impairment.
R regressive reconstructive approach a The program is typically customized to meet the
technique in psychotherapy in which the client specific needs of each individual and may in-
is encouraged to reexperience with emotional clude physical therapy, recreational therapy,
intensity traumatic situations from an earlier and occupational therapy; psychological, social
stage of life. Through such concurrent or subse- service, educational, and vocational programs;
quent mechanisms as transference and inter- and appropriate specialty services, such as
pretation, the approach is posited to help bring speech therapy and audiology.
about personality change and development of rehabilitation psychology a specialty
greater emotional adaptation and maturity in branch of psychology devoted to the application
the client. of psychological knowledge and understanding
regulatory drive any generalized state of to the study, prevention, and treatment of dis-
arousal or motivation that helps preserve physi- abling and chronic health conditions. Rehabili-
ological homeostasis and thus is necessary for tation psychologists consider the entire network
the survival of the individual organism, such as of factors (biological, psychological, social, envi-
hunger and thirst. Compare nonregulatory ronmental, and political) that affect functioning
drive. to help individuals attain optimal physical, psy-
rehabilitation n. the process of bringing an in- chological, and interpersonal functioning.
dividual to a condition of health or useful and rehabilitation team a group of health care
constructive activity, restoring to the fullest pos- specialists who coordinate their efforts in the re-
sible degree their independence, well-being, and habilitation of patients on an individual basis. A
level of functioning following injury, disability, rehabilitation team may include plastic sur-
or disorder. It involves providing appropriate re- geons, orthopedic surgeons, neurologists, psy-
490
relapse prevention
chologists, psychiatrists, physical therapists, menter arranges that a rat’s lever presses are fol-
occupational therapists, and others, depending lowed by presentation of food), or they can
upon the needs of the patient. occur as natural consequences of a response (as
rehearsal n. 1. preparation for a forthcoming when a door opens when pushed), or they can
event or confrontation that is anticipated to in- occur by accident (see accidental reinforce-
duce some level of discomfort or anxiety. By ment). Also called response–reinforcement
practicing what is to be said or done in a future contingency.
encounter, the event itself may be less stressful. reinforcement counseling a behavioral ap-
Rehearsal may be carried out in psychotherapy proach to counseling based on the idea that be-
with the therapist coaching or role-playing to havior is learned and can be predictably
help the client practice the coming event. See modified by various reinforcement techniques
also behavior rehearsal; role play. 2. the that strengthen or weaken specific types of be-
repetition of information in an attempt to main- havior through schedules of positive or negative
tain it longer in memory. According to the reinforcement. See also reinforcement ther-
dual-store model of memory, rehearsal oc- apy.
curs in short-term memory and may allow a Reinforcement Survey Schedule (RSS) an
stronger trace to be then stored in long-term assessment form that elicits information about
memory. Although rehearsal implies a verbal activities, stimuli, or situations that a person
process, it is hypothesized to occur also in other finds rewarding or pleasurable. This information
modalities. is used by behavior therapists to help patients
rehospitalization n. see readmission. organize contingencies that increase positive be-
Reichian analysis a highly controversial and haviors or decrease negative behaviors. [devel-
largely scientifically discredited system of psy- oped in 1967 by U.S. psychologist Joseph R.
chotherapy, developed by Austrian-born U.S. Cautela (1927–1999) and Robert Kastenbaum]
psychoanalyst Wilhelm Reich (1897–1957), in reinforcement therapy a therapeutic process
which orgastic potency is emphasized as the based on operant conditioning and the use of
criterion of mental health. Notwithstanding the positive reinforcement to initiate and maintain
widespread judgment of the approach as alter- behavioral change. See also reinforcement
native (see alternative psychotherapy) and counseling.
unsupported by research, Reich made early con- reinforcer n. a stimulus or circumstance that
tributions to psychology in his theories concern- acts effectively to produce reinforcement
ing emotional catharsis and authoritarianism. when it occurs in a dependent relationship, or
reification n. treating an abstraction, concept, contingency, with a response. Also called rein-
or formulation as though it were a real object or forcing stimulus. See natural reinforcer.
static structure. reinforcing cause a condition that tends to
reiki n. a complementary therapy that aims to maintain a healthy or maladaptive behavior or
promote physical, emotional, and spiritual heal- behavioral pattern in an individual. An example
ing through the use of energy and the laying on of the healthy–maladaptive range can be seen
of hands, which is believed to improve the flow when special attention is given to a person who
of life energy in the patient. See also comple- is ill, which can contribute either to a speedy or
mentary and alternative medicine. [Japa- to a delayed recovery. It is typical, however, to
nese, “universal life energy”] use the term in relation to negative or mal-
adaptive consequences.
R
reinforcement n. 1. in operant condition-
ing, a process in which the frequency or proba- reintegration n. see redintegration.
bility of a response is increased by a dependent rejected child in sociometric measures of peer
relationship, or contingency, with a stimulus or acceptance, a child who is frequently mentioned
circumstance (the reinforcer). See reinforce- in negative terms and is actively disliked by his
ment contingency. 2. the procedure that re- or her peers. Compare isolate.
sults in the frequency or probability of a
rejecting–neglecting parenting see par-
response being increased in such a way. 3. in
enting.
pavlovian conditioning, the presentation of
an unconditioned stimulus after a conditioned rejection n. 1. denial of love, attention, interest,
stimulus. See also negative reinforcement; or approval. 2. an antagonistic or discriminatory
positive reinforcement. attitude toward a group of people.
reinforcement contingency the contin- relapse n. the recurrence of symptoms of a disor-
gency (relationship) between a response and a der or disease after a period of improvement or
reinforcer. The contingency may be positive apparent cure.
(if the occurrence of the reinforcer is more prob- relapse prevention procedures that are used
able after the response) or negative (if it is less after successful treatment of a condition, disease,
probable given the response). Reinforcement or disorder in order to reduce relapse rates. These
contingencies can be arranged by establishing often include a combination of cognitive and be-
dependencies between a particular type of re- havioral skills that are taught to clients before
sponse and a reinforcer (as when an experi- therapy is terminated. Such procedures are often
491
relapse rate
used with disorders (e.g., addictions and depres- the position that the person’s ingroup actually
sion) that have unusually high relapse rates. See has and the position the person thinks it ought
also tertiary prevention. to have. According to some research, social un-
relapse rate the incidence of clients or patients rest tends to be greatest in areas with high levels
who have recovered or improved but who later of relative deprivation. See also social compar-
experience a recurrence of their disorder or dis- ison theory.
ease. relative risk the ratio of the incidence of a cer-
tain disorder or condition in groups exposed to
relational aggression behavior that manipu- (or possessed of) a specific risk factor and groups
lates or damages relationships between individu-
not exposed to (or possessed of) that factor.
als or groups, such as bullying, gossiping, and
humiliation. relaxation technique any therapeutic tech-
nique to induce relaxation and reduce stress.
relationship n. a continuing and usually bind-
relaxation therapy the use of muscle-
ing association between two or more people, as
relaxation techniques as an aid in the treatment
in a family, friendship, marriage, partnership, or
of emotional tension. Also called therapeutic
other interpersonal link in which the partici-
relaxation. See also progressive relaxation.
pants have some degree of influence on each
other’s thoughts, feelings, and even actions. In relaxation training see progressive relax-
psychotherapy, the therapist–patient rela- ation.
tionship is thought to be an essential aspect of release n. the letting go of physical, mental, or
patient improvement. As with other relation- emotional tension or pent-up energy, which
ships in life, therapeutic relationships char- tends toward relaxation or arousal reduction.
acterized by trust, warmth, respect, and un- release therapy 1. any therapy whose ultimate
derstanding are more likely to result in positive value is in the release of deep-seated, forgotten,
outcomes for the patient. or inhibited emotional and psychic pain
relationship therapy 1. any form of psycho- through open expression and direct experience
therapy that emphasizes the nature of the rela- of anger, sorrow, or hostility in the therapy con-
tionship between client and therapist and views text. The technique is used, for example, in play
it as the primary therapeutic tool and agent of therapy. 2. a form of therapy in which young
positive change. Relationship therapy is based children reenact anxieties, frightening experi-
on the idea of providing emotional support and ences, and traumatic events with such materials
creating an accepting atmosphere that fosters as figurines, toy animals, and water guns. [devel-
personality growth and elicits attitudes and past oped in the 1930s by U.S. psychiatrist David M.
experiences for examination and analysis during Levy (1892–1977)]
sessions. 2. any form of psychotherapy focused releasing hormone any of a class of hypotha-
on improving the relationship between indi- lamic hormones that travel via the hypotha-
viduals, particularly those in a marriage or other lamic–pituitary portal system to control the
committed partnership, by helping them to re- release of hormones by the anterior pituitary
solve interpersonal issues and modify mal- gland. Examples are corticotropin-releasing
adaptive patterns of interactions, which in turn factor and gonadotropin-releasing hor-
fosters the healthy psychosocial growth of all mone.
parties. It is an umbrella term encompassing reliability n. the ability of a measurement in-
R couples therapy and family therapy. [first strument (e.g., a test) to measure an attribute
described by U.S. social worker Jessie Taft (1882– consistently, yielding the same results across
1960) and child psychiatrist Frederick H. Allen multiple applications to the same sample. The
(1890–1964)] basic index of reliability is the correlation co-
relative deprivation the perception by an inefficient. —reliable adj.
dividual that the amount of a desired resource relief n. a positive emotion that occurs as a re-
(e.g., money, social status) he or she has is less sponse to a threat that has abated, disappeared,
than some comparison standard. This standard or failed to materialize.
can be the amount that was expected or the
relief–discomfort quotient (relief–dis-
amount possessed by others with whom the per-
tress quotient) see distress–relief quo-
son compares him- or herself. The concept was
tient.
introduced as a result of studies of morale in the
U.S. Army during World War II, which indicated religiosity n. pious, exaggerated religious zeal.
that soldiers were dissatisfied if they believed religious delusions delusions associated
they were not obtaining as many military re- with religious beliefs and grandiose ideas with
wards and benefits as their peers. In 1966 British religious content. Delusional ideation fre-
sociologist Walter Garrison Runciman (1934– ) quently includes beliefs that the individual is the
distinguished between egoistic relative depri- embodiment of a notable religious figure, such
vation, the perceived discrepancy between an as a messiah or prophet, and that he or she pos-
individual’s own current position and the com- sesses special powers, such as being able to cure
parison standard; and fraternalistic relative dean illness. Such beliefs may be a feature of gran-
privation, the perceived discrepancy between diose-type delusional disorder.
492
renifleur
religious healing see faith healing. Events that occurred in adolescence and early
religious mania a state of acute hyperactivity, adulthood (often called the reminiscence bump)
agitation, and restlessness accompanied by hal- are most often remembered. See also autobio-
lucinations of a religious nature. graphical memory; episodic memory; life
review. 2. an increase in the amount remem-
religiousness n. a tendency to adhere to reli- bered, or in performance, that occurs after a
gious beliefs and to engage in religious practices.
delay interval following the initial exposure to
religious therapy therapeutic intervention the information, instead of the more usual for-
through such approaches as pastoral counsel- getting after a delay.
ing, scriptural study, and church-sponsored
community activities. Such interventions are
reminiscence therapy the use of life histo-
ries—written, oral, or both—to improve psy-
sometimes led by a mental health professional
chological well-being. The therapy is often used
but often not. See also supportive psycho-
with older people.
therapy.
REM abbreviation for rapid eye movement. Razadyne n. a trade name for galantamine.
REM behavior disorder (RBD) a sleep dis- remission n. a reduction or significant abate-
order involving motor activity during rem ment in symptoms of a disease or disorder, or the
sleep, which typically includes an actual physi- period during which this occurs. Remission of
cal enactment of dream sequences. Because the symptoms does not necessarily indicate that a
dreams that are acted out are generally unpleas- disease or disorder is fully cured. See also spon-
ant or combative, this behavior is usually disrup- taneous remission.
tive and can result in violence. In DSM–IV–TR REM latency the time between onset of sleep
this disorder is classified as a parasomnia not and the first occurrence of rapid eye movement
otherwise specified. (REM).
remedial therapy intervention aimed at assist- remorse n. a strong sense of guilt and regret for a
ing a person to achieve a normal or increased past action.
level of functioning when functioning is below
expectation in a particular area (e.g., reading). remote cause a cause that is removed from its
Also called remedial training. effect in time or space but is nevertheless the ul-
timate or overriding cause. In a causal chain, it
remembering n. the process of consciously re-
may be considered to be the precipitating event
viving or bringing to awareness previous events,
without which the chain would not have begun
experiences, or information. Remembering also
(the original cause). For example, the proxi-
involves the process of retaining such material,
mate cause of Smith’s aggression may be a triv-
which is essential to learning, since without it
ial snub, but the remote cause may be Smith’s
one would not profit from training, practice,
early childhood experiences. See also causal la-
or past experience. According to Estonian-born
tency; delayed effect.
Canadian psychologist Endel Tulving (1927– ),
remembering is distinct from knowing (see remotivation n. intervention aimed at increas-
remember–know procedure). ing the likelihood that a person will cooperate
remember–know procedure a procedure with and benefit from treatments. It includes
used to measure two different ways of accessing efforts directed toward stimulating withdrawn
events from one’s past and as an assessment of patients with chronic disorders in mental hospi-
episodic memory and semantic memory, re- tals, for example, by involving them in poetry- R
spectively. Remembering is the conscious and reading groups or conversation groups in which
vivid recollection of a prior event such that a a bridge to reality is established by discussing
person can mentally travel to the specific time current topics.
and place of the original event and retrieve the REM sleep rapid-eye-movement sleep: the stage
details; he or she is able to bring back to mind of sleep, formerly called desynchronized sleep,
a particular association, image, or something in which dreaming occurs and the electro-
more personal from the time of the event. encephalogram shows activity characteristic of
Knowing refers to the experience in which a per- wakefulness (hence it is also known as paradoxi-
son is certain that an event has occurred but fails cal sleep) except for inhibition of motor expres-
to recollect anything about its actual occurrence sion other than coordinated movements of the
or what was experienced at the time of its occur- eyes. It accounts for one quarter to one fifth of
rence; the retrieval of the event is not accompa- total sleep time. Also called activated sleep.
nied by any specific recollection about the time, See dream state. Compare nrem sleep.
place, or details. [introduced in 1985 by Esto- Renard Diagnostic Interview a structured
nian-born Canadian psychologist Endel Tulving interview developed in 1977 at the Renard Hos-
(1927– )] pital, Washington University (St. Louis), to elicit
Remeron n. a trade name for mirtazapine. enough information to establish criteria for the
remifentanil n. see fentanyl. diagnosis of 15 major psychiatric disorders. See
reminiscence n. 1. the recalling of previous ex- research diagnostic criteria.
periences, especially those of a pleasant nature. renifleur n. a person with a morbid interest in
493
Renpenning’s syndrome
body odors, especially as a means of sexual ex- quantified through the study of past behavior.
citement. See osphresiolagnia. Also called behavioral repertoire.
Renpenning’s syndrome a condition that is repertory grid a technique used to analyze an
inherited as an X-linked trait (see sex-linked), individual’s personal constructs. A number
marked by eye defects, microcephaly, psy- of significant concepts are selected, each of
chomotor retardation, short stature, small testes, which is rated by the participant on a number
and mental retardation. [Hans Renpenning of dimensions using a numerical scale. The
(1929– ), Canadian physician] findings are displayed in matrix form and can
be subjected to statistical analysis to reveal corre-
renunciation n. 1. in general, the act of giving
lations. The repertory grid was developed prin-
something up or denying oneself. 2. in psycho-
cipally as a means of analyzing personal relation-
analytic theory, a refusal of the ego to follow im-
ships but has also been used to determine the
pulses of the id. —renounce vb.
complexity of a person’s thinking (cognitive
reorganization principle the principle that complexity) and in various other applications.
new learning or perception disrupts old cogni- [introduced by U.S. psychologist George A. Kelly
tive structures, requiring a reorganized structure. (1905–1967)]
This is in opposition to the associationist princi- repetition compulsion in psychoanalytic
ple that new learning is essentially added on to theory, an unconscious need to reenact early
existing structures. traumas in the attempt to overcome or master
reorientation therapy see conversion the- them. In repetition compulsion the early painful
rapy. experience is repeated in a new situation sym-
bolic of the repressed prototype. Repetition com-
reparation n. 1. amelioration of or expiation for
pulsion acts as a resistance to therapeutic
harm previously done. See also restitution. 2.
change, since the goal of therapy is not to repeat
in the object relations theory of Melanie
but to remember the trauma and to see its rela-
klein, acts that are performed during the de-
tion to present behavior. Also called compul-
pressive position to repair the relationship
sion to repeat.
with the good object. Klein viewed all creative
and positive acts in adulthood as examples of repetitive strain injury (RSI) a group of
reparation. musculoskeletal disorders involving chronic in-
flammation of the muscles, tendons, or nerves
reparative therapy 1. therapy given to people and caused by overuse or misuse of a specific
who have experienced a sexual assault, includ-
body part. RSI most commonly affects the
ing childhood sexual abuse and adult rape. Pro-
hands, wrists, elbows, arms, shoulders, back, or
cedures generally involve working through the
neck and results in pain and fatigue of the
emotional trauma that was experienced and cog-
affected areas, for example, tendinitis (inflam-
nitive therapy on such issues as self-blame. The
mation, irritation, and swelling of a tendon). Re-
aim of reparative therapy is to turn a victim into
petitive strain injuries are often associated with
a survivor, who is able to return to normal func-
occupational situations, and their prevention is
tioning emotionally, interpersonally, and sexu-
an important issue in ergonomics and human
ally. 2. see conversion therapy.
factors. Also called cumulative trauma dis-
reparenting n. 1. a controversial therapeutic order (CTD); repetitive motion disorder or
procedure used to provide a client with missed injury (RMD; RMI); repetitive stress in-
R childhood experiences. The client, who typically jury.
has severe problems, is treated as a child or in- repetitive transcranial magnetic stimu-
fant; for example, he or she may be fed with a lation (rTMS) see transcranial magnetic
spoon or bottle, hugged, sung to, and provided stimulation.
with what the client or therapist feels the client
missed in childhood. Reparenting has been un- replacement memory see screen memory.
ethically used to justify recreation of the birth replacement therapy 1. treatment in which a
process by wrapping a client in a blanket and natural or synthetic substance is substituted for
having him or her struggle to get out. 2. in self- one that is deficient or lacking in an individual.
help and some forms of counseling, a therapeu- See hormone replacement therapy. 2. the
tic technique in which individuals are urged to process of replacing abnormal thoughts or be-
provide for themselves the kind of parenting at- havior with healthier ones through the use of
titudes or actions that their own parents were therapy focused on constructive activities and
unable to provide. interests.
repeated measures design see within- replication n. the repetition of an original ex-
subjects design. periment to bolster confidence in its results,
based on the assumption that correct hypothe-
repeat offender see recidivism. ses and procedures consistently will be sup-
repertoire n. the sum total of potential behavior ported. In exact replication, procedures are
or responses that a person or nonhuman animal identical to the original experiment or dupli-
is capable of performing. It usually refers to be- cated as closely as possible. In modified replica-
havior that has been learned and is generally tion, alternative procedures and additional
494
residential treatment
conditions may be incorporated. In conceptual sion” because material is expelled from con-
replication, different techniques and manipula- sciousness after it has become conscious. Also
tions are introduced to gain theoretical informa- called secondary repression.
tion. repression-resistance n. in psychoanalysis,
reportability n. the quality of psychological the resistance deployed by the patient in order
events that enables them to be described by the to maintain repression of unacceptable im-
experiencing individual. It is the standard be- pulses. This may manifest itself in the patient’s
havioral index of conscious experience (see con- forgetting of events, an impeded flow of free as-
sciousness). Also called verbal report. sociations, or in the patient’s application of in-
representation n. that which stands for or sig- terpretations offered by the analyst to others but
nifies something else. For example, in cognitive not to himself or herself. Also called ego resis-
psychology the term denotes a mental repre- tance. Compare id resistance.
sentation whereas in psychoanalytic theory it repression–sensitization defense mecha-
refers to the use of a symbol to stand for a nisms involving approach and avoidance re-
threatening object or a repressed impulse. —rep- sponses to threatening stimuli. The sensitizing
resent vb. —representational adj. —repre- process involves intellectualization in approach-
sentative adj. ing or controlling the stimulus, whereas repres-
representative design an experimental de- sion involves unconscious denial in avoiding the
sign in which background variables are inten- stimulus.
tionally not controlled so that research results repressive coping style a pattern of dealing
will apply more realistically to the real world. with life characterized by downplaying prob-
representativeness heuristic a strategy for lems or misfortunes and maintaining an artifi-
making categorical judgments about a given per- cially positive view. Repressive coping is
son or target based on how closely the exemplar diagnosed by a combination of high scores on
matches the typical or average member of the social desirability bias and low scores on re-
category. For example, given a choice of the ported anxiety. See also positive illusion.
two categories “poet” and “accountant,” judges Research Diagnostic Criteria (RDC) a mod-
are likely to assign a person in unconventional ification of criteria developed from the renard
clothes reading a poetry book to the former cate- diagnostic interview for diagnosis of psychi-
gory; however, the much greater frequency of atric disorders, expanding the number of disor-
accountants in the population means that such a ders from the original 15 to 25. It focuses on
person is more likely to be an accountant. Com- present or past episodes of illness and gives in-
pare availability heuristic. clusion and exclusion criteria for diagnosis of
representative sampling the selection of in- the different disorders.
dividuals for a study from a larger group (popula- reserpine n. see rauwolfia derivatives.
tion) in such a way that the sample obtained
accurately reflects the total population. residential care long-term care for older
adults, patients with chronic illness, or individu-
repressed memory see recovered memory.
als undergoing rehabilitation that provides
repression n. 1. in classic psychoanalytic theory housing and meals and may also provide medi-
and other forms of depth psychology, the cal, nursing, and social services.
basic defense mechanism that consists of ex-
residential habilitation a home and com-
cluding painful experiences and unacceptable
munity-based service provided for a person
R
impulses from consciousness. Repression oper-
ates on an unconscious level as a protection with mental retardation or a related condition.
against anxiety produced by objectionable sex- This service is similar to day habilitation but is
ual wishes, feelings of hostility, and ego- delivered in a supervised or supportive residen-
threatening experiences of all kinds. It also tial setting or in a family home.
comes into play in most other forms of defense, residential schools special educational facili-
as in denial, in which individuals avoid unpleas- ties that provide residential services for children
ant realities by first repressing them and then with mental retardation. Although historically
negating them. See primary repression; re- significant, the use of such facilities greatly di-
pression proper. 2. the suppression or exclu- minished during the latter part of the 20th cen-
sion of individuals or groups within the social tury, and children with mental retardation now
context, through limitations on personal rights receive public education in their home commu-
and liberties. Compare suppression. —repress nities.
vb. residential treatment treatment that takes
repression proper in psychoanalytic theory, a place in a hospital, special center, or other facil-
form of repression that acts upon experiences ity that offers a treatment program and residen-
and wishes that have been conscious to make tial accommodation. Some programs require
them unconscious. This is in contrast to pri- residence for a specific time (e.g., a one-month
mary repression, which operates on material treatment for addictions), and some may include
that has never been conscious. Sigmund freud provision for the client to learn or work in the
also called this form of repression “afterexpul- community during the day.
495
residual
residual 1. adj. denoting a condition in which resistant attachment see ambivalent at-
acute symptoms have subsided but chronic or tachment.
less severe symptoms remain. 2. adj. denoting re- resocialization n. the process of enabling indi-
maining ability (e.g., residual hearing) or a re- viduals with mental disorders to resume appro-
maining disability (e.g., residual loss of vision) priate interpersonal activities and behaviors and,
after a trauma or surgery. 3. n. in statistics, the generally, to participate in community life
difference between the value of an empirical ob- through more adaptive attitudes and skills.
servation and the value of that observation pre- resolution phase see sexual-response cycle.
dicted by a model.
resource awareness knowledge by a therapist
residual attention-deficit disorder in or counselor of community services and agen-
DSM–III, the condition (designated attention- cies that could assist clients in meeting their
deficit disorder, residual type) of a child previ- needs or in bolstering positive strategies, direc-
ously diagnosed as having attention-deficit tions, or gains achieved in psychotherapy or
disorder with hyperactivity in whom the hyper- counseling.
activity component has ceased. In DSM–IV–TR respect n. an attitude of, or behavior demon-
the equivalent diagnosis is attention-def- strating, esteem, honor, regard, concern, or
icit/hyperactivity disorder not otherwise other such positive qualities on the part of one
specified or attention-deficit/hyperactiv- individual or entity for another individual or en-
ity disorder, predominantly inattentive type. tity. Respect can serve an important purpose in
residual schizophrenia a subtype of schizo- interpersonal and intergroup relations by aiding
phrenia diagnosed when there has been at least in communication, for example. It is considered
one schizophrenic episode but positive symp- to play a crucial role as a bidirectional process in
toms (e.g., delusions, hallucinations, disorga- psychotherapy according to many theorists and
nized speech or behavior) are no longer present practitioners.
and only negative symptoms (e.g., flat affect, respiratory depression slow and shallow
poverty of speech, or avolition) or mild behav- breathing that can be induced by opioids and
ioral and cognitive disturbances (e.g., eccentrici- other sedatives. These drugs raise the threshold
ties, odd beliefs) occur. level of respiratory centers in the medulla
resignation n. an attitude of surrender to or ac- oblongata of the brain that normally would react
ceptance of one’s situation or symptoms. to increased carbon dioxide in the tissues by in-
creasing the rate and depth of breathing. Respi-
resilience n. the process and outcome of success- ratory depression is a primary hazard of the use
fully adapting to difficult or challenging life of morphine and other opioid analgesics, but
experiences, especially through mental, emo- is also observed with cns depressants, such as
tional, and behavioral flexibility and adjustment barbiturates. Respiratory depression is less com-
to external and internal demands. A number of mon with benzodiazepines unless they are
factors contribute to how well people adapt to taken together with another CNS depressant,
adversities, predominant among them (a) the such as alcohol.
ways in which individuals view and engage with
respiratory disorder any disorder involving
the world, (b) the availability and quality of so-
one or more components of the respiratory
cial resources, and (c) specific coping strate-
system, such as the diaphragm, lungs, trachea,
gies. Psychological research demonstrates that
R larynx, or nasal cavities. See also asthma; hy-
resources and skills in each of these domains as-
perventilation; pseudoasthma.
sociated with more positive adaptation (i.e.,
greater resilience) can be cultivated and prac- respiratory distress syndrome a disorder of
ticed. Also called psychic resilience; psycho- some newborn babies in which the lungs fail to
logical resilience. See also coping behavior; expand due to deficiency of a natural surfactant
coping-skills training. —resilient adj. that prevents the alveoli (air sacs) from collaps-
ing. The alveoli are lined with a membrane of
resistance n. 1. in psychotherapy and analysis, hyaline material. The condition, which is most
unconscious obstruction, through the client’s common in premature infants, may worsen pro-
words or behavior, of the therapist’s or analyst’s gressively before the lungs begin producing
methods of eliciting or interpreting psychic ma- surfactant. Also called hyaline membrane
terial brought forth in therapy. Psychoanalytic disease.
theory classically interprets resistance as a form
respite care assistance, supervision, and recre-
of defense and distinguishes three types: con-
ational or social activities provided for a person
scious resistance, id resistance, and repres-
who is unable to care for him- or herself (e.g., be-
sion-resistance. 2. the degree to which an
cause of a disability or chronic illness) for a lim-
organism can defend itself against disease-
ited period in order to temporarily relieve family
causing microorganisms. 3. the degree to which
members from caregiving responsibilities or en-
disease-causing microorganisms withstand the
able them to conduct necessary personal or
action of drugs. —resist vb. —resistant adj.
household affairs. These services may be pro-
resistance stage see general adaptation vided for a child or adult on a scheduled or un-
syndrome. scheduled basis, either regularly or occasionally,
496
retardation
after school hours, at weekends, or overnight, cal or nursing care. See adult home; assisted
and either in the home or at another location. living.
Also called in-home respite. restitution n. the act of restoring or compensat-
respondent n. 1. the organism that responds to ing for something lost through prior damaging
a stimulus. 2. a person who is interviewed or actions or events. Acts of restitution exist on
who replies to a survey or questionnaire. 3. in a behavioral spectrum: They may be a healthy,
conditioning, any reflex that can be condi- even necessary, part of acknowledging and deal-
tioned by pavlovian conditioning proce- ing with harm committed intentionally or un-
dures. intentionally, but they may also, more pathologi-
response n. any glandular, muscular, neural, or cally, take such forms as a compulsive drive to
other reaction to a stimulus. A response is a “do for others” or a persistent pattern of martyr-
clearly defined, measurable unit of behavior dis- dom.
cussed in terms of its result (e.g., pressing a lever) restless-legs syndrome see ekbom’s syn-
or its physical characteristics (e.g., raising an drome.
arm. restoration therapy 1. treatment that is di-
response acquiescence see yea-saying. rected toward the reestablishment of structure
and function in a body part or system following
response amplitude the magnitude of a re-
disease or injury. For example, vision restoration
sponse, especially in conditioning.
therapy for individuals following post-gen-
response bias a tendency to give one response iculate visual system lesions is intended to en-
more than others, regardless of the stimulus con- large the size of the visual field and facilitate
dition. In signal detection theory, response recovery of more complex visual function. 2. a
bias is the overall willingness to say “yes” (signal form of complementary and alternative
present) or “no” (signal not present), regardless medicine that uses techniques and concepts
of the actual presence or absence of the signal. from massage, chiropractic, osteopathy, shiatsu,
response maintenance the extent to which acupressure, and herbal formulas to treat specific
changes are maintained for a period of time after ailments and enhance overall health by balanc-
an intervention has been completed. ing the body’s life-force energy (see chi) and
breaking down soft tissues, which then rebuild
response prevention a type of behavior ther- themselves. [created by Japanese professor Henry
apy used to treat obsessive-compulsive disor-
S. Okazaki (1890–1951)]
der, involving exposure to situations or cues
that trigger obsessions or provoke compul- restorative environment an environment,
sions, followed by the prevention of the com- often a natural setting, that rejuvenates and can
pulsive behavior. Also called exposure and re- help restore depleted attention resources or re-
sponse prevention. duce emotional and psychophysiological stress.
Characteristic features of restorative environ-
response set a tendency to answer questions in ments include legibility and elements that give
a systematic manner that is unrelated to their rise to contemplation and provide a break from
content. [first extensively discussed and studied one’s normal routine. There is growing interest
by Lee J. cronbach] in the incorporation of restorative elements into
restatement n. in psychotherapy and counsel- health care settings because of evidence that
ing, the verbatim repetition or rephrasing by the they speed recovery.
therapist or counselor of a client’s statement.
R
Restoril n. a trade name for temazepam.
The purpose is not only to confirm that the cli-
ent’s remarks have been understood, but also to restraint n. 1. the ability to control or prevent
provide a “mirror” in which the client can see his actions or behaviors that are harmful or other-
or her feelings and ideas more clearly (see mir- wise undesirable. See self-control. 2. the use
roring). Compare clarification; interpreta- of control measures to prevent violent patients
tion; reframing. from injuring themselves or others.
rest-cure technique a treatment approach, de- restricted affect emotional expression that is
veloped in the 19th century, for individuals with reduced in range and intensity. It is common in
nervous disorders attributed to the hectic pace of depression, inhibited personalities, and schizo-
life in the “railroad age.” The regimen consisted phrenia. See flat affect.
not only of extended rest, but also physical RET abbreviation for rational emotive therapy.
therapy, massage, environmental change, mild See rational emotive behavior therapy.
exercise, and a nutritious diet. Although the retardation n. 1. a slowing down of or delay of
technique itself is no longer used, the concept it an activity or process, as in psychomotor re-
embodies is still applied in such activities as tak- tardation or mental retardation. 2. in con-
ing time off work for a “mental health day” or ditioning, a delay in the appearance of a
spending time at a health spa. [developed by U.S. conditioned (learned or acquired) response due
physician Silas Weir Mitchell (1829–1914)] to prior experience. For example, presentation of
rest home a facility for convalescent care or for a stimulus to be used later as a conditioned stim-
older adults who do not need continuous medi- ulus slows the development of conditioning.
497
retarded depression
retarded depression an obsolescent name for formation is accompanied by the feeling that
a major depressive episode that includes there is an impediment or block to its recollec-
psychomotor retardation and appetite loss. tion, as in the well-known tip-of-the-tongue
retarded ejaculation see male orgasmic dis- phenomenon.
order. retrieval cue a prompt or stimulus used to
retention n. 1. persistence of learned behavior guide memory recall.
or experience during a period when it is not retrieval failure the inability to recollect in-
being performed or practiced, as indicated by the formation that is known to be available in mem-
ability to recall, recognize, reproduce, or relearn ory.
it. 2. the storage and maintenance of a memory.
Retention is the second stage of memory, after retrograde amnesia see amnesia.
encoding and before retrieval. 3. the inabil- retrograde ejaculation the ejaculation of
ity or refusal of an individual to defecate or uri- semen in a reverse direction, that is, into the uri-
nate. —retentive adj. nary bladder, from which it is excreted later. This
retest reliability an estimate of the ability of may be a result of surgery of the prostate gland,
an assessment instrument (e.g., a test) to mea- and it also occurs when the penis is squeezed just
sure an attribute consistently: It is obtained as before ejaculation—a misguided attempt at pre-
the correlation between scores on two adminis- venting impregnation. Retrograde ejaculation is
trations of the test to the same individual. Also occasionally associated with the use of antide-
called test–retest reliability. pressants, including the tricyclic antidepres-
sants and ssris, as well as conventional
reticular activating system (RAS) a part of
antipsychotic agents (particularly thioridazine).
the reticular formation thought to be partic-
There are also reports of retrograde ejaculation
ularly involved in the regulation of arousal,
with the use of atypical antipsychotics (e.g.,
alertness, and sleep–wake cycles.
risperidone).
reticular formation an extensive network of
nerve cell bodies and fibers within the retrograde memory the ability to recall
brainstem, extending from the medulla oblong- events that occurred or information that was ac-
ata to the upper part of the midbrain, that is quired prior to a particular point in time, often
widely connected to the spinal cord, cerebellum, the onset of illness or physical damage such as
thalamus, and cerebral cortex. It is most promi- brain injury. For example, an individual with
nently involved in arousal, alertness, and sleep– deficits of retrograde memory (amnesia) might
wake cycles, but also functions to control some not remember the name of a close childhood
aspects of action and posture. Also called friend but would remember the name of a new
brainstem reticular formation. See also person just introduced to him or her. Compare
reticular activating system. anterograde memory.
retifism n. a form of fetishism in which sexual retrogression n. the return to a previous inap-
excitement is achieved through contact or mas- propriate behavior or to a behavior appropriate
turbation with a shoe or foot. Shoes or feet are to an earlier stage of maturation when more
among the most common varieties of object fe- adult techniques fail to solve a conflict. It is ap-
tish, but there is little understanding of why this proximately equivalent to regression, but
occurs. The condition is named for French writer without the full psychoanalytic connotations.
R Nicolas-Edme Rétif (1734–1806), also known as retrospection n. the process of reviewing or re-
Rétif de la Bretonne, who is said to have had a flecting upon an experience from the past, either
sexual interest in women’s footwear. directed (as in learning and memory research) or
retinodiencephalic degeneration see lau- spontaneous (as in evaluating one’s behavior in
rence–moon–biedl syndrome. a given situation).
retirement counseling individual or group retrospective audit in health administration,
counseling of employees to help them prepare a method of determining medical necessity or
for retirement. Discussions usually include such appropriate billing practice for services that have
topics as norms for this transition, mental and already been rendered.
physical health, recreational activities, part-time retrospective falsification the addition of
or consultant work, finances, insurance, govern- false details to memories of past experiences,
ment programs, and issues related to change of particularly as done by a person with paranoid
residence. schizophrenia to support a persecutory delu-
retreat from reality see flight from real- sional system.
ity.
retrospective information information that
retrieval n. the process of recovering or locating is gained by asking people to recall feelings,
information stored in memory. Retrieval is the events, and behaviors from their distant past.
final stage of memory, after encoding and re- This type of information is usually regarded as
tention. less accurate and reliable than information
retrieval block a brief retrieval failure in gained by recording events and experiences
which the inability to recall a specific piece of in- while they are occurring.
498
Rh factor
retrospective medical audit see medical reverse tolerance an effect of certain drugs,
audit. usually psychoactive substances (particularly
retrospective research observational, non- CNS stimulants), in which repeated use alters the
experimental research that tries to explain the body’s sensitivity so that repeated administra-
present in terms of past events; that is, research tion of a drug will enhance the effects of that
that starts with the present and follows subjects drug. Also called sensitization. Compare tol-
backward in time. For example, a retrospective erance.
study may be undertaken in which individuals reversible inhibitors of monoamine
are selected on the basis of whether they exhibit oxidase (RIMAs) see monoamine oxidase in-
a particular problematic symptom and are then hibitor.
studied to determine if they had been exposed to Reversol n. a trade name for edrophonium.
a risk factor of interest. Compare prospective ReVia n. a trade name for naltrexone.
research.
revivification n. a hypnotic technique in
Rett syndrome a pervasive developmental which suggestion is used to induce an individual
disorder that occurs almost exclusively in fe- to revive and relive forgotten or inhibited mem-
male children who develop normally early in life ories.
but then, between 6 and 18 months, undergo
rapid regression in motor, cognitive, and social
revolving-door phenomenon the repeated
readmission of patients to hospitals or other in-
skills; these skills subsequently stabilize at a level
stitutions, often because they were discharged
that leaves the child with mental retardation.
before they had adequately recovered.
Symptoms generally include loss of language
skills, hand motion abnormalities (e.g., hand reward system a set of interrelated factors that
wringing and other repetitive, purposeless link a particular stimulus with some form of sat-
movements), learning difficulties, gait distur- isfaction or pleasure.
bances, breathing problems, seizures, and pro- Rey Auditory Verbal Learning Test
nounced deceleration of head growth. [first (RAVLT) a test for evaluating verbal learning
described in 1966 by Andreas Rett (1924–1997), and memory, including proactive inhibition,
Austrian pediatrician] retroactive inhibition, retention, encoding ver-
reuptake n. the process by which neurotrans- sus retrieval, and organization. Originally devel-
mitter molecules that have been released at a oped in the 1940s, the RAVLT now has several
synapse are taken up by the presynaptic neuron variations. The standard format starts with a list
that released them. Reuptake is performed by of 15 words, and the participant is required to re-
transporter proteins in the presynaptic mem- peat all the words he or she can remember, in
brane. any order. This procedure is carried out a total of
five times. Next, the examiner presents a second
reversal error a mistake in which a letter or list of 15 words, allowing the participant only
word is read or written backward (e.g. tip for pit
one attempt at recall. Immediately following
or b as d). When reversal errors are marked and
this, the participant is asked to remember as
developmentally inappropriate, they are indica-
many words as possible from the first list. A de-
tive of dyslexia. See also strephosymbolia.
layed recall trial as well as a recognition trial may
reversal of affect in psychoanalytic theory, a also be administered. [André Rey (1906–1965),
change in the aim of the instinct into its oppo- Swiss psychologist]
site, as when a masochistic impulse to hurt the RFT abbreviation for rod-and-frame test. R
self is transformed into a sadistic impulse to hurt
others, or vice versa. Also called affect inver- Rh blood-group incompatibility an anti-
sion; inversion of affect. gen-antibody reaction that occurs when blood
from an Rh-positive individual is mixed with
reversal theory a theory of motivation, emo- blood from an Rh-negative individual (see rh
tion, and personality that attempts to explain factor) during transfusion or pregnancy. In
the relationship between arousal and perfor- pregnancy, this arises if an Rh-negative mother
mance. It suggests that the way an individual in- bears a child that has inherited Rh-positive
terprets the arousal, rather than the amount of blood: The fetal Rh antigens pass through the
arousal, affects performance and that he or she placental membrane, and maternal antibodies
can reverse the positive–negative interpretation react through the placenta to destroy the fetal
from moment to moment. red blood cells. The damaged blood cells yield
reverse anorexia a condition characterized bilirubin, which the fetus cannot detoxify, and
by an individual’s desire to increase body size, kernicterus may result. Also called rhesus in-
particularly muscularity. As with anorexia ner- compatibility. See also rh reaction.
vosa, in which the desire is to lose weight or re- RHC abbreviation for rural health clinic.
duce body size, the drive to alter body size is not
rhesus factor see rh factor.
diminished by achieving extensive body modifi-
cation. The individual’s unhappiness with self- rheumatoid arthritis see arthritis.
image, despite excessive gains in muscle mass Rh factor (rhesus factor) any of at least eight
and definition, is still present. See also muscle different antigens, each determined genetically,
dysmorphia. that may be attached to the surface of an individ-
499
rhizomelic
ual’s red blood cells (the name derives from the teeth and hypoplasia (underdevelopment) of the
rhesus monkey, used in early studies of the fac- enamel. Visual disorders usually involve anoma-
tor). A person whose blood cells carry an Rh fac- lies of the iris and cornea. Mental retardation is
tor is said to be Rh-positive. One whose blood sometimes present. Also called hypodontia.
cells lack an Rh factor is Rh-negative. Some 99% [initially reported in 1935 by Herwigh Rieger
of African Americans, Native Americans, and (1898–1986), German ophthalmologist]
Asian Americans and 85% of Caucasians are Rh- right brain the right cerebral hemisphere. The
positive. See also rh reaction. term is sometimes used to designate functions or
rhizomelic adj. relating to or affecting the hip, cognitive style supposedly mediated by the
shoulder, or both. Rhizomelic abnormalities are right (rather than by the left) hemisphere, such
associated with certain congenital defects that as spatial perception. See also hemispheric
may be accompanied by mental retardation. An lateralization.
affected individual may, for example, have one right hemisphere the right half of the cere-
leg shorter than the other or contractures of the brum, the part of the brain concerned with sen-
hip and shoulder joints. sation and perception, motor control, and
Rh reaction an adverse effect that can occur in higher level cognitive processes. The two cere-
blood transfusions and pregnancies when an Rh- bral hemispheres differ somewhat in function;
negative person’s blood is mixed with Rh- for example, in most people the right hemi-
positive blood from another individual (see rh sphere has greater responsibility for spatial at-
factor). This reaction is similar to the immune tention. See hemispheric lateralization.
reaction that occurs in response to an invasion Compare left hemisphere.
of the body tissues by a foreign agent. In preg- right-hemisphere consciousness a hypoth-
nancy, an Rh-negative mother may carry an Rh- esis that the right cerebral hemisphere of the
positive fetus, her body forming anti-Rh anti- brain is conscious, like the left hemisphere, even
bodies that destroy the red blood cells of the though it has no control of spoken communica-
fetus. See also rh blood-group incompatibil- tion (compare left-hemisphere conscious-
ity. ness). The right hemisphere is postulated to
rhyming delirium compulsive speaking or re- function in a holistic, nonlinear manner, spe-
sponding in rhymes, occasionally associated cialized for spatial and prosodic perception. [at-
with a manic episode. tributed to Roger sperry]
rhythm n. 1. a regular pattern of changes, fluctu- rights of patients see patients’ rights.
ations, or occurrences, for example, a biologi- rights of people with mental retarda-
cal rhythm. 2. the frequency of brain waves, tion rights enshrined in the United Nations
identified as alpha waves, beta waves, gamma Standard Rules on the Equalization of Opportu-
waves, delta waves, and theta waves. 3. the ca- nities for Persons with Disabilities (1993). People
dence or long-term temporal structure of similar with mental retardation have the same rights as
sounds. —rhythmic or rhythmical adj. other human beings. These include (a) the right
rhythm method a technique of contraception to receive proper medical care, physical therapy,
in which the woman abstains from coitus during education, training, rehabilitation, assistive
the days of her menstrual cycle in which she is technology, and guidance; (b) the right to eco-
most likely to become pregnant, that is, from nomic security and to work; (c) the right to live
just before until just after ovulation. The rhythm with their families or with foster parents or, if
R method is not very effective because of the diffi- this is not feasible, to live in a residential setting
culty in making advance predictions of the pre- under circumstances as close as possible to fam-
cise time of ovulation. The predictions are made ily life; and (d) the right to protection from abuse
by charting rectal or vaginal temperature and exploitation.
changes daily or by testing changes in the sugar right to die the right to physician-assisted sui-
content of the cervical mucus. See also calen- cide that some consider should be available for
dar method of birth control. terminally ill patients (see assisted death). This
ribonucleic acid see rna. is distinguished from the right to refuse
Ribot’s law 1. the principle that the most re- treatment in cases in which the patient is on
cently acquired memories are the most vulnera- life support.
ble to disruption from brain damage. As a result, right to effective treatment the policy posi-
a temporal gradient is observed in retrograde tion or ethical stance that people with a disabil-
amnesia. 2. a generalization stating that when a ity or a disorder have the legal, civil, or moral
multilingual person recovers from aphasia right to receive services to alleviate or cure their
caused by a stroke or cerebral injury, the lan- condition. With respect to specific therapies,
guage recovered first will be the person’s native this entails the use of methods that have been
language. [Théodule Ribot (1839–1916), French empirically and scientifically validated for effi-
psychologist] cacy and effectiveness.
Rieger’s syndrome an autosomal dominant right to refuse treatment 1. the right of pa-
disorder marked by dental and eye abnormali- tients with mental illness to refuse treatment
ties. The dental anomalies may include missing that may be potentially hazardous or intrusive
500
ritual
(e.g., electroconvulsive therapy or psycho- likely to pose if released from the confinement
active drugs), particularly when such treat- in which he or she is held as a result of mental ill-
ment does not appear to be in the best interests ness or criminal acts. See actuarial risk assess-
of the patient. In the United States, various state ment; clinical risk assessment.
laws and court rulings support the rights of pa- risk aversion the tendency, when choosing be-
tients to receive or reject certain treatments, but tween alternatives, to avoid options that entail a
there is a lack of uniformity in such regulations. risk of loss, even if that risk is relatively small.
See also forced treatment. 2. the right of ter-
minally ill patients (e.g., those on life-support risk factor a clearly defined behavior or consti-
systems) to refuse treatment intended to prolong tutional (e.g., genetic), environmental, or other
their lives. See also right to die. characteristic that is associated with an increased
possibility or likelihood that a disease or disorder
right to treatment 1. a statutory right, estab- will subsequently develop in an individual.
lished at varying governmental levels, stipulat-
ing that people with disabilities or disorders, risk metrics numbers, formulas, graphs, or
usually persistent or chronic in nature, have the other means of presenting or describing the pro-
right to receive care and treatment suited to their bability or likelihood of developing a disease or
needs. Such statutory rights may apply nation- disorder.
ally or to certain state or provincial areas, or they risk perception an individual’s subjective as-
may be limited to certain conditions and disabil- sessment of the level of risk associated with a
ities. 2. the principle that a facility that has as- particular hazard. Risk perceptions will vary ac-
sumed the responsibility of offering treatment cording to such factors as past experiences, age,
for a patient is legally obligated to provide treat- gender, and culture. For example, women tend
ment that is adequate and appropriate. to overestimate their risk of developing breast
right to withdraw the right of participants in cancer. These exaggerated perceptions of risk
research to remove themselves from the study or often motivate people to seek genetic services,
procedure at any point. Ethically speaking, this genetic testing, or prophylactic surgery.
prerogative would follow naturally from volun- risk–rescue rating a formula comparing the
tary participation and from the guarantee that inherent risk of a method of attempted suicide
refusal to continue will not result in penalty or with the likelihood of discovery and rescue.
loss of any benefits that a participant might have risk taking 1. a pattern of unnecessarily engag-
independent of the study. See also informed ing in activities or behaviors that are highly
consent. subject to chance or dangerous. This pattern of
rigid family a family structure in which rules behavior is often associated with substance
are never questioned and there are no excep- abuse, gambling, and high-risk sexual behaviors.
tions to rules. Such a structure can be a cause of 2. accepting a challenging task that simulta-
emotional and behavioral problems for the chil- neously involves potential for failure as well as
dren of the family. for accomplishment or personal benefit. It is
rigidity n. 1. stiffness or inflexibility, particu- often associated with creativity and taking calcu-
larly muscular rigidity. 2. a personality trait lated risks in the workplace or in educational set-
characterized by strong resistance to changing tings.
one’s behavior, opinions, or attitudes or inabil- risk tolerance the level of risk to which an indi-
ity to do this. 3. the tendency, after brain injury, vidual is willing to be exposed while performing
to be inflexible and complete a task in only one an action or pursuing a goal. Tolerance of risk is R
manner, despite more effective available alterna- usually based upon an assumption (justified or
tives. —rigid adj. not) that the risk is slight, the consequences are
RIMAs abbreviation for reversible inhibitors of minor, and that both are outweighed by imme-
monoamine oxidase. See monoamine oxidase diate benefits.
inhibitor. risperidone n. an atypical antipsychotic of
ring chromosome 18 a congenital chromo- the benzisoxazole class. It was the second atypi-
somal disorder characterized by microcephaly, cal antipsychotic introduced into the U.S. mar-
ear and eye abnormalities, and severe mental re- ket (clozapine was the first). It has a less
tardation. The condition is not hereditary but frequent incidence of extrapyramidal symptoms
due to breakage of the arms of chromosome 18, than conventional antipsychotics when used at
which fuse to form one or more rings of varying a lower dose range and it acts as a potent inhibi-
sizes. tor of both D2 dopamine and 5-HT2 serotonin re-
risk n. 1. the probability or likelihood that an ceptors. U.S. trade name: Risperdal.
event will occur, such as the risk that a disease or Ritalin n. a trade name for methylphenidate.
disorder will develop. 2. the probability of expe- ritual n. 1. a form of compulsion involving a
riencing loss or harm that is associated with an rigid or stereotyped act that is carried out repeat-
action or behavior. See also at risk; morbidity edly and is based on idiosyncratic rules that do
risk; risk factor. —risky adj. not have a rational basis (e.g., having to perform
risk assessment the process of determining the a task in a certain way). Rituals may be per-
threat of dangerousness an individual would be formed in order to reduce distress and anxiety
501
ritual abuse
caused by an obsession. 2. a ceremonial act or do, 50% are likely to have mental retardation.
rite, usually involving a fixed order of actions or Also called Appelt–Gerken–Lenz syndrome.
gestures and the saying of certain prescribed [described in 1919 by John Bingham Roberts
words. 3. more generally, any habit or custom (1852–1924), U.S. physician, and in 1966 by
that is performed routinely and with little or no Hans Appelt (1919–1988), H. Gerken, and Widu-
thought. —ritualism n. —ritualistic adj. kind Lenz (1919–1995), German physicians]
ritual abuse organized, repetitive, and highly Robitussin n. see dextromethorphan.
sadistic abuse of a physical, sexual, or emotional
rocking n. a stereotyped motor behavior in
nature, perpetrated principally on children. The
which the body rocks to and fro, often observed
abuse is reported as using rituals and symbols
in children or adults with severe or profound
from religion (e.g., upside-down crosses), the oc-
mental retardation, autistic disorder, or ste-
cult, or secret societies. It may also include the
reotypic movement disorder. Also called
creation of pornography or the selling of sexual
body rocking.
access to children. Victims may be forced to en-
gage in heinous acts, such as the killing of ani- Rod-and-Frame Test (RFT) a test used to
mals, as a means of coercing their participation study the role of visual and gravitational cues in
and silence. judging the visual vertical. It is the most widely
rivastigmine n. a carbamate that is a revers- used measure of field dependence and field
ible acetylcholinesterase inhibitor, used for independence. The test consists of a movable
the treatment of mild to moderate dementia rod inside a frame; the participant must adjust
associated with Alzheimer’s disease (see noo- the rod to a true vertical position as the position
tropic). Because it can cause nausea and loss of of the frame is changed. Degree of error (i.e., the
appetite, low starting doses with a slow upward number of degrees away from 90%) is the mea-
titration are recommended. U.S. trade name: sure used to score the test. The higher the score,
Exelon. the more field dependent the participant is; the
lower the score, the more field independent he
RMD abbreviation for repetitive motion disorder or she is. [developed in 1948 by U.S. psycholo-
(see repetitive strain injury). gists Herman A. Witkin (1916–1979) and Solo-
RMI abbreviation for repetitive motion injury mon asch]
(see repetitive strain injury). Rogerian therapy see client-centered ther-
RMT abbreviation for recognition memory apy.
test.
Rogers, Carl (1902–1987) U.S. psychologist.
RN abbreviation for registered nurse. Rogers received his doctorate from Columbia
RNA ribonucleic acid: a nucleic acid that directs University’s Teachers College in 1931. He held a
the synthesis of protein molecules in living cells. number of faculty positions in his career, but it
There are three main types of RNA. messenger was while teaching at the University of Chicago
rna carries the genetic code from the cell nu- (1944–1957) that he most fully developed and
cleus to the cytoplasm. Ribosomal RNA is found described his distinctive approach to psycho-
in ribosomes, small particles where proteins are therapy. Rogers originated client-centered
assembled from amino acids. Transfer RNA car- therapy and the nondirective approach,
ries specific amino acids for protein synthesis. which he conceived as providing the client with
Each of the 20 amino acids has a corresponding a warm, accepting climate that would foster per-
R transfer RNA molecule to place the amino acid in sonality growth and the realization of inner
the proper sequence in protein assembly. RNA is potential. Fitting within the loosely associated
similar to dna in structure except that it consists group of theories and techniques of humanistic
of a single strand of nucleotides (compared with sychology, client-centered therapy offered
the double strands of DNA), the base uracil (U) an important alternative to the Freudian and
occurs instead of thymine (T), and the sugar unit behaviorist psychotherapies then dominant.
is ribose, rather than deoxyribose. Rogers viewed psychological dysfunction as typ-
road rage aggressive or confrontational behav- ically resulting from conditional positive re-
ior while driving, typically triggered by an actual gard, namely, the conditions put on love and
or imagined transgression by another driver. affection by early authority figures, such as par-
Often associated with traffic congestion, road ents and teachers. He believed that individuals
rage varies in severity and can involve hostile who suppressed their own needs in order to re-
verbal expression, hazardous driving, and inter- ceive positive regard from others would develop
personal violence. low self-esteem and be unable to achieve self-
actualization. Client-centered therapy was de-
Robaxin n. a trade name for methocarbamol. signed as a corrective, with the therapist provid-
Roberts syndrome an autosomal recessive dis- ing an atmosphere of unconditional positive
order in which the child is born with abnormally regard, warmth, and uncriticalness that
short arms and legs as well as a cleft lip and pal- would theoretically enable the client to thrive
ate. Other features include microcephaly and and become what Rogers would call a fully func-
genital hypertrophy (enlargement). Few affected tioning person. See also conditions of worth;
individuals survive early infancy; of those who growth principle. —Rogerian adj.
502
rootwork
Rokeach Dogmatism Scale a 66-item scale person under hypnosis takes on a role assigned
developed in 1960 to measure individual differ- by the hypnotist and behaves in accordance
ences in openness or closedness of belief systems with this role while in the hypnotic condition.
(i.e., dogmatism) across several continua, such role expectations expectations regarding the
as “isolation and differentiation between belief traits, attitudes, and behaviors appropriate to a
and nonbelief systems” and “interrelations particular role. These expectations may be com-
among primitive, intermediate, and peripheral municated to the occupant of a role by other
beliefs.” Some studies have found the scale more people or by the occupant himself or herself.
useful in assessing “general authoritarianism”
and “general intolerance.” [Milton Rokeach role overload a situation in which one is asked
(1918–1988), U.S. psychologist] to do more than one is capable of doing in a spe-
cific period of time (quantitative overload) or in
Rokeach Value Survey (RVS) an instrument which one is taxed beyond one’s knowledge,
that assesses participants’ values to help them skills, and abilities (qualitative overload).
determine what is most important in their lives
and make good personal choices (often used as a role play a technique used in human relations
career development instrument). “Value” is de- training and psychotherapy in which partici-
fined as “an enduring belief that a specific mode pants act out various social roles in dramatic sit-
of conduct or end-state of existence is personally uations. Originally developed in psychodrama,
or socially preferable to an opposite or converse role play is now widely used in industrial, educa-
mode of conduct or end-state of existence.” Two tional, and clinical settings for such purposes as
kinds of values are distinguished in the survey: training employees to handle sales problems,
instrumental, that is, modes of conduct and be- testing out different attitudes and relationships
havioral characteristics that are seen as socially in group and family psychotherapy, and rehears-
desirable; and terminal, that is, end-states of ex- ing different ways of coping with stresses and
istence or ultimate modes of living that have conflicts.
been idealized. [Milton Rokeach] role reversal a technique used for therapeutic,
rok-joo n. see koro. educational, and management development
purposes in which an individual exchanges roles
role n. a coherent set of behaviors expected of an with another individual in order to experience
individual in a specific position within a group
alternative cognitive styles (e.g., in problem
or social setting. Since the term is derived from
solving), feelings, and behavioral approaches.
the dramaturgical concept of role (the dialogue
and actions assigned to each performer in a role taking awareness or adoption of the view-
play), there is a suggestion that individuals’ ac- point of another person, typically for the pur-
tions are regulated by the part they play in the pose of understanding his or her thoughts and
social setting rather than by their personal predi- actions.
lections or inclinations. role therapy in psychotherapy, a system that
role conflict a state of tension or distress caused uses real-life psychodrama. The client selects a
by inconsistent or discordant expectations asso- role model, works out the aspects of the model
ciated with one’s social or group role, as when a with the therapist, and then role-plays the
role’s demands are inconsistent with each other model both in the therapeutic session and in real
(intrarole conflict) or individuals occupy life. [developed by U.S. psychologist George A.
more than one role and the behaviors required Kelly (1905–1967)]
by these roles are incompatible with one another rolfing n. a deep-massage technique developed R
(interrole conflict). in the 1930s. It aims to relieve muscular tension,
role confusion 1. a state of uncertainty about a improve posture and balance, and enhance per-
given social or group role. 2. gender role be- sonal functioning through realignment of body
havior in a male or female that is traditionally as- structure. The technique is based on a theory
sociated with the opposite sex. See also gender that muscle massage will relieve both physical
identity disorder; transgender. 3. see iden- and psychological pain. Also called structural
tity versus identity confusion. integration. [devised by Ida P. Rolf (1896–
role diffusion a state of confusion about one’s 1979), U.S. physical therapist]
social role that typically occurs during adoles- Romazicon n. a trade name for flumazenil.
cence. See identity versus identity confu- rootedness n. in the psychoanalytic theory of
sion. [described by Erik erikson] Erich fromm, the need to establish bonds or ties
role-divided psychotherapy a form of with others that provide emotional security and
group therapy in which members meet for part serve to reduce the isolation and insignificance
of the session without the therapist and part that Fromm believed to lie at the heart of human
with the therapist. Also called role-divided existence. It is manifested positively in broth-
therapy. See also cotherapy. [developed by erliness and negatively in incestuous ties.
Latvian-born U.S. therapist George R. Bach rootwork n. a cultural or folk health belief sys-
(1914–1986)] tem, common in some highly localized parts of
role-enactment theory a social psychological the southern United States and the Caribbean,
explanation of hypnosis according to which the that attributes illness to witchcraft, hexing, voo-
503
Rorschach, Hermann
doo, or spells (i.e., “roots”). The individual dis- is primarily outside their control. Those with
plays intense fear, symptoms of anxiety, and high internal measures tend to take more re-
related somatic complaints and typically responsibility for and control of their learning, re-
mains in this state until a traditional healer, sulting in better performance (e.g., on academic
called a root doctor, removes the root. Also tasks). In contrast, those with high external mea-
called brujeria; mal puesto. sures have been shown to take less responsibil-
Rorschach, Hermann (1884–1922) Swiss psy- ity, resulting in poorer performance on tasks.
chiatrist. Rorschach earned his doctorate of [Julian Bernard Rotter (1916– ), U.S. psycholo-
medicine at the University of Zürich in 1912. He gist]
was the originator of the widely used ror- roughness discrimination test a test of
schach inkblot test of personality. For this, he somesthetic sensitivity in which participants are
standardized a set of inkblots, developed criteria asked to determine by touch which of a choice of
for scoring them quantitatively, compared pa- surfaces (e.g., grades of sandpaper) has a greater
tients of varying diagnoses, and conceived the roughness. The ability is sometimes impaired
notion of different experience types that could following a lesion in a brain area related to the
be differentiated using the inkblot test. He was sense of touch.
working on a general theory of personality when round-table technique a group therapy
he died suddenly of peritonitis. The Rorschach technique used in a hospital setting. Three con-
test, developed between 1918 and 1922, did not necting rooms are required. In one, the therapist
come into widespread use until the 1950s, when and others use a one-way window to watch the
it became, for a time, the test of choice in therapy session in progress. In the second room,
psychodiagnosis. selected patients also use a one-way window to
Rorschach Inkblot Test a projective tech- watch the same session. The patients in the third
nique in which the participant is presented with room—the therapy room—sit around a table
ten unstructured inkblots (mostly in black and with a microphone in the center. Their task is to
gray but sometimes in color) and is asked “What recommend a member of their group to go to a
might this be?” or “What do you see in this?” staff meeting for possible discharge and, if the
The examiner classifies the responses according member is discharged, to pick a member from
to such structural and thematic (content) factors the patient group in the adjoining room to join
as color (C), movement (M), detail (D), whole their group. A majority vote prevails. See also mi-
(W), popular or common (P), animal (A), form lieu therapy. [pioneered by U.S. psychologist
(F), and human (H). Various scoring systems, ei- Willis H. McCann (1907–1998)]
ther qualitative or quantitative, are used. The ob- Rouse v. Cameron see least restrictive al-
ject is to interpret the participant’s personality ternative.
structure in terms of such factors as emotional- routes of administration see administra-
ity, cognitive style, creativity, impulse control, tion.
and various defensive patterns. Perhaps the best routinized thoughts see automatic
known, and certainly one of the most controver- thoughts.
sial, assessment instruments in all of psychol-
ogy—it is almost considered “representative” by Royer’s syndrome see prader–willi syn-
the general public—the Rorschach is widely used drome.
and has been extensively researched, with re- RSH syndrome see smith–lemli–opitz syn-
R sults ranging from those that claim strong sup- drome.
port for its clinical utility (e.g., for selecting RSI abbreviation for repetitive strain injury.
treatment modalities or monitoring patient RSTS abbreviation for rubinstein–taybi syn-
change or improvement over time) to those that drome.
demonstrate little evidence of robust or consis-
RSVP in cognitive psychology, abbreviation for
tent validity and that criticize the instrument as
rapid sequential visual presentation.
invalid and useless. [developed in the early
1920s by Hermann rorschach] rTMS abbreviation for repetitive transcranial
magnetic stimulation.
rotation system a technique of group ther-
apy in which the therapist works with each indi- Rubinstein–Taybi syndrome (RSTS; RTS)
vidual in sequence in the presence of other a familial disorder marked by facial abnormal-
group members. ities, including microcephaly and hyper-
telorism, broad thumbs and toes, and mental
rotation treatment see gyrator treatment. retardation, caused by several different genetic
Rotter Internal–External Locus of Con- factors. Hypotonia (flaccid muscles) and a stiff
trol Scale (RIELC) a scale that is used to pro- gait are common. One study found more than
vide information regarding a client’s feelings for 80% of affected individuals had IQs of less than
causality of events. Clients who measure high on 50. Also called Rubinstein syndrome. [Jack H.
internal locus of control (see internalizers) Rubinstein (1925–2006) and Hooshang Taybi
assume causality is primarily under their con- (1919–2006), U.S. pediatricians]
trol; clients who measure high on external locus rule-governed behavior any behavior that is
of control (see externalizers) assume causality influenced by verbal antecedents, such as fol-
504
RxP
lowing instructions (as when a child cleans his mental retardation, and it is possible that delays
or her room because told to do so) or reacting to in development may be due partly to the disor-
one’s own private thinking (as when an adult be- der. Also called merycism. —ruminate vb.
gins an exercise program after thinking “I need rumination disorder in DSM–IV–TR, a disor-
to lose weight”). Also called verbally gov- der characterized by the repeated voluntary re-
erned behavior. gurgitation of ingested food involving ejection
rule modeling an imitative technique in which or reswallowing, but without nausea. Individ-
people learn to control their behavior by follow- uals may develop potentially fatal weight loss
ing the same rules that have been followed by a and malnutrition. It lasts for a period of at least 1
model, even when there are slight situational month and generally occurs during infancy (age
variations. 3 to 12 months), following a period of normal
feeding; however, it may also be observed in in-
rule of abstinence in psychoanalysis, the rule dividuals with severe mental retardation.
that the patient should abstain from all gratifica-
tions that might distract him or her from the an- rural health clinic (RHC) a clinic, physician
alytic process or drain off instinctual energy, practice, or country health department that, in
anxiety, and frustration that could be used as a compliance with the Rural Clinic Services Act, is
driving force in the therapy. Examples of such located in a medically underserved area and uses
gratifications are smoking, engaging in idle con- a physician, physician assistant, nurse prac-
versation, or acting out during the sessions, titioner, or some combination of these to de-
and unlimited sexual activity, absorbing inter- liver primary outpatient health care. See also
ests, and other pleasures pursued outside the ses- national association of rural health clin-
sions. Also called abstinence rule. ics.
rush n. the effect reported when someone re-
rumination n. 1. obsessional thinking involv-
ceives an intravenous injection of amphet-
ing excessive, repetitive thoughts or themes that
amine, cocaine, or methamphetamine. The
interfere with other forms of mental activity. It is
sensation is sometimes described as a dramatic
a common feature of obsessive-compulsive
awakening accompanied by a high and sudden
disorder. 2. the voluntary regurgitation of food
degree of euphoria.
from the stomach to the mouth, where it is mas-
ticated and tasted a second time. It frequently RVS abbreviation for rokeach value survey.
occurs among people with severe or profound RxP abbreviation for prescriptive authority.
505
Ss
s symbol for specific factor. ochism). 2. a paraphilia in which a person
SA abbreviation for social age. is both sadistic and masochistic, deriving sexual
arousal from both giving and receiving pain.
sacrificial paraphilia sexual interest and
—sadomasochist n. —sadomasochistic adj.
arousal involving staged or actual death, with
ritualistic sacrifice features. This may involve, as sadomasochistic personality formerly, in
the sacrificial objects, animals or people. See also psychoanalysis, the characterization of people
paraphilia. who enjoy both exhibiting and receiving aggres-
sive behavior.
SAD abbreviation for seasonal affective disor-
der. SADS abbreviation for schedule for affective
disorders and schizophrenia.
S-adenosylmethionine (SAM) n. a non-
protein chemical compound that mediates nu- Saethre–Chotzen syndrome see chotzen’s
merous metabolic reactions, including those syndrome.
involving certain proteins, phospholipids, neu- safe sex sexual activity in which the exchange of
rotransmitters, and nucleic acids. It is commonly bodily fluids is inhibited as much as possible to
used as a dietary supplement in the treatment of help reduce the risk of unwanted pregnancy or
depression because it may increase levels of sero- contracting sexually transmitted diseases. Pre-
tonin in the brain. It also has been implicated in cautions may include avoidance of high-risk be-
Alzheimer’s disease: Low S-adenosylmethionine haviors, careful selection of one’s partners, and
levels often are observed in those with the disor- the use of preventive barriers (e.g., condoms,
der, which may be a sign of alteration of SAM dental dams).
metabolism. safety and health education instruction re-
sadism n. the derivation of pleasure through cru- garding health-related matters, including the
elty and inflicting pain, humiliation, and other causes and prevention of malnutrition, alcohol-
forms of suffering on individuals. The term gen- ism, drug addiction, and sexually transmitted
erally denotes sexual sadism. In psychoana- disease, as well as safety on the roads, in the
lytic theory, sadism is attributed to the working workshop, at home, and on the playing field. See
of the death instinct and is manifested in also accident prevention.
innate aggressive tendencies expressed from safety behavior a behavior performed by an
the earliest stages of development. For example, anxious individual in an attempt to minimize or
during the oral-biting phase the infant prevent a feared catastrophe. For example, a per-
expresses sadism by taking pleasure in biting. son with panic disorder might only go out
See also anal sadism; oral sadism. [Donatien when accompanied, and a person with social
Alphonse François, Comte (Marquis) de Sade phobia might wear sunglasses indoors to avoid
(1740–1814), French soldier and writer] —sa- eye contact. Safety behaviors may also include
dist n. —sadistic adj. internal mental processes: A person with social
sadistic personality disorder in DSM–III–R phobia might memorize what he or she plans to
(but not in DSM–IV–TR), a personality disorder say at a social gathering. Safety behavior contrib-
characterized by an abusive and intimidating utes to the maintenance of anxiety disorders
manner, inclined to gain satisfaction in coercing when people believe that the behavior, rather
and humiliating others. Such people are often than the lack of actual danger, is what prevents
reckless and undaunted by danger or punish- the feared catastrophe. Also called safety cues;
ment. safety-seeking behavior; safety signals.
sadness n. an emotional state of unhappiness, [first defined in 1991 by British psychologist
ranging in intensity from mild to extreme and Paul M. Salkovskis]
usually aroused by the loss of something that is safety device in the therapeutic approach of
highly valued, for example, by the rupture or German-born U.S. psychoanalyst Karen D.
loss of a relationship. Persistent sadness is one Horney (1885–1952), any psychic means used by
of the two defining symptoms of a major dean individual to protect himself or herself from
pressive episode, the other being anhedonia. threats, particularly the hostile elements of the
—sad adj. environment. As such, the concept is similar to
sadomasochism n. 1. sexual activity between the classical psychoanalytic concept of the de-
consenting partners in which one partner enjoys fense mechanism. See also basic anxiety.
inflicting pain (see sexual sadism) and the safety need a desire for freedom from illness or
other enjoys experiencing pain (see sexual mas- danger and for a secure, familiar, predictable en-
506
Sanfilippo’s syndrome
vironment. Safety needs comprise the second SAMHSA abbreviation for substance abuse and
level of maslow’s motivational hierarchy, mental health services administration.
after basic physiological needs. sample n. a subset of a population of interest
St. John’s wort a perennial flowering plant, that is selected for study. It is important to en-
Hypericum perforatum, that has an extensive his- sure that a sample is representative of the popu-
tory of folk use, particularly as a sedative, a treat- lation as a whole.
ment for nerve pain and malaria, and a balm for sampling n. the process of selecting a limited
wounds, burns, and insect bites. It is currently a number of subjects or cases for participation in
highly popular product used in the treatment of experiments, surveys, or other research. There
mild to moderate depression, anxiety, and in- are a number of different types (e.g., stratified
somnia. There is some research supporting its ef- sampling, opportunistic sampling), each
fectiveness for these purposes, but studies have having a different potential of obtaining a sam-
not demonstrated the superiority of St. John’s ple appropriately representative of the popula-
wort over placebo in the management of major tion under study.
depression. There is also some research suggest- sampling bias any flaw in sampling processes
ing the herb possesses anti-inflammatory and that makes the resulting sample unrepresenta-
antioxidant properties as well. The active agents tive of the population, hence possibly distorting
are presumed to be hypericin and related com- research results.
pounds. Hypericin is known to exert some ef-
sampling distribution the distribution of a
fects common to other antidepressants, such
statistic, such as the mean, over infinite repeated
as inhibition of the reuptake of norepinephrine,
samples drawn from a population; that is, the
dopamine, and serotonin. It may also exert some
theoretical distribution of a statistic.
effects by modulating the neurotransmitters
gamma-aminobutyric acid (GABA) and glu- sampling error the predictable margin of error
tamate. The agent should be used with caution, that occurs in studies employing sampling, as re-
as it may interact adversely with or limit the ef- flected in the variation in the estimate of a pa-
fectiveness of a number of other drugs, particu- rameter from its true value in the population.
larly those used to treat HIV/AIDS and cancer Sampling error is exacerbated by the use of sam-
and to prevent transplant rejection. Although ples that are not representative of the population
rare, side effects may include dry mouth, dizzi- from which they were drawn.
ness, diarrhea, nausea, increased sensitivity to sampling frame a complete listing of all of the
sunlight, and fatigue. elements in a population from which a sample
is to be drawn.
salicylates pl. n. a group of drugs that are based
on salicin, a compound obtained from the bark sampling population the population from
of willow trees (Salix), and includes salicylic acid which a sample is selected in experimental stud-
and its derivatives. The latter are used as analge- ies.
sics, antipyretics, and anti-inflammatory agents. sampling with replacement a sampling
They act on both the peripheral and central technique in which a selected unit is returned to
nervous systems, particularly the thalamus, but the pool and may subsequently be redrawn in
also mimic some aspects of the adrenal hor- another sample. In sampling without replace-
mones. The best known member is aspirin ment the sampling unit is not returned to the
(acetylsalicylic acid), introduced in 1899. Other pool.
salicylates include salicylamide and compounds Sandimmune n. a trade name for cyclo-
used in topical formulations for the relief of sporine.
muscle and joint pain. S
S and M abbreviation for sadism and masochism.
salicylism n. poisoning with salicylates, the See sadomasochism.
most common form of which is due to sane society see Erich fromm.
overdosage of aspirin. Symptoms of mild sali-
Sanfilippo’s syndrome a disorder causing se-
cylism include tinnitus, mental confusion, head-
vere mental retardation associated with bone
ache, nausea, and vomiting. More severe forms
and joint defects and a tendency toward dwarf-
of salicylism are characterized by severe acidosis,
ism. Affected children may also show signs of
hemorrhage, and changes in mental status that
corneal opacities. The disease is transmitted as
may lead to convulsions, coma, and death.
an autosomal recessive trait that causes a sys-
saliromania n. sexual interest and arousal asso- temic form of mucopolysaccharidosis. After
ciated with objects that are filthy, disgusting, or normal early mental development, the child
deformed. shows mental regression. The ability to speak
deteriorates and eventually is lost, as is motor
SAM abbreviation for s-adenosylmethionine.
control. Lifespan may be 10 to 20 years. Also
same-sex marriage a long-term, intimate, sta- called heparitinuria; mucopolysaccha-
ble, and in some jurisdictions legally recognized ridosis Type III; polydystrophic oligo-
relationship between two people of the same phrenia; Sanfilippo (A, B, C, D). [described
sex. It is less frequently called homosexual mar- in 1963 by Sylvester Sanfilippo, U.S. pediatri-
riage. See domestic partnership. cian]
507
sangue dormido
sangue dormido a culture-bound syn- sive series, for example, according to their
drome found among inhabitants (indigenous magnitude or value.
and immigrant) of Cape Verde. Symptoms in-
scale development the process of construct-
clude pain, numbness, tremor, paralysis, convul-
ing, standardizing, and validating a measuring
sions, stroke, blindness, heart attack, infection,
instrument.
and miscarriage. [Portuguese, literally: “sleeping
blood”] Scale of Prodromal Symptoms (SOPS) a
sanity n. 1. in law, the state of being not legally psychological assessment instrument designed
insane (see insanity), and therefore not suffer- to identify and assess the prodromal syn-
ing from a mental disease or defect that impairs drome of schizophrenia and other psychotic
one’s ability to understand or appreciate one’s disorders. It includes behaviorally defined diag-
acts or to conform to the requirements of the nosis criteria and provides a six-point scale
law. 2. more generally, soundness of mind or to quantitatively rate the severity of five atten-
judgment. —sane adj. uated positive symptoms, four disorganiza-
tion symptoms, and four general symptoms.
Sansert n. a trade name for methysergide. [originally developed in 2001 by U.S. psychia-
sapphism n. an older name for lesbianism. trist Thomas H. McGlashan (1941– ) and col-
Sarafem n. a trade name for fluoxetine. leagues]
sarcoma n. see cancer. scaling n. the process of constructing a scale to
SAR workshop abbreviation for sexual atti- measure or assess some quantity or characteristic
tude reassessment workshop. (e.g., height, weight, happiness, empathy).
satellite clinic a freestanding outpatient facil- scanning n. in medicine, the process of using ra-
ity that is physically separate from but adminis- diological, magnetic, or other means (e.g., a
tratively attached to a parent medical facility. brain scan) to visualize and examine the body
Staff interaction and sharing of services occur be- or a portion of it to diagnose a disease or disor-
tween the clinic and parent facility. der.
satiation n. 1. the satisfaction of a desire or scanning hypothesis the hypothesis that
need, such as hunger or thirst; another name for rapid eye movements observed during dream-
satiety. 2. the temporary loss of effectiveness of ing sleep correspond to subjective gaze shifts of
a reinforcer due to its repeated presentation. the dreamer looking around in the dream with
—satiate vb. fixations in specific locations.
satisfaction of instincts in psychoanalytic scapegoating n. blaming: the process of direct-
theory, the gratification of basic needs, such ing one’s anger, frustration, and aggression onto
as hunger, thirst, sex, and aggression, which dis- other, usually less powerful, groups or individu-
charges tension, eliminates unpleasure, and als and targeting them as the source of one’s
restores the organism to a balanced state. Satis- problems and misfortunes. —scapegoat n., vb.
faction may occur on a conscious, preconscious,
or unconscious level. Also called gratification scapegoat theory 1. an analysis of violence
of instincts. See also libido. and aggression that assumes that individuals un-
satyriasis n. excessive or insatiable desire in a dergoing negative experiences (such as failure or
male for sexual gratification. Sexual activity with abuse by others) may blame an innocent indi-
one person is found not to be enough, and many vidual or group for causing the experience. Sub-
other sexual partners are sought. See also don sequent mistreatment of this scapegoat then
juan; erotomania. serves as an outlet for individuals’ frustrations
S savant n. a person with mental retardation or an
and hostilities (see displaced aggression). It
has also been suggested that when scapegoats
autistic spectrum disorder (autistic savant) have been targets for aggression over the years
who demonstrates exceptional, usually isolated, they may thus acquire the quality of a stimulus
cognitive abilities, such as rapid calculation, for aggression. 2. an analysis of prejudice that
identifying the day of the week for any given assumes that intergroup conflict is caused, in
date, or musical talent. The term idiot savant ini- part, by the tendency of individuals to blame
tially was used to denote such a person but has their negative experiences on other groups. The
been discarded because of its colloquial, pejora- theory is supported by studies suggesting that ra-
tive connotation. cial prejudice increases during periods of eco-
sawtooth waves bursts of small, sharp waves nomic downturn and high unemployment. See
recorded on an electroencephalogram during also frustration–aggression hypothesis.
rem sleep.
scatologia n. preoccupation with obscenities,
SBS abbreviation for shaken baby syndrome. lewdness, and filth, mainly of an excremental
sc abbreviation for subcutaneous. nature. The term is derived from the Greek word
scalability n. the characteristic of an item (e.g., for dung. In psychoanalytic theory, scatalogia is
in a test) that allows it to fit into a progression of usually associated with anal eroticism. Also
scores or values. called scatology. —scatological adj.
scale n. a system for arranging items in a progres- scatophilia n. sexual interest and arousal de-
508
schizoid disorder of childhood or adolescence
rived from talking about sexual or excremental (KSADS), is also available. [originally developed
matters and using obscene language. in 1978 by U.S. psychiatrist Robert L. Spitzer
scattering n. a type of thinking characterized by and U.S. clinical psychologist Jean Endicott
tangential or irrelevant associations that may be (1936– )]
expressed in incomprehensible speech. It is ob- schema n. (pl. schemata) 1. a collection of basic
served in individuals with schizophrenia. knowledge about a concept or entity that serves
Schachenmann’s syndrome see cat’s-eye as a guide to perception, interpretation, imagi-
syndrome. nation, or problem solving. For example, the
schema “dorm room” suggests that a bed and a
Schachter–Singer theory the theory that ex-
desk are probably part of the scene, that a micro-
periencing and identifying emotional states are
wave oven might or might not be, and that ex-
functions of both physiological arousal and
pensive Persian rugs probably will not be. Also
cognitive interpretations of the physical state.
called cognitive schema. See also frame of
Also called attribution of emotion; cogni-
reference; perceptual schema. 2. an outlook
tive arousal theory of emotion; Schachter
or assumption that an individual has of the self,
theory; two-factor theory of emotion.
others, or the world that endures despite objec-
[Stanley Schachter (1922–1997) and Jerome E.
tive reality. For example, “I am a damaged per-
Singer (1924–2010), U.S. psychologists]
son” and “Anyone I trust will eventually hurt
schadenfreude n. the gaining of pleasure or sat- me” are negative schemas that may result from
isfaction from the misfortune of others. [from negative experiences in early childhood. A goal
German Schaden, “harm,” and Freude, “joy”] of treatment, particularly stressed in cognitive
scheduled awakening a form of behavior therapy, is to help the client to develop more
therapy for elimination of persistent nightmares realistic, present-oriented schemas to replace
(see nightmare disorder; sleep terror dis- those developed during childhood or through
order). The procedure includes the regular wak- traumatic experiences. See also self-image. 3. in
ening of the sleeper at intervals related to rem social psychology, a cognitive structure repre-
sleep. senting a person’s knowledge about some entity
scheduled drug any of various drugs whose or situation, including its qualities and the rela-
prescription or use has been restricted by the tionships between these. Schemas are usually
U.S. Drug Enforcement Administration. Sched- abstractions and therefore simplify a person’s
ule I drugs are those for which all nonresearch world. In 1932 British psychologist Frederic C.
use is illegal (e.g., LSD, heroin). Schedule II drugs Bartlett (1886–1969) showed that past experi-
include most opiates, stimulants (e.g., cocaine, ences are stored in memory as schemas; impres-
amphetamines, and methylphenidate), barbitu- sions of other people are also thought to be
rates, and prescribed forms of tetrahydro- organized in this way. —schematic adj.
cannabinol (dronabinol). For Schedule II drugs, schema change therapeutic techniques to alter
no refills or telephone prescriptions are permit- cognitive, emotional, and physical patterns of
ted. Schedule III drugs include some opioids, meaning that individuals have derived about the
barbiturates, and stimulants subject to abuse; self, other individuals, social groups, and situa-
prescriptions must be rewritten after 6 months, tions from early experiences and that now inter-
with a maximum of five refills. Schedule IV fere with adaptive living.
drugs include certain opioids, some stimulants,
schizoaffective disorder in DSM–IV–TR, an
and most of the benzodiazepines. Refills are lim-
uninterrupted illness featuring at some time a
ited to five, and prescriptions must be rewritten
major depressive episode, manic episode, or
after 6 months. Schedule V drugs include several
opiates with low abuse potential (low doses of
mixed episode concurrently with characteristic S
symptoms of schizophrenia (e.g., delusions,
codeine and others). The Schedule of Controlled
hallucinations, disorganized speech, catatonic
Substances, originally designed to restrict the
behavior) and, in the same period, delusions or
prescription of commonly abused drugs, is peri-
hallucinations for at least 2 weeks in the absence
odically updated as the popularity of new
of prominent mood symptoms. Also called
agents—generally drugs of abuse—reaches the
schizoaffective psychosis; schizoaffective
attention of authorities.
schizophrenia.
Schedule for Affective Disorders and
Schizophrenia (SADS) a structured inter- schizoid adj. denoting characteristics resembling
view to identify and describe in detail a range of schizophrenia but in a milder form: character-
psychopathological symptoms, used to make ized by lack of affect, social passivity, and mini-
standardized and reliable diagnoses in adults. mal introspection.
The SADS includes a progression of questions schizoid disorder of childhood or adoles-
and criteria and provides for the rating of symp- cence in DSM–III, a disorder characterized by
tom severity, both for lifetime occurrence and absence of close friends other than relatives or
most recent or current occurrence, using a 0–4, isolated children, no apparent interest in mak-
0–6, or 0–7 scale. A version of the SADS for use ing friends, no pleasure from peer interactions,
with children and adolescents, the Kiddie Sched- general avoidance of social contacts, lack of in-
ule for Affective Disorders and Schizophrenia terest in team sports and other activities that in-
509
schizoid–manic state
volve other children, and a duration of at least least one schizophrenic episode and are cur-
three months. In DSM–IV–TR, this diagnostic rently free of schizophrenic symptoms.
category has been subsumed under pervasive Schizophrenia Patient Outcomes Re-
developmental disorders. search Team (PORT) a team of researchers es-
schizoid–manic state a psychotic state com- tablished in 1992 by the Agency for Health Care
bining features of both manic and schizophrenic Policy and Research and the National Institute of
excitement. Also called schizomania. [identi- Mental Health. The team conducted a 5-year
fied by Swiss-born U.S. psychiatrist Adolf Meyer study to assess the treatment and management
(1866–1950), Austrian-born U.S. psychiatrist of schizophrenia (including pharmacotherapies,
Abraham Brill (1874–1948), and Swiss psychia- psychological and family interventions, voca-
trist Eugen Bleuler (1857–1939)] tional rehabilitation, and assertive community
schizoid personality disorder in DSM–IV– treatment) and subsequently developed 15 rec-
TR, a personality disorder characterized by long- ommendations for improving patient outcomes.
term emotional coldness, absence of tender feel- The researchers reviewed the literature on
ings for others, indifference to praise or criticism schizophrenia treatment outcomes and also sur-
and to the feelings of others, and inability to veyed a random sample of 719 individuals diag-
form close friendships with more than two peo- nosed with schizophrenia in two U.S. states to
ple. The eccentricities of speech, behavior, or determine how the scientific evidence compared
thought that are characteristic of schizotypal with actual clinical practice in outpatient and
personality disorder are absent in those with inpatient settings in both urban and rural areas.
schizoid personality disorder. It was found that the overall rates at which
patients’ treatment conformed to the study rec-
schizomania n. see schizoid–manic state. ommendations were generally below 50%, indi-
schizophrenia n. a psychotic disorder charac- cating the need for greater efforts to ensure that
terized by disturbances in thinking (cognition), treatment research results are translated into
emotional responsiveness, and behavior. Schizo- practice, and that the key to improving patient
phrenia was first formally described in the outcomes is adoption of a comprehensive and
late 19th century by German psychiatrist Emil individualized strategy that includes not only
Kraepelin (1856–1926), who named it dementia proper doses of appropriate medications but also
praecox; in 1911 Swiss psychiatrist Eugen patient and family education and support.
Bleuler (1857–1939) renamed the disorder schizophrenic disorders in DSM–III, a group
“schizophrenia” and described what he regarded of disorders that in DSM–IV–TR are regarded as
as its fundamental symptoms. According to subtypes of schizophrenia, namely: catatonic
DSM–IV–TR, which provides the criteria for diag- type (see catatonic schizophrenia), disorga-
nosis that are now most widely used, the charac- nized type (see disorganized schizophrenia),
teristic disturbances must last for at least 6 paranoid type (see paranoid schizophrenia),
months and include at least 1 month of active- residual type (see residual schizophrenia),
phase symptoms comprising two or more of the and undifferentiated type (see undifferenti-
following: delusions, hallucinations, disorga- ated schizophrenia).
nized speech, grossly disorganized or catatonic
behavior, or negative symptoms (e.g., lack of schizophrenic episode a period during which
emotional responsiveness, extreme apathy). an individual exhibits promiment symptoms
These signs and symptoms are associated with of schizophrenia, such as hallucinations, delu-
marked social or occupational dysfunction. Dis- sions, disordered thinking, and disturbances in
organized thinking (see formal thought emotional responsiveness and behavior. See also
S disorder; loosening of associations; schizo- acute schizophrenic episode.
phrenic thinking) has been argued by some schizophrenic reaction a former diagnosis
(beginning with Bleuler) to be the single most for the symptoms of schizophrenia that has its
important feature of schizophrenia. But, lacking origin in the theories of Swiss-born U.S. psychia-
an objective definition of thought disorder trist Adolf Meyer (1866–1950). See also reac-
and limited to evaluation of an individual’s tion type.
speech, DSM–IV–TR and its predecessors have schizophrenic thinking pervasive, marked
not emphasized this feature. The age of onset impairment of thinking in terms of loosening
is typically between the late teens and mid-30s, of associations and slowness of associations,
occasionally later. Five distinct subtypes of schizo- representing positive symptoms and negative
phrenia are described in DSM–IV–TR (see cata- symptoms, respectively, of schizophrenia. Be-
tonic schizophrenia; disorganized schizo- cause thinking must be inferred rather than
phrenia; paranoid schizophrenia; residual merely observed, and because no single defini-
schizophrenia; undifferentiated schizo- tion or test or technique of inference has been
phrenia). In DSM–III, schizophrenia was viewed universally accepted, evaluation is usually lim-
as comprising a group of schizophrenic disor- ited to examining samples of speech or writing
ders. —schizophrenic adj. that the individual is inclined to express. On cer-
schizophrenia in remission a diagnosis for tain psychological tests (e.g., Rorschach, MMPI),
cases in which individuals have experienced at schizophrenic thinking is identified in terms of
510
schwannoma
deviant verbalizations, which are unusual, exag- vere environmental stresses. [presented as a con-
gerated, or otherwise abnormal responses to cept in 1962 by Paul Everett meehl]
items presented during the test, for example, in- schizotypal personality disorder in DSM–
venting a word (see neologism) to describe a IV–TR, a personality disorder characterized by
Rorschach inkblot. On the Whitaker Index of various oddities of thought, perception, speech,
Schizophrenic Thinking (WIST; 1980), which ac- and behavior that are not severe enough to war-
tively tests for both positive and negative schizo- rant a diagnosis of schizophrenia. Symptoms
phrenic thinking, schizophrenic impairment of may include perceptual distortions, magical
thinking is defined as simultaneously illogical, thinking, social isolation, vague speech with-
impaired, and without apparent awareness, all to out incoherence, and inadequate rapport with
a marked degree. others due to aloofness or lack of feeling.
schizophreniform disorder in DSM–IV–TR, schizotypy n. in research contexts, a type of per-
a disorder whose essential features are identical sonality organization defined by milder forms of
to those of schizophrenia except that the total positive symptoms of schizophrenia, such as
duration is between 1 and 6 months (i.e., inter- cognitive slippage, and negative symptoms,
mediate between brief psychotic disorder such as inability to experience pleasure (see
and schizophrenia) and social or occupational anhedonia). Schizotypy is studied in individu-
functioning need not be impaired. The diagnosis als and family members as a predictor of or liabil-
applies without qualification to an episode of be- ity for the later occurrence of schizophrenia.
tween 1 and 6 months’ duration from which the
individual has already recovered. The diagnosis Schmid-Fraccaro syndrome see cat’s-eye
is provisional when there is no certainty of re- syndrome.
covery within the 6-month period. If the distur- school avoidance see school refusal.
bance persists beyond 6 months, the diagnosis school counseling guidance, offered at or out-
would be changed to schizophrenia. side the school to students, parents, and other
schizophreniform psychosis a type of caregivers, that focuses on students’ academic,
nonschizophrenic psychosis in which symp- personal, social, and career adjustment, develop-
toms typical of nuclear schizophrenia are ment, and achievement. Counseling is offered
present but there is good premorbid adjust- by certified and licensed professionals at all edu-
ment, sudden onset in response to a clear precip- cational levels, from elementary through college
itating event, and a good prognosis and high and professional school.
probability of return to normal levels of func- school phobia see school refusal.
tioning. Characteristics of schizophreniform
school refusal persistent reluctance to go to
psychosis can be seen in the DSM–IV–TR diag-
school, which usually occurs during the primary
nostic category of schizophreniform disor-
school years and is often a symptom of an educa-
der. Also called schizophreniform state.
tional, social, or emotional problem. School re-
[proposed in the late 1930s by Norwegian psy-
fusal may be a feature of separation anxiety
chiatrist Gabriel Langfeldt (1895–1983)]
disorder. It may be triggered by a stressor (e.g.,
schizophrenogenic adj. denoting a factor or loss of a pet or loved one, a change of school, loss
influence viewed as causing or contributing to of a friend due to a move) or it may occur after a
the onset or development of schizophrenia. summer vacation when the child has spent more
schizophrenogenic mother the stereotypic time with the primary caregiver. School refusal is
mother of an individual with schizophrenia. She often associated with physical symptoms (e.g.,
is held to be emotionally disturbed, cold, reject- upset stomach, nausea, dizziness, headache) and
ing, dominating, perfectionistic, and insensitive. anxiety at the start of the day along with com- S
At the same time, however, she is overprotective, plaints that the child is too sick to go to school.
fosters dependence, and is both seductive and Also called school avoidance; school pho-
rigidly moralistic. Historically, this type of bia.
mother was considered to play a causal role in school truancy see truancy.
the development of schizophrenia, but this view Schwann cell a type of nonneuronal peripheral
is now no longer widely held. See also nervous system cell (glia) that forms the myelin
schizophrenogenic parents. [first defined in sheath around axons. Extensions of a single
1948 by German-born U.S. psychiatrist Frieda Schwann cell wind tightly and many times
Fromm-Reichmann (1889–1957)] around several neighboring axons, so that the
schizophrenogenic parents parents whose myelin sheath consists of multiple layers of the
harmful influences are presumed to cause Schwann-cell plasma membrane. [Theodor
schizophrenia in their offspring. This concept— Schwann (1810–1882), German histologist]
the subject of much debate in the 1940s espe- schwannoma n. a type of tumor that develops
cially—is now considered an oversimplification. from schwann cells. Although typically be-
See also schizophrenogenic mother. nign, schwannomas tend to displace and com-
schizotaxia n. a genetic predisposition to press surrounding neurons as they grow. A
schizophrenia, held to be necessary for the disor- schwannoma is very similar to a neurofibroma
der to become manifest and to be activated by se- but is distinguished by its capsule.
511
SCID-I
SCID-I acronym for structured clinical in- ment generally, a specific treatment approach,
terview for dsm–iv axis i disorders. or referral to a treatment facility. This evaluation
SCID-II acronym for structured clinical in- is made on the basis of medical or psychological
terview for dsm–iv axis ii personality disor- history, mental status examination, diagnos-
ders. tic formulation, or some combination of these.
3. the process of selecting items for a psychologi-
scientist-practitioner model a concept for cal test.
the university training of doctoral clinical (or
other applied) psychologists in the United States screening test any testing procedure designed
that is intended to prepare individuals both to to separate people or objects according to a fixed
provide services and to conduct research on characteristic or property. Screening tests are
mental health problems, essentially integrating typically used to distinguish people who have a
these two functions in their professional work by disease, disorder, or predisease condition from
making a laboratory of their applied settings and those who do not; they may be used, for exam-
studying their phenomena and the results of ple, in primary health care settings to identify
their administrations scientifically. The purpose people who are depressed. Screening tests are de-
of the model is to ensure that practitioners con- signed to be broadly sensitive, and subsequent
tribute to the scientific development of their highly specific or focused testing is often re-
field. The training emphasizes research tech- quired to confirm the results.
niques applicable to applied (therapeutic) set- screening tests for young children check-
tings. The model emerged from a conference lists or assessment protocols that have been
held in Boulder, Colorado, in 1949, which was developed to detect developmental delays,
sponsored by the U.S. Veterans Administration criterion behaviors, or other risk factors associ-
and the National Institute of Mental Health. ated with certain conditions or disorders during
Also called Boulder model. infancy and early childhood through the pri-
SCL-90-R abbreviation for symptom checklist- mary school years. Such tests do not provide di-
90-revised. agnostic information, but instead are used with
large numbers of children in order to identify
scopolamine n. an anticholinergic drug those who may require assessment for emotional
found as an alkaloid in henbane and related disturbance, mental retardation, neurological
plants. Its most common therapeutic use is for conditions, or other disorders.
the prevention of motion sickness; in the past it
was sometimes used in labor to produce twilight screen memory in psychoanalytic theory, a
sleep (a conscious but drowsy state with lack of memory of a childhood experience, usually triv-
sensitivity to pain) and amnesia for the event. ial in nature, that unconsciously serves the pur-
Small doses can have a sedative effect, but large pose of concealing or screening out an associated
doses may cause restlessness, agitation, or delir- experience of a more significant and perhaps
ium. Also called hyoscine. U.S. trade names: traumatic nature. Also called cover memory;
Scopace; Transderm-Scop. replacement memory.
scopophilia n. sexual pleasure derived from script n. a cognitive schematic structure—a
watching others in a state of nudity, undressing, mental road map—containing the basic actions
or engaging in sexual activity. If scopophilia is (and their temporal and causal relations) that
persistent, the condition is essentially voyeur- comprise a complex action. Also called script
ism. Also called scoptophilia; scotophilia. schema.
See also active scopophilia; passive sco- script analysis in transactional analysis,
pophilia. the analysis of the client’s unconscious life plan,
S or script. The script is based on fantasies, atti-
scotomization n. in psychoanalytic theory, the
tendency to ignore or be blind to impulses or tudes, and games or ploys derived from the
memories that would threaten the individual’s individual’s early experiences. [developed by Ca-
ego. Scotomization is a defensive process and nadian-born U.S. psychiatrist Eric Berne (1910–
may also be a form of resistance. Also called 1970)]
scotomatization. See also blind spot. script theory 1. in transactional analysis,
scotophilia n. see scopophilia. the theory that an individual’s approach to so-
cial situations follows a sequence that was
screen defense in psychoanalytic theory, a de- learned and established early in life. 2. the prop-
fense in which a memory, fantasy, or dream osition that discrete affects, such as joy and fear,
image is unconsciously employed to conceal the are prime motivators of behavior and that per-
real but disturbing object of one’s feelings. sonality structure and function can be under-
screening n. 1. a procedure or program to detect stood in terms of self-defining affective scenes
early signs of a disease in an individual or popu- and scripts. [proposed by U.S. personality psy-
lation. Individuals at increased hereditary risk of chologist Silvan S. Tomkins (1911–1991)]
developing a disease are advised to follow regular SCU abbreviation for special care unit.
screening plans. See also screening test. 2. the
initial evaluation of a patient to determine his or sculpting n. see family sculpting.
her suitability for medical or psychological treat- SD abbreviation for standard deviation.
512
secondary emotion
SDAT abbreviation for senile dementia of the but produced instead by indirect association
alzheimer’s type. with the erogenous zones (e.g., sexual arousal
S data see q data. from contact with urine).
SDS abbreviation for zung self-rating depres- secondary care health care services provided
sion scale. by medical specialists (e.g., cardiologists, urolo-
gists, dermatologists), to whom, typically, pa-
Seashore Rhythm Test a neuropsychological
tients are referred by the primary care
test in which the participant listens to a record-
provider. Compare primary care; tertiary
ing of pairs of rhythmic patterns and indicates
care.
whether they are the same or different. The test
is used by neuropsychologists to measure gener- secondary cause a contributing factor to the
alized cerebral function. [Carl Seashore, Swed- onset of symptoms of a disorder that in itself
ish-born U.S. Psychologist (1866–1949)] would not be sufficient to cause the disorder.
seasonal affective disorder (SAD) a mood secondary control behavior that, while not di-
disorder in which there is a predictable occur- rectly controlling, is aimed at producing a sense
rence of major depressive episodes, manic ep- of control by altering oneself (e.g., one’s values,
isodes, or both at particular times of the year. priorities, behavior) so as to bring oneself in line
The typical pattern is the occurrence of major with the environment. Compare primary con-
depressive episodes during the fall or winter trol. See locus of control.
months. Also called seasonal mood disorder. secondary coping a stress-management strat-
seasonality effect the proposal that individu- egy in which a person seeks to adjust his or her
als with schizophrenia are most likely to have hopes, expectations, attributions, and other
been born during the period January to April. aspects of the self to achieve a better fit with
The hypothesized significance of the season of current events and prevailing conditions. This
birth is uncertain. See also viral hypothesis of adaptation of oneself to the environment repre-
schizophrenia. [advanced by U.S. psychiatrist sents a more internally focused coping strat-
E. Fuller Torrey (1938– )] egy that generally is applied when stressors
seasonal mood disorder see seasonal affec- cannot easily be counteracted directly. It in-
tive disorder. cludes such behaviors as distraction, positive
Seckel’s bird-headed dwarfism a familial thinking, cognitive restructuring, and re-
disorder, now linked to a defect on chromosome thinking about the stressor or problem in such
3 (locus 3q22.1–24), marked by microcephaly, a way as to facilitate acceptance. Also called
a beaklike nose, prominent eyes, narrow face, secondary control coping. Compare pri-
and short stature. Typically, affected individuals mary coping. [identified in 1982 by Fred M.
show intellectual skills consistent with mild Rothbaum (1949–2011) and John R. Weisz
to profound mental retardation. Also called Sec- (1945– ), U.S. clinical and developmental psy-
kel nanism; Virchow–Seckel syndrome. chologists, and Samuel S. Snyder, U.S. develop-
[reported in 1960 by Helmut P. G. Seckel (1900– mental psychologist]
1960), German physician; the term “bird-headed secondary defense symptoms a set of defen-
dwarf” was introduced by Rudolf Virchow sive measures employed by obsessive individuals
(1821–1902), German pathologist] when their primary defenses against repressed
seclusiveness n. the tendency to isolate oneself memories no longer offer protection. The sec-
from social contacts or human relationships. See ondary defenses usually include obsessional
also privacy. —seclusive adj. thinking, doubting mania, and speculations,
which may be expressed as phobias, ceremoni-
secondary aging changes due to biological als, superstitions, or pedantry. S
aging, but accelerated by disabilities resulting
from disease or produced by extrinsic factors, secondary deviance see primary deviance.
such as stress, trauma, lifestyle, and environ- secondary drive a learned drive; that is, a drive
ment. Secondary aging is often distinguished that is developed through association with or
from primary aging, which is governed by in- generalization from a primary drive. For exam-
born and age-related processes, but the distinc- ple, in an avoidance conditioning experi-
tion is not a precise one. ment in which a rat must go from one
secondary amenorrhea see amenorrhea. compartment into another to escape from an
secondary appraisal in the cognitive ap- electric shock, the secondary drive is fear of the
praisal theory of emotion, assessment of one’s shock and the primary drive with which it is as-
ability to cope with the consequences of an in- sociated is avoidance of pain. Also called ac-
teraction with the environment, which follows quired drive.
a primary appraisal. See also coping poten- secondary elaboration in psychoanalysis,
tial; core relational themes. [proposed by the process of altering the memory and descrip-
U.S. psychologist Richard S. Lazarus (1922– tion of a dream to make it more coherent and
2002)] less fragmentary or distorted. See also dream-
secondary autoeroticism a type of auto- work.
eroticism not involving direct masturbation secondary emotion an emotion that is not
513
secondary environment
recognized or manifested universally across cul- secondary motivation motivation that is cre-
tures or that requires social experience for its ated by personal or social incentives (e.g., the
construction. For some theorists, pride repre- urge to learn classical music or become a movie
sents a secondary emotion, stemming from the star) rather than by primary, physiological needs
conjunction of a primary emotion (joy) and a (e.g., for food).
favorable public reaction. Other secondary emo-
secondary personality a second discrete
tions include envy, love, and jealousy.
identity that repeatedly controls behavior in in-
secondary environment an environment dividuals with dissociative identity disor-
that is incidental or marginally important in a der. This personality state is in sharp contrast to
person’s life and in which interactions with oth- the original, primary personality and gener-
ers are comparatively brief and impersonal. An ally has a different name as well as dramatically
example is a bank or a shop. Compare primary different attitudes, behavior, manner of speak-
environment. ing, and style of dress.
secondary erectile dysfunction 1. a condi- secondary prevention intervention for indi-
tion in which a man is no longer capable of viduals or groups that demonstrate early psy-
producing or maintaining a penile erection suffi- chological or physical symptoms, difficulties,
cient for sexual intercourse, although he was or conditions (i.e., subclinical-level problems),
previously capable of performing intercourse which is intended to prevent the development
successfully. 2. a condition in which a man can of more serious dysfunction or illness. Compare
have an erection in some situations (e.g., during primary prevention; tertiary prevention.
masturbation) or with some partners, but not
during sexual activity with his current primary secondary process in psychoanalytic theory,
partner. See also erectile dysfunction; impo- conscious, rational mental activities under the
tence; male erectile disorder. Compare pri- control of the ego and the reality principle.
mary erectile dysfunction. These thought processes, which include prob-
secondary gain in psychoanalytic theory, ad- lem-solving, judgment, and systematic think-
vantages derived from a neurosis in addition to ing, enable individuals to meet both the external
the primary gains of relief from anxiety or in- demands of the environment and the internal
ternal conflict. Examples are extra attention, demands of their instincts in rational, effective
sympathy, avoidance of work, and domination ways. Also called secondary process think-
of others. Such gains are secondary in that they ing. Compare primary process.
are derived from others’ reactions to the illness secondary reinforcement 1. in operant
instead of causal factors. They often prolong the conditioning, the process in which a neutral
neurosis and create resistance to therapy. Also stimulus acquires the ability to influence the fu-
called advantage by illness. ture probability of a particular response by virtue
secondary group one of the larger, less inti- of being paired with another stimulus that natu-
mate, more goal-focused groups typical of rally enhances such probability. That is, the ini-
more complex societies. These social groups in- tially neutral stimulus or circumstance functions
fluence members’ attitudes, beliefs, and actions, as effective reinforcement only after special
but as a supplement to the influence of small, experience or training. For example, a person
more interpersonally intensive primary groups. teaching a dog to understand the command “sit”
Whereas primary groups, such as families and might provide a treat and a simultaneous pop-
children’s play groups, are the initial socializing ping noise from a clicker tool each time the dog
agents, adolescents and adults are increasingly successfully performs the behavior. Eventually,
influenced by such secondary groups as work the clicker noise itself can be used alone to main-
S tain the desired behavior, with no treat reward
groups, clubs, congregations, associations, and
so on. being necessary. 2. the contingent occurrence of
such a stimulus or circumstance after a response.
secondary identification in psychoanalytic
Also called conditioned reinforcement.
theory, identification with admired figures other
Compare primary reinforcement.
than the parents.
secondary memory (SM) memory that retains secondary repression see repression pro-
a large number of items relatively permanently, per.
in contrast to primary memory. The term was secondary sexual dysfunction any distur-
used in the dual-store model of memory be- bance in sexual functioning (see sexual dys-
fore being replaced by long-term memory. [in- function) that is not lifelong or that occurs
troduced by William james] only with some partners or in some situations.
secondary mental deficiency below average Compare primary sexual dysfunction.
intelligence due to disease or brain injury rather secondary stuttering dysfluency in speech
than congenital factors. characterized by uncomfortable awareness and
secondary mood disorder a mood disorder attempts to modify the dysfluency. Effort, fear,
that occurs in the context of another disorder and anxiety are typically conveyed through ab-
and whose symptoms may be caused by the normal or unusual movements of the face, head,
other disorder. or body (e.g., tics, blinking, lip tremor, head
514
sedative, hypnotic, and anxiolytic drugs
jerks, fist clenching). Compare primary stut- parent is present, shows mild distress when the
tering. parent leaves, and quickly reestablishes contact
secondary symptoms 1. according to Swiss when the parent returns. 2. an adult attachment
psychiatrist Eugen Bleuler (1857–1939), those style that combines a positive internal work-
symptoms of schizophrenia, such as delusions ing model of attachment of oneself, charac-
and hallucinations, that are shared with other terized by a view of oneself as worthy of love,
disorders and therefore not specifically diagnos- and a positive internal working model of attach-
tic of schizophrenia. Bleuler theorized that these ment of others, characterized by the view that
symptoms do not stem directly from the disease others are generally accepting and responsive.
but rather begin to operate when the person re- Compare dismissive attachment; fearful at-
acts to some internal or external process. Also tachment; preoccupied attachment.
called accessory symptoms. Compare funda- secure treatment setting a locked residential
mental symptoms. 2. symptoms that are not a setting providing safety and treatment services
direct result of a disorder but are associated with for adolescent or adult offenders, usually felons,
or incidental to those that are (e.g., social avoid- with mental retardation or developmental dis-
ance accompanying obsessive-compulsive disor- abilities.
der). 3. symptoms that appear in the second security n. a sense of safety, confidence, and
stage of a disorder or that are derived from an freedom from apprehension. In psychology, se-
earlier traumatic event, disease process, or disor- curity is believed to be engendered by such fac-
dered condition. tors as warm, accepting parents and friends;
second-generation antipsychotic see development of age-appropriate skills and abili-
atypical antipsychotic. ties; and experiences that build ego strength.
second messenger an ion or molecule inside a The development of security in the psycho-
cell whose concentration increases or decreases therapeutic context (most often referred to as
in response to stimulation of a cell receptor trust) is seen as a mediating goal that encourages
by an agonist (e.g., a neurotransmitter, hor- open exploration of emotional and behavioral
mone, or drug). The second messenger acts to issues and is viewed to be part of a strong and
relay and amplify the signal from the agonist healthy therapist–patient relationship.
(the “first messenger”) by triggering a range of security blanket see transitional object.
cellular activities. For example, receptors for security operations in the approach of U.S.
catecholamine neurotransmitters (epinephrine psychoanalyst Harry Stack Sullivan (1892–1949),
and norepinephrine) are coupled to g proteins, a variety of interpersonal defensive measures,
whose activation in postsynaptic neurons affects such as arrogance, boredom, or anger, that are
levels of second messengers that act to open or used as a protection against anxiety or loss of
close certain ion channels. Second messengers self-esteem.
include cyclic amp, IP3 (see inositol phos-
phates), and calcium ions. sedative 1. n. a drug that has a calming effect
and therefore relieves anxiety, agitation, or be-
second-order factor a factor that results from havioral excitement by depressing the central
the factoring of correlated factors by correlating
nervous system. The degree of sedation depends
the derived factors among themselves. Compare
on the agent, the size of the dose, the method of
first-order factor.
administration, and the condition of the pa-
second-person perspective the point of view tient. A drug that sedates in small doses may in-
of one person addressing another and aware of duce sleep in larger doses and may be used as a
the other’s consciousness, characterized by “I– hypnotic; such drugs are commonly known as
you” communication. Compare first-person sedative–hypnotics. benzodiazepines are com- S
perspective; third-person perspective. monly used as sedatives. 2. adj. producing seda-
SECs abbreviation for stimulus evaluation tion.
checks. sedative amnestic disorder see sedative-,
sector therapy a therapeutic procedure in hypnotic-, or anxiolytic-induced persist-
which patterns of association that have pro- ing amnestic disorder.
duced emotional problems in the client are sedative, hypnotic, and anxiolytic drugs
replaced by more realistic and constructive pat- cns depressants that have been developed for
terns. Unlike depth therapy, this process, de- therapeutic use because of their calming effect
scribed as goal-limited adjustment therapy, (i.e., sedatives) and ability to induce sleep (i.e.,
focuses on specific areas (sectors) revealed by the hypnotics) and reduce anxiety (i.e., anxiolytics).
client’s own autobiographical account. The pro- They include the barbiturates, meprobamate,
cedure enables the client to understand his or and the benzodiazepines. At low doses these
her faulty associations and gradually establish drugs are prescribed for daytime use to reduce
new ones with the aid of the therapist. [devel- anxiety; at higher doses many of the same drugs
oped by Felix Deutsch (1884–1964)] are prescribed as sleeping pills. Although effica-
secure attachment 1. in the strange situa- cious when used sparingly, over the long term all
tion, the positive parent–child relationship, in induce marked tolerance, and cessation of use
which the child displays confidence when the can precipitate potentially life-threatening with-
515
sedative, hypnotic, or anxiolytic abuse
drawal phenomena. Acute abuse can yield dan- condition that prompted treatment or a
gerous intoxication effects, and chronic abuse recurrence of that condition; and tonic–clonic
can cause a range of other serious, irreversible seizures. Risks of physiological dependence and
conditions. withdrawal are present with long-term use of all
sedative, hypnotic, or anxiolytic abuse benzodiazepines and similarly acting anxiolyt-
in DSM–IV–TR, a pattern of use of sedative, hyp- ics. Short-acting benzodiazepines pose particular
notic, or anxiolytic drugs manifested by recur- withdrawal risks, and patients taking high doses
rent significant adverse consequences related to of short-acting agents must be carefully with-
the repeated ingestion of these substances. This drawn over an extended period to avoid adverse
diagnosis is preempted by the diagnosis of seda- outcomes. See also substance withdrawal.
tive, hypnotic, or anxiolytic dependence: If sedative, hypnotic, or anxiolytic with-
the criteria for sedative, hypnotic, or anxiolytic drawal delirium a reversible syndrome that
abuse and sedative, hypnotic, or anxiolytic de- develops over a short period of time (usually
pendence are both met, only the latter diagnosis hours to days) following cessation of prolonged,
is given. heavy consumption of sedative, hypnotic, or
anxiolytic drugs. It involves disturbance of con-
sedative, hypnotic, or anxiolytic de-
sciousness (e.g., reduced ability to focus, sustain,
pendence in DSM–IV–TR, a cluster of cogni-
or shift attention), accompanied by changes in
tive, behavioral, and physiological symptoms
cognition (e.g., memory deficit, disorientation,
indicating continued use of sedative, hypnotic,
or language disturbance) in excess of those usu-
or anxiolytic drugs despite significant problems
ally associated with withdrawal from these
related to these substances. There is a pattern of
substances. See also sedative, hypnotic, or
repeated ingestion resulting in tolerance, charac-
anxiolytic withdrawal.
teristic withdrawal symptoms on cessation of
use (see sedative, hypnotic, or anxiolytic sedative–hypnotics pl. n. see sedative.
withdrawal), and an uncontrollable drive to seduction n. 1. the inducement of a person to
continue use. See also sedative, hypnotic, or participate in sexual intercourse, without the use
anxiolytic abuse. of force. Local laws vary in their interpretation of
sedative-, hypnotic-, or anxiolytic- seduction, and common law does not recognize
induced persisting amnestic disorder a it as a crime. However, some laws define seduc-
disturbance in memory due to the persisting ef- tion as a crime if it involves a promise by a man
fects of sedative, hypnotic, or anxiolytic drugs. to marry a woman in the near future if she will
The ability to learn new information or to recall submit to intercourse now. 2. more generally,
previously learned information is impaired se- the act or process of attracting or alluring. —se-
verely enough to interfere markedly with social duce vb.
or occupational functioning and to represent a segmentation n. a technique of behavior
significant decline from a previous level of func- modification in which a complex sequence of
tioning. Unlike those diagnosed with alcohol- behaviors is divided into parts so that the client
induced persisting amnestic disorder, peo- can more easily learn and master one or two at a
ple diagnosed with this disorder can recover time.
memory functioning.
segregated model in evaluation research, an
sedative, hypnotic, or anxiolytic intoxi- administrative relationship, used in formative
cation a reversible syndrome specific to the reevaluation, between the program director, the
cent ingestion of sedative, hypnotic, or production unit, and the evaluation unit as
anxiolytic drugs. It includes clinically significant three distinct entities. In this model the produc-
S behavioral or psychological changes (e.g., inap- tion unit and the evaluation unit share equal im-
propriate sexual or aggressive behavior, mood portance and improved access to the program
lability, impaired judgment, and impaired social director. Compare integrated model.
or occupational functioning), as well as one or
more signs of physiological involvement (e.g., seizure n. a discrete episode of uncontrolled, ex-
slurred speech, an unsteady gait, involuntary eye cessive electrical discharge of neurons in the
movements, memory or attentional problems, brain. The resulting clinical symptoms vary
incoordination, and stupor or coma). based on the type and location of the seizure. See
epilepsy.
sedative, hypnotic, or anxiolytic with-
drawal in DSM–IV–TR, a characteristic with- selection n. the process of choosing an item
drawal syndrome, potentially life-threatening, (e.g., an individual or object) for a purpose, such
that develops after cessation of (or reduction in) as study, testing, classifying, or working (em-
prolonged, heavy consumption of sedative, hyp- ployee selection).
notic, or anxiolytic drugs. Symptoms may in- selective amnesia the forgetting of particular
clude autonomic hyperactivity; increased hand issues, people, or events that is too extensive to
tremor; insomnia; nausea or vomiting; transient be explained by normal forgetfulness and that is
visual, tactile, or auditory hallucinations or illu- posited to be organized according to emotional,
sions; psychomotor agitation; anxiety; either a rather than temporal, parameters. The selectivity
transient worsening (rebound) of the anxiety appears to be of benefit to or convenient for
516
self-abuse
the person who cannot remember. See also determined by such factors as interest, experi-
dissociative amnesia. ence, motivation, and emotional arousal.
selective attention concentration on certain selective serotonin reuptake inhibitor
stimuli in the environment and not others, en- see ssri.
abling important stimuli to be distinguished selective silence in psychotherapy, a pro-
from peripheral or incidental ones. Selective at- longed silence imposed by the therapist to gen-
tention is typically measured by instructing erate tension that may encourage the client to
participants to attend to some sources of infor- speak, thus beginning or resuming communica-
mation while ignoring others and then deter- tion in a session.
mining their effectiveness in doing this. Also
called controlled attention; directed at- selegiline n. a drug used as an adjunct in the
tention. treatment of Parkinson’s disease. At low doses
it selectively inhibits the enzyme monoamine
selective estrogen receptor modulators
oxidase B (MAO-B)—which degrades the neuro-
(SERMs) see antiestrogen.
transmitter dopamine—and thereby increases
selective inattention 1. unmindful absence levels of dopamine in the brain. Because se-
or failure of attention to particular physical or legiline is an irreversible monoamine oxidase
emotional stimuli. 2. a perceptual defense in inhibitor (MAOI), and at higher doses it inhib-
which anxiety-provoking or threatening experi- its both MAO-A and MAO-B, great care must be
ences are ignored or forgotten. [defined by U.S. taken not to exceed the therapeutic dosage in
psychiatrist Harry Stack Sullivan (1892–1949)] order to avoid the severe adverse effects of
selective mutism in DSM–IV–TR, a rare disor- nonselective, irreversible MAOIs. Adverse drug
der, most commonly but not exclusively found interactions have been observed with com-
in young children, characterized by a persistent monly prescribed antidepressants, and concur-
failure to speak in certain social situations (e.g., rent administration of selegiline and these
at school) despite the ability to speak and to un- should be avoided. Also called deprenyl. U.S.
derstand spoken language. Age of onset is usu- trade name: Eldepryl.
ally before 5 years, and the failure to speak lasts self n. the totality of the individual, consisting of
at least 1 month (not counting the first month at all characteristic attributes, conscious and un-
school, when many children are shy about talk- conscious, mental and physical. Apart from its
ing). Generally, these individuals function nor- basic reference to personal identity, being, and
mally in other ways, although some may have experience, the term’s use in psychology is ex-
additional disabilities. Most learn age-appro- tremely wide-ranging and lacks uniformity. Ac-
priate skills and academic subjects. Currently, se- cording to William james, self can refer either to
lective mutism is thought to be related to severe the person as the target of appraisal (i.e., one in-
anxiety and social phobia, but the exact cause trospectively evaluates how one is doing) or to
is unknown. It was formerly (in DSM–III and ear- the person as the source of agency (i.e., one at-
lier editions) called elective mutism. tributes the source of regulation of perception,
selective optimization with compensa- thought, and behavior to one’s body or mind).
tion a process used in successful aging to Carl jung maintained that the self gradually de-
adapt to biological and psychological deficits velops by a process of individuation, which is
associated with aging. The process involves em- not complete until late maturity is reached. Al-
phasizing and enhancing those capacities af- fred adler identified the self with the individ-
fected only minimally by aging (optimization) ual’s lifestyle, the manner in which he or she
and developing new means of maintaining func- seeks fulfillment. German-born U.S. psychoana-
tioning in those areas that are significantly af- lyst Karen D. Horney (1885–1952) held that S
fected (compensation). [described by German one’s real self, as opposed to one’s idealized
psychologists Paul Baltes (1939–2006) and self-image, consists of one’s unique capacities for
Margret Baltes (1939–1999)] growth and development. Gordon allport sub-
selective reminding test any memory test in stituted the word proprium for self, and con-
which the participant is given the answer when ceived of it as the essence of the individual,
it cannot be remembered so that he or she is consisting of a gradually developing body sense,
more likely to answer correctly on subsequent identity, self-estimate, and set of personal val-
trials. For instance, if the word “pencil” is pre- ues, attitudes, and intentions. See also false
sented on a list-learning task and the participant self; phenomenal self; sense of self; true
is unable to recall it, the word would then be pre- self.
sented along with other words not recalled. self-abasement n. 1. the act of degrading or de-
selective response a response that has been meaning oneself. 2. extreme submission to the
differentiated from a group of possible alterna- will of another person. Also called self-
tive responses. debasement.
selective retention variation between individ- self-abuse n. a euphemism for masturbation.
uals in the capacity to remember with respect to The term apparently evolved from an attempt by
the vividness, accuracy, quantity, and specific certain 18th-century religious and medical writ-
contents of memory. This selectivity is usually ers to identify masturbation as “the sin of Onan”
517
self-acceptance
(see onanism) and to substantiate unscientific alternative explanation to cognitive disso-

claims that a number of disorders (e.g., blindness nance theory for some phenomena. See also
and mental retardation) were produced by mas- dissonance reduction; self-consistency
turbation. perspective of cognitive dissonance the-
self-acceptance n. a relatively objective sense ory. [originally proposed by U.S. psychologist
or recognition of one’s abilities and achieve- Claude M. Steele (1946– )]
ments, together with acknowledgment and ac- self-alienation n. a state in which the individ-
ceptance of one’s limitations. Self-acceptance is ual feels a stranger to himself or herself, typically
often viewed as a major component of mental accompanied by significant emotional distanc-
health. ing. The self-alienated individual is frequently
self-accusation n. the act of blaming oneself unaware of or largely unable to describe his or
unjustifiably for negative occurrences. It is often her own intrapsychic processes.
associated with a major depressive episode. self-alien syndrome any of various conditions
self-activity n. the performance of actions that in which an aspect of oneself is perceived as out-
have been decided upon by oneself, without de- side one’s normal experience and control. This
pendence on outside activators. perception is common in neurological and psy-
chological disorders but also occurs in such ev-
self-actualization n. the complete realization eryday situations as failures of impulse control.
of that of which one is capable, involving maxi-
mum development of abilities and full involve- self-analysis n. 1. generally, the investigation
ment in and appreciation for life, particularly as or exploration of the self for the purpose of
manifest in peak experiences. The term is asso- better understanding of personal thoughts, emo-
ciated particularly with Abraham maslow, who tions, and behavior. Self-analysis occurs con-
viewed the process of striving toward full poten- sciously and unconsciously in many contexts
tial as fundamental yet obtainable only after the of daily life. To some degree or other, and with
basic needs of physical survival, safety, love and the assistance and sometimes interpretation of
belongingness, and esteem are fulfilled. Also the therapist, it is a particularly crucial process
called self-realization. within most forms of psychotherapy. 2. an at-
tempt to apply the principles of psychoanaly-
self-advocacy n. the process by which people
sis to a study of one’s own drives, feelings, and
make their own choices and exercise their rights
behavior. It was proposed by Sigmund freud
in a self-determined manner. For people with de-
early in his career as part of the preparation of an
velopmental and other disabilities, for example,
analyst but later dropped in favor of a training
self-advocacy might entail promoting increased
analysis. Much of Freud’s early theory of psy-
control of resources related to services and mak-
choanalysis was based on his own self-analysis as
ing informed decisions about what services to
described in The Interpretation of Dreams (1900).
accept, reject, or insist be altered. See also con-
—self-analytic adj.
sumer empowerment.
self-appraisal n. see self-concept.
self-affirmation n. 1. any behavior by which a
person expresses a positive attitude toward his or self as agent the aspect of the self that has goals,
her self, often by a positive assertion of his or her plans, and some degree of control over actions. It
values, attributes, or group memberships. self- contrasts with the self as object and is synony-
affirmation theory assumes that the desire for mous with the “I” of William james.
self-affirmation is basic and pervasive and that self as known the aspect of the self that is
many different behaviors reflect this motive. 2. known through reflection. It is sometimes con-
in psychotherapy, a positive statement or set of trasted with the self as knower.
S such statements about the self that a person is re- self-assertion n. the act of putting forward
quired to repeat on a regular basis, often as part one’s own opinions or taking actions that ex-
of a treatment for depression, negative thinking, press one’s needs, rights, or wishes. Self-assertion
or low self-esteem. 3. see compensatory self- is often seen as a goal of treatment and in some
enhancement. 4. in performance or competi- cases is specifically targeted by structured group
tive situations, any thought about oneself that is treatments. —self-assertive adj.
believable and vivid and that reinforces positive
characteristics, abilities, or skills. self-assessment n. see self-concept.
self-affirmation theory a theory postulating self-as-target effect the tendency to assume
that people are motivated to maintain views of wrongly that, or to overestimate the degree to
themselves as well adapted, moral, competent, which, external events refer to the self. For ex-
stable, and able to control important outcomes. ample, a person may think quite wrongly that
When some aspect of this self-view is chal- other people’s conversations and actions, or
lenged, people experience psychological discom- even music lyrics, are directed at him or her. In
fort. They may attempt to reduce this discomfort its milder forms the self-as-target effect is com-
by directly resolving the inconsistency between mon and normal, but extreme forms are associ-
the new information and the self, by affirming ated with paranoia.
some other aspect of the self, or both. Self- self-awareness n. self-focused attention or
affirmation theory has been used to provide an knowledge. There has been a continuing contro-
518
self-construal
versy over whether nonhuman animals have view their own attitudes, values, goals, body
self-awareness. Evidence of this in animals most concept, personal worth, and abilities. The ten-
often is determined by whether an individual nessee self-concept scale is an example.
can use a mirror to groom an otherwise unseen self-confidence n. self-assurance, or trust in
spot on its own forehead. A few chimpanzees, one’s own abilities, capacities, and judgment.
gorillas, and orangutans have passed this test. Because it is most typically viewed as a positive
self-awareness theory any hypothetical con- personality trait, the encouragement or bolster-
struct that attempts to describe how self-focused ing of self-confidence is often a mediate or end
attention occurs and what purpose it serves. Dis- goal in psychotherapeutic treatment. —self-
tinctions are sometimes made between subjec- confident adj.
tive self-awareness, arising directly from the self-confrontation n. examining one’s own
observation and experience of oneself as the attitudes, behaviors, and shortcomings to pro-
source of perception and behavior, and objective vide an impetus to change and to gain insight
self-awareness, arising from comparison be- into how one is perceived by others.
tween the self and (a) the behaviors, attitudes,
and traits of others or (b) some perceived stan- self-conscious emotion an emotion that cele-
dard for social correctness in any one of these brates or condemns the self and its actions, gen-
areas. erated when the self is known to be the object
of another person’s evaluation. Self-conscious
self-blaming depression a major depressive emotions include shame, pride, guilt, and
episode in which unreasonable guilt is a promi- embarrassment. Recently, the term other-
nent feature. conscious emotions has been suggested as a
self-care n. activities required for personal care, better name for these emotions, to emphasize
such as eating, dressing, or grooming, that can the importance of the appraisal of other human
be managed by an individual without the assis- beings in generating them.
tance of others. self-consciousness n. 1. a personality trait as-
self-censure n. an individual’s conscious self- sociated with the tendency to reflect on or
blame, condemnation, or guilt in judging his or think about oneself. Psychological use of the
her own behavior to be inconsistent with per- term refers only to individual differences in self-
sonal values or standards of moral conduct. reflection, not to embarrassment or awkward-
self-completion theory the theory that many ness. Some researchers have distinguished
behaviors are performed to claim desired identi- between two varieties of self-consciousness:
ties, so that by behaving in a certain way one is (a) private self-consciousness, or the degree
symbolically “proving” oneself to be a certain to which people think about private, internal
kind of person. Insecurity about being the sort of aspects of themselves (e.g., their own thoughts,
person one wants to be is often the reason for en- motives, and feelings) that are not directly open
gaging in such self-completing acts. For exam- to observation by others; and (b) public self-
ple, a person who takes pride in being very fit consciousness, or the degree to which people
and active may respond to the first signs of ill- think about public, external aspects of them-
ness or exhaustion by increasing, rather than re- selves (e.g., their physical appearance, manner-
ducing, his or her activities. isms, and overt behavior) that can be observed
self-complexity n. the degree to which differ- by others. 2. extreme sensitivity about one’s
ent aspects of the self-concept are discon- own behavior, appearance, or other attributes
nected from one another. Low self-complexity and excessive concern about the impression
entails considerable integration; high self- one makes on others, which leads to embarrass-
complexity results from compartmentaliza- ment or awkwardness in the presence of others. S
tion, so that what affects one part of the self —self-conscious adj.
may not affect other parts. self-consistency n. behavior or personality that
self-concept n. one’s description and evaluation has a high degree of internal harmony and sta-
of oneself, including psychological and physical bility.
characteristics, qualities, and skills. Self-concepts self-consistency perspective of cognitive
contribute to the individual’s sense of identity dissonance theory a variation of cognitive
over time. The conscious representation of self- dissonance theory postulating that cogni-
concept is dependent in part on unconscious tive dissonance is particularly likely to occur
schematization of the self (see schema). Al- when an inconsistency involves some aspect of
though self-concepts are usually available to the self. This perspective differs from self-
some degree to the consciousness, they may be affirmation theory in that it assumes that dis-
inhibited from representation yet still influence sonance can only be reduced by resolving the
judgment, mood, and behavioral patterns. Also specific inconsistency that gave rise to the dis-
called self-appraisal; self-assessment; self- comfort; it does not allow for the possibility that
evaluation; self-rating. See self-image; self- dissonance can be reduced by affirming some
perception. other aspect of the self. [originally proposed by
self-concept test a type of personality assess- U.S. psychologist Elliot Aronson (1932– )]
ment designed to determine how participants self-construal n. any specific belief about the
519
self-control
self. The term is used particularly in connection self-denial n. the act of suppressing desires and
with the distinction between independent forgoing satisfactions.
self-construals and interdependent self- self-derogation n. the tendency to disparage
construals. A self-construal is much more spe- oneself, often unrealistically. It is often associ-
cific than a self-concept. ated with a major depressive episode.
self-control n. the ability to be in command of self-desensitization n. a procedure used in be-
one’s behavior (overt, covert, emotional, or havior therapy in which the individual, when
physical) and to restrain or inhibit one’s im- confronted with objects or situations that arouse
pulses. In circumstances in which short-term fear or anxiety, engages in coping strategies de-
gain is pitted against long-term loss or long-term signed to reduce anxiety, for example, repeating
greater gain, it is the ability to opt for the long- positive self-statements, mentally rehearsing a
term outcome. Choice of the short-term out- potential confrontation, or employing muscle
come is called impulsiveness (see impulsive). relaxation. See also desensitization; system-
See also self-discipline; self-regulation. atic desensitization.
—self-controlled adj. self-destructiveness n. actions by an individ-
self-control technique a technique in behav- ual that are damaging and not in his or her best
ior therapy in which clients are trained to eval- interests. The behavior may be repetitive and re-
uate their own behavior and reinforce desired sistant to treatment, sometimes leading to sui-
behavior with appropriate material or social re- cide attempts. The individual may not be aware
wards. of the damaging influence of the actions or may
self-control therapy a form of behavior on some level wish for the resulting damage. See
therapy that involves self-monitoring (e.g., dia- also death instinct. —self-destructive adj.
ries of behavior), self-evaluation, goal setting, self-determination n. the process or result of
behavioral contracts, teaching, self-re- engaging in behaviors without interference or
inforcement, and relapse prevention. Also called undue influence from other people or exter-
self-management therapy. [developed by nal demands. Self-determination refers particu-
Austrian-born U.S. clinical psychologist Freder- larly to behaviors that improve one’s circum-
ick H. Kanfer (1925–2002)] stances, including choice making, problem
solving, self-management, self-instruction, and
self-correction n. any situation in which an in-
self-advocacy.
dividual makes an error but fixes it spontane-
ously, with no external instructions or cues. self-determination theory a theory that em-
phasizes the importance of autonomy and in-
self-criticism n. the examination and evalua- trinsic motivation for producing healthy
tion of one’s behavior, with recognition of one’s adjustment. According to this theory, negative
weaknesses, errors, and shortcomings. Self- outcomes ensue when people are driven mainly
criticism can have both positive and negative ef- by external forces and extrinsic rewards.
fects; for example, a tendency toward harsh self-
criticism is thought by some to be a risk factor for self-direction n. see self-determination.
depression. —self-critical adj. self-discipline n. the control of one’s own im-
pulses and desires, forgoing immediate satis-
self-debasement n. see self-abasement.
faction in favor of long-term goals or of
self-deception n. the process or result of con- improvement generally. See also self-control;
vincing oneself of the truth of something that is self-regulation. —self-disciplined adj.
false or invalid, particularly the overestimation self-disclosure n. the act of revealing informa-
of one’s abilities and concurrent failure to recog-
S nize one’s own limitations.
tion about one’s self, especially one’s private
self, to other people. In psychotherapy, the rev-
self-defeating behavior actions by an indi- elation and expression by the client of personal,
vidual that invite failure or misfortune and thus innermost feelings, fantasies, experiences, and
prevent him or her from attaining goals or fulfill- aspirations is believed by many to be a requisite
ing desires. An example is a college student pro- for therapeutic change and personal growth. In
crastinating about studying and subsequently addition, pertinent revelation by the therapist of
getting a poor grade on an important exam. his or her personal details to the client can—if
self-defeating personality disorder in used with discretion—be a valuable tool to in-
DSM–III–R (but not DSM–IV–TR), a personality crease rapport and earn the trust of the client.
disorder characterized by a reluctance to seek self-discovery n. the process of searching for
pleasurable activities, encouraging others to ex- and finding one’s unique self or identity.
ploit or take advantage of oneself, focusing on self-discrepancy n. an incongruence between
one’s very worst personal features, and a ten- different aspects of one’s self-concept, particu-
dency to sabotage one’s good fortunes. See also larly between one’s actual self and either
masochistic personality disorder. the ideal self or the ought self. [derived from
self-degradation n. negative imagery or neg- the theory of U.S. psychologist E. Tory Higgins
ative self-talk that causes one to think less of (1946– )]
oneself and one’s ability. self-dynamism n. the pattern of motivations or
520
self-help group
drives that comprise one’s self-system, includ- self-focus n. 1. the ability of human beings to di-
ing especially the pursuit of biological satis- rect conscious attention on themselves and their
faction, security, and freedom from anxiety. own thoughts, needs, desires, and emotions.
[proposed by U.S. psychiatrist Harry Stack Trait self-focus refers to a chronic habit or pat-
Sullivan (1892–1949)] tern of self-attention, whereas state self-focus re-
self-effacement n. 1. acting in such a way as fers to any temporary occurrence of the state.
not to draw attention to oneself or make oneself 2. the capacity of an individual to analyze and
noticeable. 2. in the approach of German-born evaluate his or her mental and emotive states.
U.S. psychoanalyst Karen D. Horney (1885– 3. excessive concern for the self and its needs:
1952), a neurotic idealization of compliancy, de- selfishness. —self-focused adj.
pendency, and selfless love as a reaction to self-fulfilling prophecy a belief or expecta-
identification with the hated self. See also com- tion that helps to bring about its own fulfill-
pliant character; neurotic trend. —self- ment, as, for example, when a person expects
effacing adj. nervousness to impair his or her performance in
self-efficacy n. an individual’s capacity to act a job interview or when a teacher’s preconcep-
effectively to bring about desired results, espe- tions about a student’s ability influence the
cially as perceived by the individual (see per- child’s achievement for better or worse. See also
ceived self-efficacy). demand characteristics.
self-gratification n. the satisfaction of the
self-enhancement motive the desire to think
needs of the self.
well of oneself and to be well regarded by others.
This motive causes people to prefer favorable, self-guide n. a specific image or goal of the self
flattering feedback rather than accurate but pos- that can be used to direct self-regulation. In
sibly unfavorable information. Compare ap- particular, self-guides include mental representa-
praisal motive; consistency motive. tions of valued or preferred attributes, that is,
ideals and notions of how one ought to be; these
self-enucleation n. see autoenucleation. may be chosen by the self or may come from
self-esteem n. the degree to which the qualities others.
and characteristics contained in one’s self- self-handicapping n. a strategy of creating ob-
concept are perceived to be positive. It reflects a stacles to one’s performance, so that future an-
person’s physical self-image, view of his or her ticipated failure can be blamed on the obstacle
accomplishments and capabilities, and values rather than on one’s own lack of ability. If one
and perceived success in living up to them, as succeeds despite the handicap, it brings extra
well as the ways in which others view and re- credit or glory to the self. The theory originally
spond to that person. The more positive the cu- was proposed to explain alcohol and drug abuse
mulative perception of these qualities and among seemingly successful individuals. —self-
characteristics, the higher one’s self-esteem. A handicap vb.
high or reasonable degree of self-esteem is con-
sidered an important ingredient of mental self-hate n. extreme self-derogation.
health, whereas low self-esteem and feelings of self-help n. a focus on self-guided, in contrast to
worthlessness are common depressive symp- professionally guided, efforts to cope with life
toms. problems. This can involve self-reliance, draw-
ing upon publicly available information and ma-
self-evaluation n. see self-concept.
terials, or joining together with others similar to
self-expression n. free expression of one’s feel- oneself, as is the case in self-help groups.
ings, thoughts, talents, attitudes, or impulses self-help clearinghouse an organization that
through such means as verbal communication; serves as an information and referral source
S
the visual, decorative, literary, and performing about self-help groups in a given locality or re-
arts; and other commonplace activities (e.g., gar- gion, providing up-to-date directories of all
dening and sports). groups in that jurisdiction, as well as national
self-extension n. according to Gordon all- self-help group resources. It serves as an impor-
port, an early stage in the development of the tant resource for citizens, groups, and pro-
proprium or self, beginning roughly at age 4 fessionals. Some clearinghouses also provide
and marked by the child’s emerging ability to in- consultation to groups and group leaders and at-
corporate people, objects, and abstractions into tempt to educate the public and professionals
the self-concept. Self-extension is the invest- about the nature, value, and availability of
ment of ego in those objects outside the self with groups. The Self-Help Sourcebook of a well-known
which the individual feels affinity or identifica- clearinghouse in the United States, the American
tion. Self-Help Clearinghouse, provides an interna-
self-extinction n. in psychoanalytic theory, a tional listing of self-help clearinghouses.
form of neurotic behavior in which the patient self-help group a group composed of individu-
lacks experience of himself or herself as an entity als who meet on a regular basis to help one an-
and identifies vicariously with the experiences other cope with a common life problem. Unlike
and lives of others. [introduced by German-born therapy groups, self-help groups are not led by
U.S. psychoanalyst Karen D. Horney (1885–1952)] professionals, do not charge a fee for service, and
521
self-help group ideology
do not place a limit on the number of members. dysfunctions and of self-abusive, self-defeating,
They provide many benefits that professionals or destructive behavior. See also schema.
cannot provide, including friendship, emotional self-inflicted wound a physical injury that re-
support, experiential knowledge, identity, sults from self-injurious behavior or attempted
meaningful roles, and a sense of belonging (see suicide.
also self-help group processes). Psychologists
self-injurious behavior apparently inten-
have become increasingly active in researching
tional actions that inflict damage upon one’s
and supporting the development of self-help
own body.
groups. Examples of self-help groups are alco-
holics anonymous, compassionate friends, self-insight n. understanding oneself in some
and recovery, inc. See also mutual support depth (see insight). It is a mediate goal or the
group; support group. desired outcome of many types of psychother-
apy. See also derivative insight.
self-help group ideology the set of beliefs
about the cause and best means to address the self-instructional training a form of cogni-
problem that brings members of self-help tive behavior therapy that aims to modify
groups together. Each self-help group develops maladaptive beliefs and cognitions and develop
an ideology that is distinctive and that serves as new skills in an individual. In therapy, the thera-
an aid or “antidote” to its particular type of prob- pist identifies the client’s maladaptive thoughts
lem. For instance, in the case of alcoholics (e.g., “Everybody hates me”) and models appro-
anonymous the group ideology includes the be- priate behavior while giving spoken constructive
lief that alcoholism is a life-long problem and self-instructions (or self-statements). The client
that the first step in addressing the problem is for then copies the behavior while repeating these
group members to admit that they do not have instructions aloud. See also self-statement
control over it. training. [developed by U.S. psychologist Don-
ald Meichenbaum (1940– )]
self-help group processes the means or
self-inventory n. a questionnaire or series of
mechanisms by which self-help groups are
statements on which participants check charac-
thought to exert influence on their members.
teristics or traits that they perceive to apply to
These include providing a sense of belonging,
themselves.
adaptive beliefs, emotional support, role models,
specific coping approaches, practical informa- selfishness n. the tendency to act excessively or
tion, and opportunities to contribute meaning- solely in a manner that benefits oneself, even if
fully to others and to expand or rebuild personal others are disadvantaged. —selfish adj.
social networks. self-love n. 1. regard for and interest in one’s
self-help group typology classification of own being or contentment. 2. excessive self-
self-help groups according to type. Many ty- regard, or a narcissistic attitude toward one’s
pologies include addiction/compulsion groups own body, abilities, or personality. See egotism;
(e.g., alcoholics anonymous), life stress/tran- narcissism.
sition groups (e.g., compassionate friends), self-managed reinforcement see self-
mental illness/mental health problem groups reinforcement.
(e.g., grow, inc.), and physical illness/health/dis- self-management n. 1. an individual’s control
ability groups (e.g., the National Multiple Sclero- of his or her own behavior, particularly regard-
sis Society). ing the pursuit of a specific objective (e.g.,
self-hypnorelaxation n. a form of self- weight loss). Self-management is usually consid-
hypnosis in which clients are trained to respond ered a desirable aspect for the individual person-
S to their own relaxation suggestions. ally and within the social setting, but some
forms of self-management may be detrimental
self-hypnosis n. the process of putting oneself to mental and physical health (see also coping
into a trance or trancelike state, sometimes spon- mechanism). Psychotherapy and counseling
taneously but typically through autosugges- often seek to provide methods of identifying the
tion. Also called autohypnosis. latter and modifying them into the former. 2. a
self-ideal Q sort a technique designed to mea- behavior-therapy program in which clients
sure the discrepancy between an individual’s ex- are trained to apply techniques that will help
isting and ideal self-concepts. The technique them modify an undesirable behavior, such as
requires participants to sort descriptions of char- smoking, excessive eating, or aggressive out-
acteristics twice, once with regard to how they bursts. Clients learn to pinpoint the problem, set
see themselves and then in terms of how they realistic goals for changing it, use various con-
would like to be. tingencies to establish and maintain the de-
self-identity n. see identity. sired behavior, and monitor progress.
self-management therapy see self-con-
self-image n. one’s own view or concept of one-
trol therapy.
self. Self-image is a crucial aspect of an individ-
ual’s personality that can determine the success self-medication n. see medication.
of relationships and a sense of general well- self-monitoring n. 1. a method used in behav-
being. A negative self-image is often a cause of ioral management in which individuals keep a
522
self-regulation
record of their behavior (e.g., time spent, place freud proposed that the instinct of self-
of occurrence, form of the behavior, feelings dur- preservation was one of two instincts that moti-
ing performance), especially in connection with vated human behavior, the other being the sex-
efforts to change or regulate the self (see self- ual instinct. In his later formulations he
regulation). 2. a personality trait reflecting an combined both instincts into the concept of
ability to modify one’s behavior in response to eros, or the life instinct, and opposed them
situational pressures, opportunities, and norms. to thanatos, the death instinct. Also called
High self-monitors are typically more in tune self-preservative instinct; survival in-
with the demands of the situation, whereas low stinct.
self-monitors tend to be more in tune with their self-protection n. any strategic behavior that is
internal feelings. 3. a therapeutic technique in designed to avoid losing esteem, either self-
which the therapist assigns homework to en- esteem or the esteem of others. Self-protection
courage the client to record behavior, because fosters a risk-avoidant orientation.
behavior sometimes changes when it is closely
self-monitored. 4. a motivational technique used self psychology 1. any system of psychology
in exercise programs. focused on the self. 2. a school of psycho-
analytical theory that stresses the importance of
self-mutilation n. the act of disfiguring one- an individual’s relationships with others to
self. The most common type of self-mutilation is healthy self-development and locates the source
cutting. of many psychological problems in caregivers’
self-objectification n. the achievement of lack of responsiveness to the child’s emotional
objective knowledge about the self or self- needs. In self-psychological therapy the thera-
understanding. It is one of Gordon allport’s set pist attempts to build an empathetic relation-
of seven adaptive characteristics for psychologi- ship with the client, rather than keeping an
cal maturity. emotional distance as in classic psychoanalytical
self-perception n. a person’s view of his or her practice. [pioneered by Austrian-born U.S. psy-
self or of any of the mental or physical attributes choanalyst Heinz Kohut (1913–1981)]
that constitute the self. Such a view may involve self-punishment n. the act of inflicting physi-
genuine self-knowledge or varying degrees of cal or psychological harm on oneself for one’s
distortion. Also called self-percept. See also perceived misdeeds. Self-punishment ranges
perceived self; self-concept. from self-accusation to self-mutilation or
self-perception theory a theory postulating attempted suicide and commonly occurs in se-
that people often have only limited access to vere cases of major depressive disorder.
their attitudes, beliefs, traits, or psychological self-rating n. 1. see self-concept. 2. in psycho-
states. In such cases, people must attempt to logical measurement, the act of reporting on or
infer the nature of these internal cues in a man- describing characteristics of oneself.
ner similar to the inference processes they use self-realization n. see self-actualization.
when making judgments about other people. For
example, a person may infer what his or her atti- self-reference n. a persistent tendency to direct
tude is by considering past behaviors related a discussion or the attention of others back
to the attitude object: Approach behaviors to oneself, that is, to one’s personal concerns
imply a positive attitude; avoidance behaviors and perceptions. —self-refer vb. —self-refer-
imply a negative attitude. Self-perception theory ential adj.
has been offered as an alternative explanation self-referral n. the act of consulting a clinical
for some phenomena traditionally interpreted in service provider or health care practitioner with-
terms of cognitive dissonance theory. [origi- out being directed to by a medically qualified S
nally proposed by U.S. psychologist Daryl J. Bem professional or similar person or without being
(1938– )] forced to seek such help by an employer, a
self-presentation n. any behaviors designed to spouse, or the courts. Self-referred individuals
convey a particular image of, or particular infor- are often viewed as more motivated for treat-
mation about, the self to other people. Self- ment and more likely to admit to problems.
presentational motives explain why an individ- self-reflection n. examination, contemplation,
ual’s behavior often changes as soon as anyone and analysis of one’s thoughts and actions. The
else is thought to be present or watching. Some condition of or capacity for this is called self-
common strategies of self-presentation include reflexivity.
self-promotion and supplication. See also self-regulation n. the control of one’s own
impression management. —self-presenta- behavior through the use of self-monitoring
tional adj. (keeping a record of behavior), self-evaluation
self-preservation instinct the fundamental (assessing the information obtained during self-
tendency of humans and nonhuman animals to monitoring), and self-reinforcement (rewarding
behave so as to avoid injury and maximize oneself for appropriate behavior or for attaining
chances of survival (e.g., by fleeing from danger- a goal). Self-regulatory processes are stressed in
ous situations or predators). In his early formula- behavior therapy. See also self-control; self-
tions of classic psychoanalytic theory, Sigmund management.
523
self-regulatory resources theory
self-regulatory resources theory a model spect.” It is used in self-instructional

stating that self-regulation depends on a training. See also inner dialogue.
global, but finite, pool of resources that can be self-stimulation n. 1. the act or process of in-
temporarily depleted by situational demands. ducing or increasing the level of arousal in one-
See ego depletion. self. It can be observed in various situations; for
self-reinforcement n. the rewarding of oneself example, infants who are understimulated may
for appropriate behavior or the achievement of a explore their surroundings or babble to them-
desired goal. The self-reward may be, for exam- selves. 2. see pleasure center. See also mastur-
ple, buying a treat after studying for an exam. bation; self-reinforcement.
Also called self-managed reinforcement. self-suggestion n. see autosuggestion.
self-report n. a statement or series of answers to self-system n. the relatively fixed personality of
questions provided by an individual as to his or
the individual resulting from relationships with
her state, feelings, beliefs, and so forth. Self-
his or her parents and other significant adults, in
report methods rely on the honesty and self-
which approved attitudes and behavior patterns
awareness of the participant (see self-report
tend to be retained and disapproved actions and
bias) and are used especially to measure behav-
attitudes tend to be blocked out. [first described
iors or traits that cannot easily be directly ob-
by U.S. psychiatrist Harry Stack Sullivan (1892–
served.
1949)]
self-report bias a methodological problem that
self-talk n. an internal dialogue in which an in-
arises when researchers rely on asking people to
dividual utters phrases or sentences to him- or
describe their thoughts, feelings, or behaviors
herself. The self-talk often confirms and rein-
rather than measuring these directly and objec-
forces negative beliefs and attitudes, such as fears
tively. People may not give answers that are fully
and false aspirations, which have a correspond-
correct, either because they do not know the full
ingly negative effect on the individual’s feelings
answer or because they seek to make a good
and reactions. In certain types of psychotherapy,
impression (see social desirability). The self-
one of the tasks of the therapist is to encourage
report bias is often cited as a reason to use direct
the client to replace self-defeating, negative self-
observation rather than self-reports whenever
talk with more constructive, positive self-talk. In
practicable.
sport, athletes are trained to use positive self-talk
self-report inventory a type of questionnaire to cue the body to act in particular ways, to cue
on which participants indicate the degree to attentional focus, to motivate, to reinforce self-
which the descriptors listed apply to them. efficacy, and to change mood. See also inter-
self-repudiation n. denial of one’s own plea- nalized speech; rational emotive behavior
sure or rights, usually out of a sense of guilt or therapy. [described by U.S. psychotherapist Al-
low self-esteem. bert Ellis (1913–2007)]
self-respect n. a feeling of self-worth and self- self-test n. a test that can be administered with-
esteem, especially a proper regard for one’s val- out the help of a trained professional.
ues, character, and dignity. self-transcendence n. the state in which an in-
self-schema n. a cognitive framework compris- dividual is able to look beyond him- or herself
ing organized information and beliefs about the and adopt a larger perspective that includes con-
self that guides a person’s perception of the cern for others. Some psychologists maintain
world, influencing what information draws the that self-transcendence is a central feature of the
individual’s attention as well as how that infor- healthy individual, promoting personal growth
S mation is evaluated and retained. and development. [first described by Austrian
self-serving bias the tendency to interpret psychiatrist Viktor Emil Frankl (1905–1998)]
events in a way that assigns credit to the self for self-understanding n. the attainment of
any success but denies the self’s responsibility knowledge about and insight into one’s charac-
for any failure, which is blamed on external fac- teristics, including attitudes, motives, behavioral
tors. The self-serving bias is regarded as a form of tendencies, strengths, and weaknesses. The
self-deception designed to maintain high self- achievement of self-understanding is one of the
esteem. major goals of certain forms of psychotherapy.
self-statement n. see self-instructional self-verbalization n. 1. self-directed private
training; self-statement training. speech or thinking aloud. Self-verbalization can
self-statement modification a technique be a cognitive strategy that fosters internal self-
designed to change maladaptive ideas about the regulation by verbally controlling behavior.
self that are uncovered in cognitive behavior Often used as a learning tool, it can be used to
therapy. See also self-instructional train- teach new skills, enhance problem-solving abili-
ing. ties, or alter previously held beliefs. Varying per-
self-statement training (SST) a type of cog- spectives on this type of speech include the work
nitive rehearsal that involves periodically of Lev vygotsky, Jean piaget, and Alexander
thinking or saying something positive, such as “I luria. 2. see self-talk.
am a capable individual who is worthy of re- self-verification hypothesis the hypothesis
524
senile dementia
that people seek information about themselves halo, marked by coherent but vague and ambig-
that confirms their existing self-concept, re- uous language.
gardless of whether this is good or bad. Accord- semantic encoding cognitive encoding of
ing to this theory, the consistency motive, new information that focuses on the meaningful
which seeks self-verification, is often stronger aspects of the material as opposed to its percep-
than the self-enhancement motive, which seeks tual characteristics. This will usually involve
favorable information about the self, or than some form of elaboration. See also deep pro-
the appraisal motive, which seeks accurate cessing; top-down processing.
information about the self (diagnosticity).
semantic memory memory for general factual
People seek self-verification (a) by engaging in
knowledge and concepts, of the kind that en-
situations that confirm their self-concept, (b) by
dows information with meaning and ultimately
seeking out and choosing to believe self-
allows people to engage in such complex cogni-
verifying feedback, and (c) by trying to persuade
tive processes as recognizing objects and using
others of the validity of their own views of them-
language. Examples of such semantic (or ge-
selves.
neric) knowledge include the location of the Eif-
self-worth n. an individual’s evaluation of him- fel Tower, the characteristics of a Labrador Re-
self or herself as a valuable, capable human being triever, or the elements associated with beauty.
deserving of respect and consideration. Positive Impairments of semantic memory may be seen
feelings of self-worth tend to be associated with following brain injury as well as in certain neu-
a high degree of self-acceptance and self- rological disorders, particularly dementia. For
esteem. instance, people with alzheimer’s disease
often find it increasingly difficult to categorize
SEM abbreviation for structural equation
and name items (i.e., to refer to an apple as an
modeling.
apple) as their memory deficits worsen. Seman-
semantic counseling a type of counseling in tic memory is considered by many theorists to be
which emphasis is placed on interpretations of one of the two forms of declarative memory,
meanings, particularly those related to adjust- the other being episodic memory. [defined in
ment and maladjustment. 1972 by Endel Tulving (1927– ), Estonian-born
Canadian psychologist]
semantic dementia a selective, progressive
impairment in semantic memory, leading to semantic psychosis the tendency of antisocial
difficulties in naming, comprehension of words individuals to distort the meaning of words.
and their appropriate use in conversation, and They might say, for example, I shouldn’t have
appreciation and use of objects. Nonsemantic as- done that when they merely mean I’ll say that be-
pects of language, as well as perceptual and spa- cause that’s what he wants to hear, and then he’ll let
tial skills, are preserved. The syndrome results me go. [defined by U.S. psychiatrist H. M.
from focal degeneration of the polar and Cleckley (1905–1984)]
inferolateral regions of the temporal lobes. semantic therapy a form of psychotherapy in
which the clients are trained to examine unde-
semantic differential a technique used to ex-
sired word habits and distorted ideas so that they
plore the connotative meaning that certain
can think more clearly and critically about their
words or concepts have for the individuals being
aims, values, and relationships. This approach is
questioned. Participants are asked to rate the
based on an active search for the meaning of the
word or concept on a seven-point scale with ref-
key words the client uses and on practicing the
erence to pairs of opposites, such as good–bad,
formation of clear abstractions, as well as on un-
beautiful–ugly, hot–cold, big–small, and so on. Re-
covering hidden assumptions and increased S
sponses are then averaged or summed to arrive at
awareness of the emotional tone behind the
a final index of attitudes. This procedure is one
words the client has been using. Polish-born U.S.
of the most widely used methods of assessing at-
scientist Alfred Korzybski (1879–1950) and U.S.
titudes and may be used in psychometric testing
psychologist Wendell A. L. Johnson (1906–1965)
or (in advertising, politics, etc.) to gauge public
were major early exponents of this approach.
reactions to a product, issue, or personality.
See also attitude object. [developed in the semantogenic disorder a mental disorder
1950s by U.S. psychologists Charles E. osgood, originating in a misinterpretation of the mean-
George J. Suci, and Percy H. Tannenbaum (1927– ings of emotion-colored words.
2009)] semiconscious adj. describing states of partial
wakefulness, or alertness, such as drowsiness,
semantic dissociation a distortion between
stupor, or intermittent coma.
words and their culturally accepted meanings
that is characteristic of the thought disorder senile adj. 1. relating to dementia associated
of individuals with schizophrenia. It includes se- with advanced age, used particularly with
mantic dissolution, marked by a complete loss of refernce to dementia or any other cognative or
meaning and communication; semantic disper- behavioral deterioration relating to old age. 2. a
sion, in which meaning and syntax are lost or relay term used to describe an older adult with de-
duced; semantic distortion, in which meaning mentia.
may be transferred to neologisms; or semantic senile dementia see dementia.
525
senile dementia of the Alzheimer’s type
senile dementia of the Alzheimer’s type sation type is one of Jung’s two irrational
(SDAT) an older name for dementia of the Alz- types, the other being the intuitive type. See
heimer’s type with onset after age 65. See alz- also feeling type; thinking type.
heimer’s disease. sense 1. n. any of the media through which one
senile plaque a clump of beta-amyloid pro- gathers information about the external environ-
tein surrounded by degenerated dendrites that is ment or about the state of one’s body in relation
particularly associated with symptoms of Alzhei- to this. They include the five primary senses—vi-
mer’s disease. Increased concentration of senile sion, hearing, taste, touch, and smell—as well as
plaques in the cerebral cortex of the brain is cor- the senses of pressure, pain, temperature, kines-
related with the severity of dementia. Also called thesis, and equilibrium. Each sense has its own
amyloid plaque; neuritic plaque. receptors, responds to characteristic stimuli, and
senilism n. an obsolete name for the appearance has its own pathways to a specific part of the
of symptoms of senility in old age or before. brain. Also called sense modality; sensory
modality. 2. n. a particular awareness of a phys-
senility n. an obsolete term for dementia associ- ical dimension or property (e.g., time, space) or
ated with advanced age. See also pseudo-
of an abstract quality, usually one that is desir-
senility.
able (e.g., humor, justice). 3. n. good judgment
sensate focus an approach to problems of sex- or intelligence manifested by, or absent from, a
ual dysfunction in which people are trained to person. 4. vb. to perceive something using the
focus attention on their own natural biological senses. 5. vb. to make an emotional or cognitive
sensual cues and gradually achieve the freedom judgment about something, such as another per-
to enjoy sensory stimuli. Therapy is conducted son’s mood.
by teams of male and female professionals in
sense of coherence 1. a perception of having
joint interviews with the partners. The proce-
clarity or intelligibility, that is, of being capable
dures involve prescribed body-massage exercises
of thinking and expressing oneself in a clear and
designed to give and receive pleasure, first not
consistent manner. 2. the ability to present a
involving breasts and genitals, and then moving
narrative of oneself in a way that is understand-
to these areas. This eliminates performance anxi-
able and easy to follow.
ety about arousal and allows the clients to relax
and enjoy the sensual experience of body caress- sense of identity see identity.
ing without the need to achieve erection or or- sense of presence 1. the sense of being in a
gasm. Sensate focus therapy is one component particular place or time. 2. an awareness and
of the program developed by U.S. gynecologist understanding of one’s current existence. 3. in
William H. Masters (1915–2001) and U.S. psy- parapsychology, an awareness or consciousness
chologist Virginia E. Johnson (1925– ). of unusual phenomena, such as the existence or
sensation n. 1. the process or experience of per- appearance of spirits.
ceiving through the senses. 2. an irreducible unit sense of self an individual’s feeling of identity,
of experience produced by stimulation of a sen- uniqueness, and self-direction. See also self-
sory receptor and the resultant activation of a concept; self-image.
specific brain center, producing basic awareness
of a sound, odor, color, shape, or taste or of tem-
sensibility n. 1. a capacity to respond to an
emotional situation with refined or intense feel-
perature, pressure, pain, muscular tension, posi-
ing. 2. the capacity to receive sensory input.
tion of the body, or change in the internal
organs associated with such processes as hunger, sensible adj. 1. showing reason and sound judg-
thirst, nausea, and sexual excitement. Also called ment. 2. capable of receiving sensory input (e.g.,
S sense datum; sense impression; sensum. 3. feeling pain). 3. receptive to external influences.
in the structuralism of E. B. titchener, one of 4. felt or perceived as real or material.
the three structural elements of mental experi- sensitive 1. adj. having well-developed or in-
ence, the other two being images and feelings. tense mental and affective sensibility. 2. n. in
4. in general usage, a thrilling or exciting experi- spiritualism and parapsychology, a person who
ence. See sensation seeking. —sensational is supposedly capable of receiving knowledge by
adj. paranormal means, as in clairvoyance and telep-
sensation seeking the tendency to search out athy, or of perceiving auras and similar alleged
and engage in thrilling activities as a method of phenomena beyond the range of normal percep-
increasing stimulation and arousal. Limited to tion. See also psychic.
human populations, it typically takes the form sensitive period a stage in development when
of engaging in highly stimulating activities ac- an organism can most advantageously acquire
companied by a perception of danger, such as necessary skills or characteristics. For example,
skydiving or race-car driving. in humans the 1st year of life is considered sig-
sensation type in the analytic psychology nificant for the development of a secure attach-
of Carl jung, a functional type dominated by ment bond. It is important to note, however,
sense perception, as opposed to thinking, feel- that lack of appropriate growth-dependent expe-
ing, or intuition. This type of individual lives a riences during a sensitive period does not perma-
life of sense experience and enjoyment. The sen- nently and irreversibly affect development, as it
526
sensory intensity
would during a critical period, but rather the emotional inflections of language, that is,
makes the acquisition process outside the period the rhythm, pitch, and “melody” of speech.
more difficult. sensory ataxia lack of muscular coordination
sensitivity n. 1. the capacity to detect and dis- (see ataxia) due to the loss of the sense of limb
criminate. In signal detection theory, sen- movements (see proprioception).
sitivity is measured by d prime (d′). 2. the proba- sensory awareness training 1. the methods
bility that a test gives a positive diagnosis given used in sensate focus therapy and similar ther-
that the individual actually has the condition for apies to help an individual become more acutely
which he or she is being tested. Compare speci- aware of his or her own feelings and sensations
ficity. 3. in physiology, the ability of a cell, tis- and to accept new ways of experiencing them.
sue, or organism to respond to changes in its 2. in sport, training an athlete to become aware
external or internal environment: a fundamen- of the kinesthetic sensations experienced while
tal property of all living organisms. 4. awareness performing and of the sensations related to
of and responsiveness to the feelings of others. arousal level.
sensitivity training a group process focused sensory consciousness consciousness of sen-
on the development of self-awareness, produc- sory stimuli, having visual, tactile, olfactory, au-
tive interpersonal relations, and sensitivity to ditory, and taste qualities. Compare higher
the feelings, attitudes, and needs of others. The order consciousness.
primary method used in sensitivity training is
free, unstructured discussion with a leader func- sensory conversion symptoms one of two
tioning as an observer and facilitator, although types of symptoms of conversion disorder,
other techniques, such as role play, may be the other being motor conversion symptoms.
used. Sensitivity training is employed in human Examples of sensory conversion symptoms in-
relations training in industry and general clude loss of touch or pain sensation, double
life, with various types of groups (e.g., workers, vision, blindness, deafness, tinnitus, and hallu-
executives, married couples) meeting, for exam- cinations.
ple, once a week or over a weekend. See sensory deficit a loss, absence, or marked im-
also personal-growth laboratory; t-group. pairment of a normal sensory function, such as
[originated by Kurt lewin and Carl rogers] vision, hearing, taste, touch, or smell.
sensitization n. 1. a form of nonassociative sensory deprivation the reduction of sensory
learning in which an organism becomes more re- stimulation to a minimum in the absence of nor-
sponsive to most stimuli after being exposed to mal contact with the environment. Sensory de-
unusually strong or painful stimulation. 2. the privation may be experimentally induced (e.g.,
increased effectiveness of an eliciting stimulus as via the use of a sensory deprivation chamber) for
a function of its repeated presentation. Water research purposes or it may occur in a real-life
torture, in which water is dripped incessantly situation (e.g., in deep-sea diving). Although
onto a person’s forehead, is a good example. short periods of sensory deprivation can be ben-
3. see reverse tolerance. eficial, extended sensory deprivation has detri-
sensorimotor adj. 1. describing activity, behav- mental effects, causing (among other things)
ior, or brain processes that combine sensory hallucinations, delusions, hypersuggestibility,
(afferent) and motor (efferent) function. 2. de- or panic.
scribing a mixed nerve that contains both affer- sensory disorder any disturbance in the opti-
ent and efferent fibers. mum transmission of information from a sense
sensorimotor memory 1. a memory, com- organ to its appropriate reception point in the
monly of a traumatic experience, that is encoded brain or spinal cord, particularly when related to S
in sensorimotor, rather than verbal, forms. an anatomical or physiological abnormality. An
Frequently these are memories of events that auditory disorder, for example, may be due to
occurred during the period of childhood am- damage from injury or disease to the cochlear
nesia, which commonly lasts up to the age of 3 structures.
years. See also body memory. 2. see procedu- sensory integration the neural processes in-
ral memory. volved in perceiving, organizing, and evaluating
sensorium n. the human sensory apparatus and sensory information across modalities, such as
related mental faculties considered as a whole. vision and hearing, and producing an adaptive
The state of the sensorium is tested through the response via impulses transmitted through the
traditional mental status examination; the motor nerves. Development or enhancement of
sensorium may be clear (i.e., functioning nor- sensory-integrative functioning is an important
mally) or clouded (lacking ability to concentrate goal of occupational therapy.
and think clearly). sensory integration dysfunction a condi-
sensory adj. relating to the senses, to sensation characterized by difficulties in organizing,
tion, or to a part or all of the neural apparatus processing, and analyzing sensory input (touch,
and its supporting structures that are involved in movement, body awareness, sight, sound, smell,
any of these. and taste).
sensory aprosodia an inability to understand sensory intensity the perceived intensity of a
527
sensory memory
physical stimulus, predictably related to its ac- emotional situations, especially those of a
tual intensity by psychophysical laws. romantic or maudlin nature. See also emotion-
sensory memory brief storage of information ality. —sentimental adj.
from each of the senses in a relatively unpro- sentinel event in health administration, an un-
cessed form beyond the duration of a stimulus, expected occurrence or variation to service del-
for recoding into another memory (such as ivery involving death or serious physical or
short-term memory) or for comprehension. psychological injury. The event is called “senti-
For instance, sensory memory for visual stimuli, nel” because it sends a signal or sounds a warn-
called iconic memory, holds a visual image for ing that requires immediate attention.
less than a second, whereas that for auditory separation anxiety the normal apprehension
stimuli, called echoic memory, retains sounds experienced by a young child when away (or fac-
for a little longer. Also called sensory-infor- ing the prospect of being away) from the person
mation store (SIS); sensory register. or people to whom he or she is attached (particu-
sensory modulation dysfunction a condi- larly parents). Separation anxiety is most active
tion characterized by difficulties in responding between 6 and 10 months. Separation from
appropriately to sensory input (touch, move- loved ones in later years may elicit similar anxi-
ment, body awareness, sight, sound, smell, and ety.
taste). A person may be overresponsive or un- separation anxiety disorder in DSM–IV–TR,
derresponsive to sensations or alternate rapidly an anxiety disorder occurring in childhood or
between both response patterns. adolescence that is characterized by develop-
sensory neglect inability to attend to sensory mentally inappropriate, persistent, and exces-
information, usually from one side of the body, sive anxiety about separation from the home or
as a result of brain injury. from major attachment figures. Other features
sensory neuron a neuron that receives infor- may include marked anticipatory anxiety
mation from the environment, via specialized over upcoming separation and persistent and ex-
receptor cells, and transmits this—in the form cessive worry about harm coming to attachment
of nerve impulses—through synapses with figures or about major events that might lead to
other neurons to the central nervous system. separation from them (e.g., getting lost). There
may also be school refusal, fear of being alone
sensory overload a state in which the senses
or going to sleep without major attachment fig-
are overwhelmed with stimuli, to the point that
ures present, separation-related nightmares, and
the person is unable to process or respond to all
repeated complaints of physical symptoms (e.g.,
of them. See also information overload;
vomiting, nausea, headaches, stomachaches)
stimulus overload.
associated with anticipated separation. These
sensual adj. 1. referring to the senses, particu- symptoms cause clinically significant distress or
larly gratification of or appeal to the senses. 2. re- impairment in functioning.
ferring to physical or erotic sensation.
separation distress discomfort and anxiety
sentence-completion test a language ability felt by an individual upon losing contact with an
test in which the participant must complete an attachment figure, for example, by a child upon
unfinished sentence by filling in the specific losing contact with a caregiver or by an adult in
missing word or phrase. However, the test is used reaction to the traumatic loss of a spouse or part-
more often to evaluate personality, in which ner. See separation anxiety.
case the participant is presented with an intro-
separation–individuation n. the develop-
ductory phrase to which he or she may respond
mental phase in which the infant gradually dif-
S in any way. An example might be “Today I am in
ferentiates himself or herself from the mother,
a __ mood.” As a projective test, the sentence-
develops awareness of his or her separate iden-
completion test is an extension of the word-
tity, and attains relatively autonomous status.
association test in that responses are free and
[defined by Austrian child psychoanalyst Marga-
believed to contain psychologically meaning-
ret Mahler (1897–1985)]
ful material. Also called incomplete-sentence
test. sepsis n. the condition of tissues contaminated
by the presence of pus-forming bacteria or other
sentience n. 1. the simplest or most primitive
microorganisms or the toxic substances pro-
form of cognition, consisting of a conscious
duced by such microorganisms. When spread
awareness of stimuli without association or in-
throughout the bloodstream, the condition is
terpretation. 2. the state of being sentient.
called septicemia (see blood poisoning). —sep-
sentience need in the personology of U.S. tic adj.
psychologist Henry Alexander Murray (1893–
1988), a need to enjoy sights, sounds, and other
septal area a region of the forebrain that
contains the septal nuclei and the septum
sensuous experiences.
pellucidum, which separates the lateral ventri-
sentient adj. capable of sensing and recognizing cles. The septal nuclei, which include the nu-
stimuli. cleus accumbens, form an integral part of the
sentimentality n. the quality or condition limbic system; they contribute fibers to the me-
of being excessively or affectedly swayed by dial forebrain bundle and have interconnections
528
serotonin syndrome
with the amygdala, hippocampus, and regions central nervous system, also found in the
of the hypothalamus. Functionality of this area gastrointestinal tract, in smooth muscles of the
includes pleasure and anger suppression. cardiovascular and bronchial systems, and in
septicemia n. see blood poisoning. blood platelets. It is synthesized from the dietary
amino acid L-tryptophan (see tryptophan hy-
sequela n. (pl. sequelae) a residual effect of an
droxylase), and in the pineal gland it is con-
illness or injury, or of an unhealthy or unstable
verted to melatonin. Significant amounts of
mental condition, often (but not necessarily)
serotonin are found in the upper brainstem.
in the form of persistent or permanent impair-
Serotonin is primarily degraded by monoamine
ment. Examples include paralysis, which may be
oxidase, which yields its principal metabolic
the sequela of poliomyelitis, and flashbacks,
product, 5-hydroxyindoleacetic acid (5-
which may be the sequelae of traumatic stress.
HIAA). Serotonin has roles in numerous bio-
sequence completion see number-com- regulatory processes, including emotional pro-
pletion test. cessing, mood, appetite, and sleep as well as pain
sequence effect in within-subjects designs, processing, hallucinations, and reflex regula-
the effect of the treatments being administered tion. For example, levels of serotonin correlate
in a particular sequence (e.g., the sequence ABC negatively with aggression, and release of seroto-
versus ACB, versus BCA, and so forth). This is nin may promote sleep. It is implicated in many
often confused with the order effect. psychological conditions, including depressive
sequential marriage see serial polygamy. disorders, anxiety disorders, sleep disorders,
Serax n. a trade name for oxazepam. aggression, and psychosis; many common
psychotropic drugs affect neurotransmission
Serentil n. a trade name for mesoridazine. mediated by serotonin. Also called 5-hydro-
serial interpretation a psychoanalytic tech- xytryptamine (5-HT).
nique in which the analyst studies a series of
serotonin and norepinephrine reuptake
consecutive dreams that, when taken as a
inhibitor see snri.
group, provide clues that would be overlooked in
interpretation of a single, isolated dream. See serotonin antagonists agents that oppose the
also recurrent dream. action of serotonin. They include cypro-
heptadine and methysergide, which are used
serial killer an individual who repeatedly com-
for the prevention of migraine attacks, and the
mits homicide, typically with a distinct pattern
antiemetic ondansetron.
in terms of the selection of victims, location, and
method. serotonin receptor any of various receptors
serial monogamy see monogamy. that bind and respond to serotonin (5-
hydroxytryptamine; 5-HT). They occur in the
serial polygamy a pattern of repeated marriage brain and in peripheral areas and have different
and divorce. Also called sequential marriage. sensitivities that can be measured by susceptibil-
serial processing information processing ity to ligands or blockers. At least 15 classes of
in which only one sequence of processing opera- serotonin receptors, affecting a variety of physi-
tions is carried on at a time. Those who hold that ological and psychological processes, have been
the human information-processing system oper- identified. They are designated by subscript
ates in this way argue that the mind’s apparent numbers and letters (e.g., 5-HT1A, 5-HT1B, 5-
ability to carry on different cognitive functions HT1D, 5-HT2A, etc.).
simultaneously is explained by rapid shifts be-
serotonin-receptor agonists agents that in-
tween different information sources. Also called
crease the affinity for, or availability of, seroto-
intermittent processing; sequential pro-
cessing. Compare parallel processing. See
nin at various serotonin receptors in the S
brain or peripheral tissues. Commonly used in-
also single-channel model.
direct agonists are the ssris (e.g., fluoxetine,
seriation n. the process of arranging a collection citalopram), which work by blocking the
of items into a specific order (series) on the basis presynaptic reuptake of serotonin, thereby in-
of a particular dimension (e.g., size). According creasing the availability of serotonin at post-
to Jean piaget, this ability is necessary for un- synaptic receptor sites. Other serotonin agonists
derstanding the concepts of number, time, and exert their effects directly at the receptor site; for
measurement and is acquired typically by chil- example, the triptans are direct agonists at re-
dren during the ages of 7 to 11 years. ceptor subtypes 5-HT1B and 5-HT1D. The anxio-
SERMs abbreviation for selective estrogen recep- lytic agent buspirone is a partial agonist at
tor modulators. See antiestrogen. the postsynaptic 5-HT1A receptor, whereas the
Sernyl n. trade name for a brand of phen- serotonin-like hallucinogens (e.g., lsd) act as
cyclidine hydrochloride, an animal anesthetic partial agonists at 5-HT2A receptors.
with hallucinogenic properties sometimes taken serotonin reuptake inhibitor (SRI) see
as a drug of abuse (see pcp). ssri.
Seroquel n. a trade name for quetiapine. serotonin syndrome a collection of symp-
serotonin n. a common monoamine neuro- toms, including agitation, confusion, delirium,
transmitter in the brain and other parts of the and increased heart rate, due to excess activity of
529
sertraline
the neurotransmitter serotonin. It may result klinefelter’s syndrome, xyy syndrome, and
from drug interactions that increase amounts of turner’s syndrome.
available serotonin to toxic levels. sex chromosome a chromosome that deter-
sertraline n. an ssri that is used for the treatment mines the sex of an individual. Humans and
of depressive and anxiety disorders, including other mammals have two sex chromosomes: the
major depression, panic disorder, posttraumatic x chromosome, which carries genes for certain
stress disorder, and obsessive-compulsive disorder. sexual traits and occurs in both females and
It has also been indicated for the treatment of males; and the smaller y chromosome, which is
premenstrual dysphoric disorder. U.S. trade name: normally found only in males. An individual
Zoloft. usually is considered to be a female if the body
service delivery system see human service cells contain the XX combination of chromo-
delivery system. somes and male if the cells contain the XY com-
bination, regardless of physical traits or signs of
set n. a temporary readiness to respond in a cer- hermaphroditism. Disease genes that are carried
tain way to a specific situation or stimulus. For only on a sex chromosome (usually the X chro-
example, a sprinter gets set to run when the mosome) are responsible for sex-linked inher-
starting gun fires (a motor set); a parent is set to ited conditions.
hear his or her baby cry from the next room (a
perceptual set); a poker player is set to use a tactic sex counseling guidance provided by therapists
that has been successful in other games (a men- to sex partners in such matters as birth control,
tal set). infertility, and general feelings of inadequate
sexual performance. Working on specific sex-
seven plus or minus two the number of items ual dysfunction problems is usually con-
that can be held in short-term memory at any sidered to be sex therapy rather than sex
given time and therefore accurately perceived counseling.
and recalled after a brief exposure (see chunk-
ing). The phrase originated in the title of an arti- sex determination the genetic mechanism
cle (1956) by U.S. cognitive psychologist George that determines the sex of the offspring. In hu-
Armitage Miller (1920– ), “The magical num- mans a fertilized egg with two x chromosomes
ber seven, plus or minus two: Some limitations becomes a female, and a fertilized egg with one X
on our capacity for processing information.” and one y chromosome becomes a male. See
sex differentiation.
severe mental retardation a diagnostic cate-
gory applying to those with IQs of 20 to 34, sex differences 1. the differences in physical
comprising about 7% of people with mental re- features between males and females. These in-
tardation. While able to manage basic self-care clude differences in brain structures as well as
activities such as dressing and eating, these indi- differences in primary and secondary sex char-
viduals typically do not acquire much more than acteristics. 2. the differences between males
rudimentary communication, social, educa- and females in the way they behave and think.
tional, and vocational skills and generally Sex differences are often viewed as driven by ac-
require significant assistance and supervision. tual biological gender disparity (nature), rather
Additionally, sensory and motor deficits are than by differing environmental factors (nur-
common. ture), and affect both cognition and behavior.
Compare sex role.
sex n. 1. the traits that distinguish between males
and females. Sex refers especially to physical and sex differentiation the process of acquiring
biological traits, whereas gender refers espe- distinctive sexual features during the course of
cially to social or cultural traits, although the dis- development. Human sexual differentiation is
S determined genetically at the time of fertiliza-
tinction between the two terms is not regularly
observed. 2. the physiological and psychological tion, primarily by the presence or absence of a y
processes related to procreation and erotic plea- chromosome. Fertilized eggs containing a Y
sure. chromosome develop as male embryos, whereas
ones lacking a Y chromosome develop as fe-
sex change see sex reassignment. males. This is due to the presence on the Y chro-
sex characteristic any of the traits associated mosome of a particular gene, called SRY (sex
with sex identity. Primary sex characteristics reversal on Y). It encodes a testis-determining fac-
(e.g., testes in males, ovaries in females) are di- tor that, via a cascade of signals, triggers the de-
rectly involved in reproduction of the species. velopment of testes and other male reproductive
Secondary sex characteristics are features not di- organs. In the absence of this gene, the embryo
rectly concerned with reproduction, such as develops along the default, female pathway,
voice quality, facial hair, and breast size. Also with ovaries and other female organs.
called sexual characteristic. sex drive an arousal state precipitating the desire
sex-chromosomal aberration any disorder for sexual gratification and, ultimately, for sex-
of structure, function, or both that is associated ual reproduction. Although it is not necessary
with the complete or partial absence of a sex for an individual’s survival, it is considered a pri-
chromosome or with the presence of extra sex mary drive as it is essential for species survival.
chromosomes. Examples of such disorders are In many animals, sexual activity is cyclical (e.g.,
530
sexual addiction
seasonal or dependent on cyclical hormone re- dividual’s sexual behavior in terms of physiolog-
lease), although a variety of factors (e.g., external ical, psychological, sociological, and specific ge-
stimulation) may arouse the drive. Also called netic and environmental influences.
sexual drive. See libido. sexology n. the study of sexuality, particularly
sex feeling the pleasurable feeling associated among human beings, including the anatomy,
with coitus or other sexual contact. Also called physiology, and psychology of sexual activity
sexual feeling. and reproduction. —sexological adj. —sex-
sex hormone any of the hormones that stimu- ologist n.
late various reproductive functions. Primary sex perversion see sexual perversion.
sources of sex hormones are the male and female sex-positivity n. a positive attitude or stance to-
gonads (i.e., testis and ovary), which are stimu- ward sexual activity between consenting indi-
lated to produce sex hormones by pituitary viduals where this is seen as promoting healthy
hormones. The principal male sex hormones relationships and forms of self-expression. Sex is
(androgens) include testosterone; female sex seen as neither good nor bad, per se, and the pur-
hormones include the estrogens, progester- pose of sexual relations is not deemed to be con-
one, and prolactin. fined exclusively to procreation through marital
sex hygiene the health-maintenance proce- coitus. Compare sex-negativity.
dures related to sexual activity, for example, the sex reassignment a process, involving hor-
prevention or control of sexually transmitted in- mone treatment and surgery, in which a per-
fections. Also called sexual hygiene. son’s sex characteristics are changed to conform
sex identification see sexual identifica- to that person’s sense of his or her own gen-
tion. der identity, particularly in cases of trans-
sex identity 1. the purely biologically deter- sexualism. Also called gender reassignment;
mined sexual condition or status of an individ- sex change. See also gender identity disor-
ual. 2. a person’s sense of him- or herself as male der.
or female, regardless of physical or biological sex role the behavior and attitudinal patterns
considerations. characteristically associated with being male or
sex instinct see sexual instinct. female as defined in a given society. Sex roles
thus reflect the interaction between biological
sex interest a readiness to engage or participate
heritage and the pressures of socialization, and
in discussions, viewing, or other activities re-
individuals differ greatly in the extent to which
lated to or leading to sexual contact. Also called
they manifest typical sex-role behavior.
sexual interest.
sex-role inversion a former name for trans-
sex-linked adj. describing a gene that is located
sexualism.
on one of the sex chromosomes, usually the x
chromosome (X-linked), or a trait determined sex sensations the effects of stimulation of the
by such a gene. Sex-linked diseases, such as he- genitalia and other erogenous zones. Also called
mophilia, generally affect only males, because sexual sensations.
the defective gene is usually a recessive allele. sex service see prostitution.
In females, who have two X chromosomes, it sex therapy a multimodal therapeutic approach
would be masked by the normal, dominant al- designed to improve sexual functioning, based
lele on the other X chromosome. In males, with on the assumption that sexual performance
just a single X chromosome, any sex-linked de- problems are caused by a combination of lack of
fective allele is expressed. knowledge, misinformation, and faulty learn-
sex-negativity n. a negative attitude or stance ing. Several different techniques commonly are S
toward any sexual behavior other than procre- used in sex therapy (e.g., sensate focus, cogni-
ative marital coitus. Compare sex-positivity. tive restructuring, couples therapy), but
sex object see sexual object. they share the goals of providing education, re-
ducing performance anxiety, improving com-
sex offense a sex act that is prohibited by law.
munication, and teaching skills to improve
An individual who has committed such an of-
sexual pleasuring for both partners. Sex therapy
fense is called a sex offender. Some crimes are
incorporates homework assignments, ideally re-
acts of violence involving sex, and others are vio-
hearsed with the participation of a partner.
lations of social taboos; there is much variation,
by culture and jurisdiction, concerning which sex typing the process by which particular activ-
behaviors are considered crimes and how they ities are identified within particular cultures as
may be punished. Some jurisdictions consider appropriate expressions of maleness and female-
certain consensual sex acts to be illegal. Exam- ness.
ples of sex offenses include forcible and statutory sexual abuse violation or exploitation by sexual
rape, incest, prostitution and pimping, bestial- means. Although the term typically is used with
ity, sodomy, sex murder, and forcible sexual reference to any sexual contact between adults
assault without coitus. Also called sexual of- and children, sexual abuse can also occur in
fense. See also molestation. other relationships of trust.
sexological examination the study of an in- sexual addiction a problematic sexual behav-
531
sexual adjustment
ior, such as a paraphilia or hypersexuality, sexual values, and education about sex. The
regarded as a form of addiction similar to drug workshop also involves group discussion and
addiction. The defining features of a sexual ad- personal reflection on these issues.
diction include sexual behavior that has become sexual attitudes values and beliefs about sexu-
out of control, has severely negative conse- ality. Manifested in a person’s individual sexual
quences, and that the addict is unable to stop, behavior, these attitudes are based on family and
despite a wish to do so. Other features include cultural views about sexuality, sex education
persistence in high-risk, self-destructive behav- (both formal and informal), and prior sexual ex-
ior; spending large amounts of time in sexual ac- periences.
tivity or fantasy; neglect of social, occupational,
or other activities; and mood changes associated
sexual aversion disorder in DSM–IV–TR,
negative emotional reactions (e.g., anxiety, fear,
with sexual activity.
or disgust) to sexual activity, leading to active
sexual adjustment the process of establishing avoidance of it and causing distress in the indi-
a satisfactory relationship with one or more sex- vidual or his or her partner. This can be lifelong
ual partners. Sexual adjustment may depend on or acquired, and although it usually applies to all
psychological as well as physical factors. sexual activity (generalized type), it may be spe-
sexual and gender identity disorders in cific to only some activities or some partners (sit-
DSM–IV–TR, a category of disorders involving uational type). This aversion is not caused by a
sexual or gender identity problems not attribut- medical condition, a medication, or a drug side
able to another mental disorder. It includes sex- effect.
ual dysfunctions, paraphilias, and gender sexual burnout loss of sexual function or inter-
identity disorders. est due to a period of excessively frequent or de-
sexual anesthesia an absence of normal sensa- manding sexual activity. Sexual burnout also
tion during sexual activity, including coitus. sometimes refers to the effects of advancing age
Sexual anesthesia is usually psychogenic. How- on sexual activity, although age itself does not
ever, although some patients report they obtain lead to loss of sexual interest or functioning.
sexual pleasure in masturbation but not in sexual characteristic see sex characteris-
sexual activity with a partner, many derive no tic.
pleasure from any form of sexual behavior. See sexual contact any person-to-person contact
also erectile dysfunction; female sexual that involves touching or connection of genital
arousal disorder. or erogenous skin or membrane surfaces, as in
sexual anomaly a congenital or developmental fondling, kissing, biting, or coitus.
abnormality of the reproductive system, for ex- sexual curiosity curiosity and interest in learn-
ample, the presence of both male and female going about sex and sexuality. In some cases this
nads in an infant. alone may be sufficient to produce sexual gratifi-
sexual apathy lack of interest in sexual activity. cation or orgasm.
See hypoactive sexual desire disorder. sexual desire disorder a class of sexual dis-
sexual arousal a state of physiological arousal orders, including hypoactive sexual desire
elicited by sexual contact or by other erotic stim- disorder and sexual aversion disorder,
ulation (e.g., fantasies, dreams, odors, or ob- characterized by a chronic lack of interest in sex-
jects), resulting in impulses being transmitted ual activity that causes marked distress or inter-
through the central nervous system to the sacral personal difficulty.
region of the spinal cord. The impulses also trig- sexual deviance any sexual behavior that is re-
S ger the release of sex hormones, dilation of the garded as significantly different from the stan-
arteries supplying the genital areas, and inhibi- dards established by a culture or subculture. The
tion of vasoconstrictor centers of the lumbar corresponding term in DSM–IV–TR is para-
nerves. The effects of sexual arousal are mediated philia. Deviant forms of sexual behavior may
through the hypothalamus. See sexual-res- include voyeurism, fetishism, bestiality, necro-
ponse cycle. philia, transvestism, sadism, and exhibitionism.
sexual arousal disorder a class of sexual dis- Same-sex sexual behavior is considered deviant
orders characterized by the inability to attain or in some cultures, but not in all and not by most
maintain an adequate physiological response in mental health professionals. Also called sexual
the excitement (arousal) phase of the sexual- deviation. See also sexual perversion.
response cycle. See female sexual arousal sexual dimorphism the existence within a
disorder; male erectile disorder. species of males and females that differ distinctly
sexual assault violent sexual penetration of an from each other in form. See sex characteris-
individual. It includes forced vaginal, oral, and tic; sex differences.
anal penetration. See also rape. sexual disorder any impairment of sexual
sexual attitude reassessment workshop function or behavior. Sexual disorders include
(SAR workshop) a group educational experi- sexual dysfunction and paraphilias. See also
ence in which participants view films on such is- sexual and gender identity disorders.
sues as same-sex sexual orientation, sex in aging, sexual disorder not otherwise specified
532
sexual latency
in DSM–IV–TR, a sexual problem that does not identification with heterosexual, homosexual,
meet diagnostic criteria for sexual dysfunc- or bisexual preference, that is, with his or
tion or paraphilia. Examples include feelings her sexual orientation. 2. an occasional syn-
of inadequacy about sexual performance, persis- onym for sex identity or gender identity.
tent and marked distress about sexual orienta- sexual infantilism the tendency of a mature
tion (see ego-dystonic homosexuality), and person to engage in sexual behavior characteris-
distress about a pattern of repeated unsatisfac- tic of a small child. Sexual infantilism may be
tory or exploitative sexual relationships. manifested in certain sexual disorders, such as
sexual drive see sex drive. voyeurism, fetishism, or in lovemaking that is
sexual dysfunction in DSM–IV–TR, a category limited to acts of foreplay (e.g., kissing, biting, or
of sexual disorders characterized by problems in stroking the skin).
one or more phases of the sexual-response sexual inhibition suppression of the sexual
cycle. Sexual dysfunctions include hypoactive impulse or the inability to feel sexual desire, to
sexual desire disorder, sexual aversion dis- perform sexually, or to experience sexual gra-
order, female sexual arousal disorder, tification. See hypoactive sexual desire dis-
primary erectile dysfunction, secondary order; female orgasmic disorder; male
erectile dysfunction, premature ejacula- orgasmic disorder.
tion, male orgasmic disorder, female
orgasmic disorder, dyspareunia, and vag-
sexual instinct 1. the basic drive or urge to pre-
serve the species through mating and the activi-
inismus.
ties that precede it, or, by extension, simply to
sexual dysfunction not otherwise speci- express the self and the self’s physiological and
fied in DSM–IV–TR, a category that includes psychological needs through sexual activity.
sexual dysfunctions outside the standard specific 2. in psychoanalytic theory, the instinct com-
categories, such as absence of erotic sensations prising all the erotic drives and sublimations of
despite physiologically normal sexual excite- such drives. It includes not only genital sex, but
ment and orgasm or a dysfunction that may be also anal and oral manifestations and the chan-
due to a medical condition or substance abuse. neling of erotic energy into artistic, scientific,
sexual erethism abnormal irritability or un- and other pursuits. In his later formulations,
pleasant sensitivity to stimulation of the sexual Sigmund freud saw the sexual instinct as part of
organs. It may be seen in individuals with sex- a wider life instinct that also included the self-
ual aversion disorder. preservative impulses of hunger, thirst, and
sexual fantasy pleasant mental images or sto- elimination. Also called sex instinct. See also
ries of sexual activity, not constrained by such eros; libido; self-preservation instinct.
real-world issues as partner availability or setting sexual intercourse see coitus.
and situation.
sexual interest see sex interest.
sexual feeling see sex feeling.
sexual inversion see inversion.
sexual functioning the performance of sexual
intercourse or the capability of performing sex- sexual involution sexual behavior that fea-
ual intercourse. tures deviant, unusual, involved, complicated,
or ritualistic elements. paraphilias are consid-
sexual harassment conduct of a sexual nature ered to be an example of sexual involution.
that is unwelcome or considered offensive, par-
ticularly in the workplace. In the United States, sexuality n. 1. the capacity to derive pleasure
under Title VII of the 1964 Civil Rights Act, an from all forms of sexual activity and behavior,
employee is entitled to sue employers for sexual particularly from sexual intercourse. 2. all as- S
harassment. According to the U.S. Equal Em- pects of sexual behavior, including gender iden-
ployment Opportunity Commission (EEOC), tity, orientation, attitudes, and activity. 3. in
there are two forms of sexual harassment: quid psychoanalytic theory, the “organ pleasure” de-
pro quo and behavior that makes for a hostile rived from all erogenous zones and processes
work environment. See also meritor savings of the body, including the mouth, anus, urethra,
bank v. vinson. breasts, skin, muscles, and genital organs, as well
as such functions as sucking, biting, eating, defe-
sexual hygiene see sex hygiene. cating, urinating, masturbation, and inter-
sexual identification the gradual adoption of course.
the attitudes and behavior patterns associated
Sexuality Information and Education
with being male or female. A clear concept of
Council of the United States (SIECUS) a
sexual identity gradually develops out of a per-
nonprofit organization founded in 1964 that de-
ception of physical sex differences, starting dur-
velops, collects, and disseminates information
ing the first 3 or 4 years of life, and, somewhat
about sexuality, promotes sex education, and ad-
later, awareness of psychological differences de-
vocates the right of individuals to make sexual
termined by the particular culture and particular
choices.
family. Also called sex identification. See sex
role. sexualization n. see erotization.
sexual identity 1. the individual’s internal sexual latency in psychoanalytic theory, the
533
sexual lifestyle
period from about 6 years of age until puberty, sexual pain disorder a class of sexual disor-
when the child has little, if any, interest in sex. ders, including dyspareunia and vaginismus,
sexual lifestyle an individual pattern of sexual characterized by persistent or recurring pain dur-
behavior in terms of orientation, number of ing sexual activity.
partners, and types of sexual activity engaged in. sexual perversion any sexual practice that is
Sexual lifestyle reflects such influences as early regarded by a community or culture as an abnor-
childhood observations of the family of origin, mal means of achieving orgasm or sexual
experiences with male and female contacts in arousal. Sexual perversion is an older term that is
childhood and adolescence, and cultural or reli- little used nowadays, largely having been re-
gious values. placed by sexual deviance or, in a psychiatric
sexually dimorphic nucleus a nucleus of context, paraphilia.
the central nervous system that differs in size be- sexual preference 1. loosely, sexual orienta-
tween males and females. In humans, for exam- tion. 2. any particular sexual interest and
ple, a nucleus in the medial preoptic area of the arousal pattern, which may range from the rela-
hypothalamus that synthesizes gonadotro- tively common (e.g., particular patterns of fore-
pin-releasing hormone tends to be larger and play, particular positions) to those associated
more active in males than in females because go- with a paraphilia.
nadotropin release is continuous (it is cyclical in sexual reassignment see gender reassign-
females). ment.
sexually transmitted disease (STD) an in- sexual reflex 1. penile erection produced by
fection transmitted by sexual activity. More than stimulation of the male genitalia. 2. vaginal se-
20 STDs have been identified, including those cretion and lubrication and swelling of the clito-
caused by viruses (e.g., hepatitis B, herpes, and ris produced by stimulation of the female
HIV) and those caused by bacteria (e.g., genitalia. 3. the reflex activity involved in or-
chlamydia, gonorrhea, and syphilis). STDs are gasm. 4. components of sexual behavior that are
also known as venereal diseases, the term used not under direct control of the higher brain lev-
traditionally for syphilis and gonorrhea. els and may be stimulated through spinal or bul-
sexual masochism in DSM–IV–TR, a para- bar neural connections.
philia in which sexual interest and arousal is re- sexual response a reaction to sexual stimula-
peatedly or exclusively achieved through being tion. The most noticeable sexual response in the
humiliated, bound, beaten, or otherwise made male is erection of the penis. See sexual
to suffer physical harm or threat to life. For the arousal.
diagnosis, these activities must occur in real life,
sexual-response cycle a four-stage cycle of
not fantasy, and must actually cause pain, not
sexual response that is exhibited by both men
merely simulate painful experiences.
and women, differing only in aspects deter-
sexual metamorphosis a rare delusion in mined by male or female anatomy. The stages in-
which the individual believes that his or her bio- clude the arousal (or excitement) phase, which
logical sex has been changed into the opposite lasts several minutes to hours (see sexual
sex. arousal); the plateau phase, lasting 30 s to 3
sexual object 1. in general language, a person min, marked by penile erection in men and vagi-
regarded only in terms of his or her sexual attrac- nal lubrication in women; the orgasmic phase,
tiveness. 2. in psychoanalytic theory, a person, lasting 15 s and marked by ejaculation in men
animal, or inanimate object external to the indi- and orgasm in women; and the resolution
vidual’s own body or psyche toward whom or phase, lasting 15 min to 1 day (see refractory
S which the sexual energy of an individual is di- phase).
rected. Also called sex object. sexual revolution either of two periods in U.S.
sexual orientation one’s enduring sexual at- (and, to some extent, European) history marked
traction to male partners, female partners, or by a significant change in sexual values and be-
both. Sexual orientation may be heterosexual, havior. The first sexual revolution occurred in
same-sex (gay or lesbian), or bisexual. Also called the early part of the 20th century, after the end
gender orientation; object choice. of the Victorian era, and involved efforts to in-
sexual orientation grid a method of classify- crease sexual knowledge, legitimize women’s en-
ing sexual orientation on the basis of seven joyment of sex, and eliminate prostitution. The
factors: sexual fantasy, sexual attraction, sexual second sexual revolution, during the 1960s, was
behavior, emotional attraction, social attraction, stimulated by such events as the development of
social behavior, and self-identity. Each of these oral contraception and the publication of the
factors is evaluated in three time periods: past, kinsey reports on the sexual behavior of men
present, and ideal future. Thus, a person’s sexual and women. This led to more openness of sexual
orientation is described in terms of positions in expression in literature and the media, an in-
a 3 × 7 grid. [developed by U.S. psychiatrist Fritz crease in sexual activity, more tolerance of what
Klein (1932–2006), who considered Alfred kin- were previously considered “deviant” activities,
sey’s single scale of sexual orientation to be too and more acceptance of female sexuality.
simplistic] sexual role see sex role.
534
sham rage
sexual sadism a paraphilia in which sexual deep processing. [proposed in 1972 by Cana-
excitement is achieved by intentional infliction dian psychologists Fergus I. M. Craik (1935– )
of physical or psychological suffering on an- and Robert S. Lockhart]
other person. The harm may be inflicted on a shaman n. in various indigenous cultures, espe-
consenting partner, typically involving mildly cially those that include nature and ancestor
injurious bodily suffering combined with humil- worship, a spiritual leader, male or female, who
iation. When practiced with nonconsenting uses allegedly supernatural or magical powers for
partners, sexual sadism may involve inflicting divination (particularly diagnosis) and to heal
extensive, permanent, or possibly fatal bodily in- mental or physical illness. The status of shamans
jury. This activity is likely to be repeated, with is not conferred by recognized organizations but
the severity of the sadistic acts increasing over is held to arise from a significant personal physi-
time. See also sadism; sadomasochism. cal or mental crisis or to be hereditary. Shaman-
sexual sensations see sex sensations. ism includes a wide spectrum of traditional
sexual stimulation see genital stimula- beliefs and practices, many of which involve
tion. communication with the spirit and animal
worlds in pursuit of physical or mental healing.
sexual synergism sexual arousal that results
—shamanic adj. —shamanistic adj.
from a combination of stimuli experienced at
the same time. The stimuli may appear to be shamanic trance an altered state of con-
somewhat contradictory, such as love and hate, sciousness induced by hallucinogens, rhyth-
fear, pain, or fright. mic actions and music, suggestion, experiences
of possession, or by similar means. See shaman.
sexual tension a condition of anxiety and rest-
lessness associated with the sex drive and a nor- sham disorder a colloquial name for facti-
mal desire for release of sexual energy. Sexual tious disorder.
tension may be complicated by fear of inade- shame n. a highly unpleasant self-conscious
quate performance, fear of an unwanted preg- emotion arising from the sense of there being
nancy, fear of discovery, or other concerns. something dishonorable, ridiculous, immodest,
sexual trauma any disturbing experience asso- or indecorous in one’s conduct or circum-
ciated with sexual activity, such as rape, incest, stances. It is typically characterized by with-
and other sexual offenses. It is one of the most drawal from social intercourse, for example by
common causes of posttraumatic disorders hiding or distracting the attention of another
and dissociative disorders. from one’s shameful action, which can have a
sexual-value system 1. the system of sexual profound effect on psychological adjustment
stimulation and response that an individual feels and interpersonal relationships. Shame may mo-
is necessary for a satisfactory sexual relationship. tivate not only avoidant behavior, but also de-
2. a person’s beliefs about what is normal, moral, fensive, retaliative anger. Psychological research
and acceptable sexual behavior and activity. consistently reports a relationship between pro-
neness to shame and a whole host of psychologi-
shadow n. in the analytic psychology of Carl cal symptoms, including depression, anxiety,
jung, an archetype that represents the “darker eating disorders, subclinical sociopathy, and low
side” of the human psyche, mainly the sexual self-esteem. Shame is also theorized to play a
and aggressive instincts that tend to be unac- more positive adaptive function by regulating
ceptable to the conscious ego and that are more experiences of excessive and inappropriate inter-
comfortably projected onto others. est and excitement and by diffusing potentially
shadowing n. in cognitive testing, a task in threatening social behavior. —shameful adj.
which a participant repeats aloud a message
shamelessness n. behavior marked by an appar- S
word for word at the same time that the message
ent absence of feelings of shame. This may arise
is being presented, often with other stimuli
as the result of psychological problems or reflect
being presented in the background. It is mainly
a loss of judgment after brain injury. —shame-
used in studies of attention.
less adj.
shaken baby syndrome (SBS) the neurologi-
cal consequences of a form of child abuse
sham rage sudden aggressive behavior and
motor activity occurring disproportionally in
in which a small child or infant is repeatedly
response to a weak or relatively innocuous stim-
shaken. The shaking causes diffuse, widespread
ulus. Sham rage initially was observed by
damage to the brain; in severe cases it may cause
researchers in the 1920s: following surgical re-
death.
moval of the outer layer of the cortex, cats re-
shallow affect significant reduction in appro- sponded to the touch of a hand by growling,
priate emotional responses to situations and spitting, lashing the tail, arching the back, pro-
events. See also flat affect. tracting the claws, erecting the hairs, jerking the
shallow processing cognitive processing of a limbs, rapidly moving the head from side to side,
stimulus that focuses on its superficial, percep- and attempting to bite. It subsequently has been
tual characteristics rather than its meaning. It is demonstrated to occur with direct electrical
considered that processing at this shallow level stimulation of the limbic system as well. Addi-
produces weaker, shorter-lasting memories than tionally, sham rage has been seen in some patho-
535
shaping
logical human conditions involving similar children who have been taken into custody
damage to the cerebral cortex that removes its pending investigation and placement. Shelter
inhibitory influence over the activities of the hy- care is a form of foster care.
pothalamus and other deeper, more primitive sheltered workshop a work-oriented rehabili-
structures. tation facility for individuals with disabilities
shaping n. the production of new forms of oper- that provides a controlled, noncompetitive, sup-
ant behavior by reinforcement of successive portive working environment and individually
approximations to the behavior. Also called ap- designed work settings, using work experience
proximation conditioning; behavior shap- and related services to assist individuals with dis-
ing. abilities to achieve specific vocational goals.
shared environment in behavior genetic Sheltered workshops differ from supported em-
analyses, those aspects of an environment that ployment in that the latter occurs in a competi-
individuals living together (e.g., biologically re- tive, noncontrolled working environment.
lated individuals in a family household) share shenjing shuairuo see shinkeishitsu.
and that therefore cause them to become more
shen-k’uei (shenkui) n. a culture-bound
similar to each other than would be expected on
syndrome occurring in males of Chinese or Tai-
the basis of genetic influences alone. Examples
wanese cultures and characterized by symptoms
of shared environmental factors include paren-
of anxiety, panic, and somatization, such as
tal child-rearing style, divorce, or family income
sexual dysfunction, insomnia, and dizziness.
and related variables. Compare nonshared en-
Symptoms cannot be linked to a physical cause
vironment.
and are typically ascribed to excessive loss of
shared paranoid disorder in DSM–III, a dis- semen due to unrestrained sexual activity. See
order characterized by a persecutory delu- also dhat; jiryan; sukra prameha.
sional system that develops as a result of a close
shin-byung n. a culture-bound syndrome
relationship with another person or (rarely) per-
found in Korea, characterized by anxiety and
sons who already have such delusional beliefs.
such physical complaints as general weakness,
This disorder has been subsumed under the
dizziness, loss of appetite, insomnia, and gastro-
DSM–IV–TR category of shared psychotic dis-
intestinal problems, followed by dissociation
order.
and alleged possession by ancestral spirits (see
shared psychotic disorder in DSM–IV–TR, a dissociative trance disorder). It is consid-
disorder in which the essential feature is an iden- ered by those affected to be a “divine illness,” in
tical or similar delusion that develops in an indi- which the individual experiences hallucinations
vidual who is involved with another individual of becoming a shaman, and a cure occurs when
(sometimes called the inducer or the primary this conversion takes place.
case) who already has a psychotic disorder with
shinkeishitsu n. a culture-bound syndrome
prominent delusions. Shared psychotic disorder
prevalent in Japan, with symptoms that include
can involve many people (e.g., an entire family),
obsessions, perfectionism, ambivalence, social
but is most commonly seen in relationships of
withdrawal, physical and mental fatigue, hyper-
only two, in which case it is known as folie à
sensitivity, and hypochondriasis. Japanese psy-
deux. In DSM–III–R, shared psychotic disorder
chiatrist Shoma Morita (1874–1938), a pioneer
was referred to as induced psychotic disorder.
in the study of shinkeishitsu, postulated that
Sheldon’s constitutional theory of per- there is a shinkeishitsu-prone innate tempera-
sonality the theory that every person possesses ment, which he called “hypochondriacal tem-
some degree of three primary temperamental perament.” According to Morita, people who are
S components that relate to three basic body born with this temperament are overly sensitive,
builds (somatotypes), measured on a seven- self-reflective, and notice even minimal changes
point scale. The three body types ectomorph, in their mental and physical states. This disorder
endomorph, and mesomorph are correlated is also prevalent in China, where it is known as
with the three components of temperament shenjing shuairuo. See also morita therapy.
cerebrotonia, viscerotonia, and somato-
tonia. Constitution provides a substructure, but Shipley Institute of Living Scale (SILS) a
nutrition and early experiences also influence short assessment of general cognitive function-
the physique and temperament, respectively. ing consisting of two subtests: vocabulary, in
[William H. Sheldon (1899–1970), U.S. psychol- which participants must choose which of a
ogist] group of words is most similar in meaning to a
target word; and abstraction, in which partici-
shell shock the name used during World War I pants must provide the final element in a se-
for combat stress reactions. At the time the quence of numbers, letters, or words. The scale
disorder was attributed solely to minor brain was originally developed in 1940 for use in psy-
hemorrhages or brain concussion due to explod- chiatric settings to identify and evaluate the in-
ing shells and bombs, without involving psycho- tellectual decline associated with certain mental
logical factors. disorders. Also called Shipley–Hartford Insti-
shelter care the provision of a facility without tute of Living Scale. [Walter C. Shipley
physical restrictions for the temporary care of (1903–1966), U.S. psychologist]
536
side effect
shock n. 1. the application of electric current. See tions, typically involving three components:
electroconvulsive therapy. 2. a condition of (a) global feelings of emotional arousal and spe-
lowered excitability of neural centers following cific physiological experiences (e.g., upset stom-
cutting of their connections with other neural ach, pounding heart, sweating, and blushing);
centers. For example, spinal shock occurs when (b) acute public self-consciousness, self-depre-
connections between the spinal cord and the cation, and worries about being evaluated nega-
brain are severed. 3. acute reduction of blood tively by others; and (c) observable behavior
flow in the body due to failure of circulatory con- such as cautiousness, quietness, gaze aversion,
trol or loss of blood or other bodily fluids, and social withdrawal. Extremely shy individu-
marked by hypotension, coldness of skin, usu- als are at an increased risk of developing anxiety
ally tachycardia, and sometimes anxiety. 4. a disorders such as social phobia. Also called
sudden disturbance of equilibrium. timidity. See also social anxiety. —shy adj.
shock therapy the treatment of severe mental shyness disorder see avoidant disorder of
disorders by administering drugs or an electric childhood or adolescence.
current to produce shock to the central nervous
system in order to induce loss of consciousness sibling rivalry competition among siblings for
or convulsions. Also called shock treatment. the attention, approval, or affection of one or
See coma therapy; electroconvulsive ther- both parents or for other recognition or rewards,
apy. for example, in sports or school grades.
shoe anesthesia see stocking anesthesia. sib-pair method a technique used in genetics,
shoe fetishism see retifism. particularly in attempting to discover the extent
of inherited psychiatric factors, in which the in-
shook yong see koro.
cidence of a disorder among blood relatives is
Short Portable Mental Status Question- compared with the distribution of the disorder
naire (SPMSQ) a brief questionnaire that is in the general population. Sib-pair method stud-
typically used to screen older adults for demen- ies have found a higher incidence of schizophre-
tia and other neurologically based cognitive nia in twins and close family members than in
deficits and to determine the severity of impair- the general population.
ment. It consists of 10 simple questions relating
to orientation (e.g., “What is the date today?”, sibutramine n. an appetite suppressant used
“What is the name of this place?”), knowledge of for the management of obesity. Sibutramine acts
current events, short- and long-term memory, on the central nervous system to inhibit the
and calculation. [developed in 1975 by U.S. geri- reuptake of the neurotransmitter epinephrine
atric psychiatrist Eric A. Pfeiffer] and, to a lesser extent, serotonin and dopamine.
Sibutramine may cause raised blood pressure
short-term memory (STM) the reproduction,
and, because of its ability to release mono-
recognition, or recall of a limited amount of ma-
amines, it should not be used in conjunction
terial after a period of about 10–30 s. STM is
with monoamine oxidase inhibitors. Like
often theorized to be separate from long-term
other appetite suppressants, it is effective only in
memory, and the two are the components
conjunction with dietary restriction. Due to con-
of the dual-store model of memory. STM
cerns about serious adverse effects, it has been re-
is frequently tested in intelligence or neuro-
moved from the market in many countries,
psychological examinations. See also immedi-
including the United States. U.S. trade name:
ate memory; primary memory.
Meridia.
short-term psychodynamic psychother-
apy see brief psychodynamic psychother- sick role the behavior expected of a person who
apy. is physically ill, mentally ill, or injured. Such ex- S
pectations can be the individual’s own or those
short-term psychotherapy see brief psy-
of the family, the community, or society in gen-
chotherapy.
eral. They influence both how the person be-
shrink n. slang for a psychologist, psychiatrist, haves and how others will react to him or her. In
or other mental health professional who his pioneering discussion of the subject, U.S. so-
conducts psychotherapy. It is short for head- ciologist Talcott Parsons (1902–1979) noted in
shrinker, an allusion to the practice of head- 1951 that people with a sick role were expected
shrinking. to cooperate with caregivers and to want to get
shuk yang see koro. well, but were also provided with an exemption
shunt n. a congenitally occurring or surgically from normal obligations. See also factitious
created passage diverting the flow of bodily flu- disorder.
ids such as blood or cerebrospinal fluid from one side effect any reaction secondary to the in-
part of an organ or body to another. For exam- tended therapeutic effect that may occur follow-
ple, a ventriculoatrial shunt is an artificially ing administration of a drug or other treatment.
formed passage for draining cerebrospinal fluid Often these are undesirable but tolerable (e.g.,
from the brain to the external jugular vein to re- headache or fatigue), although more serious ef-
lieve symptoms of hydrocephalus. fects (e.g., liver failure, seizures) may also occur.
shyness n. anxiety and inhibition in social situa- Occasionally, harmful side effects are unex-
537
SIDS
pected, in which case they more properly are multiple regression analysis) where the two
termed adverse drug reactions. models differ in terms of the number of parame-
SIDS acronym for sudden infant death syn- ters specified in them.
drome. significant difference the situation in which
SIECUS abbreviation for sexuality informa- a significance testing procedure indicates
tion and education council of the united that the two models being compared are legiti-
states. mately different and do not reflect chance varia-
sign 1. n. an objective, observable indication of a tion.
disorder or disease. See also soft sign. 2. vb. to significant other any individual who has a
communicate using sign language. profound influence on a person, particularly his
signal n. 1. an intelligible sign communicated or her self-image and socialization. Although
from one individual or electromagnetic device to the term most often denotes a spouse or other
another. 2. a presentation of information, usu- person with whom one has a committed sexual
ally one that evokes some action or response. relationship, it is also used to refer to parents,
3. as used in signal detection theory, a stim- peers, and others.
ulus. signifier n. in the theory of French psychoana-
signal anxiety in psychoanalytic theory, anxi- lyst Jacques Lacan (1901–1981), a symbol, such
ety that arises in response to internal conflict or as a word or symptom, that stands for some as-
an emerging impulse, and functions as a sign to pect of the patient’s unconscious. Lacan’s use of
the ego of impending threat, resulting in the use the term reflects his central belief that the un-
of a defense mechanism. Compare primary conscious is structured as a language.
anxiety. sign system an epithet for psychotherapy,
signal detection theory (SDT) a body of con- which highlights the discipline’s dependence on
cepts and techniques from communication the- language as the major tool for exploring and un-
ory, electrical engineering, and decision theory derstanding the hidden causes of cognitive, af-
that were applied during World War II to the defective, and behavioral problems and disorders.
tection of radar signals in noise. These concepts [introduced by Austrian-born U.S. psychologist
were applied to auditory and visual psy- Paul Schilder (1886–1940)]
chophysics in the late 1950s and are now widely silok n. a culture-bound syndrome found in
used in many areas of psychology. An important the Philippines, with symptoms similar to those
methodological contribution of SDT has been of latah.
the refinement of psychophysical techniques to
SILS abbreviation for shipley institute of liv-
permit the separation of sensitivity from
ing scale.
criterial, decision-making factors. SDT has also
provided a valuable theoretical framework for Silver–Russell syndrome a congenital disor-
describing perceptual and other aspects of cogni- der characterized by short stature, hypertrophy
tion and for quantitatively relating psycho- of one side of the body, and elevated urinary go-
physical phenomena to findings from sensory nadotropin hormones without precocious sex-
physiology. A key notion of SDT is that human ual maturity. Motor development is often
performance in many tasks is limited by variabil- delayed because of muscle weakness. Physical
ity in the internal representation of stimuli due features include pseudohydrocephalus, a condi-
to internal or external noise. Many of the theo- tion of normal head circumference but a small
retical notions of SDT were anticipated by Louis face, giving the appearance of an enlarged head.
thurstone. Also called detection theory. See Various studies have found a higher than aver-
S d prime; receiver-operating characteristic age incidence of mental retardation among the
curve. patients. Also called Silver’s syndrome. [Henry
significance level in null hypothesis signifi- K. Silver (1918–1991), U.S. pediatrician; Alexan-
cance testing, the probability of rejecting the der Russell (1914– ), British pathologist]
null hypothesis when it is in fact true (i.e., of Simenon’s syndrome a delusional condition
making a Type I error). It is set at some criterion, characterized by the false perception or belief
α, usually .01 or .05, and the actual value for a that one is loved by or has had a sexual affair
particular test is denoted p. Thus when the p with a public figure or other individual. See
value is less than α, the null hypothesis is re- erotic delusion; erotic paranoia. See also
jected. Also called alpha level. clérambault’s syndrome. [named for Georges
significance testing a set of procedures that is Joseph Christian Simenon (1903–1989), Belgian-
used to differentiate between two models. In the born French novelist, possibly because the con-
most common form of significance testing, one dition featured in one of his stories]
model (the null hypothesis) specifies a condi- Simmonds’ disease a disorder of the pituitary
tion in which the treatment being studied has gland caused by necrosis and failure of the ante-
no effect and the other model (the alternative rior lobe (adenohypophysis) of the gland, which
hypothesis) specifies that the treatment has may be partial or complete. This results in sec-
some effect. Significance testing may also be ondary failure of the gonads, adrenal cortex, and
used to differentiate beween two models (as in thyroid gland, which depend upon the hor-
538
single photon emission computed tomography
monal stimulation of the pituitary. Anorexia, symptoms of one disorder by another or the fak-
atrophy of sexual features, absence of libido, ing of an illness.
hypotension, bradycardia, and hypoglycemia Sinemet n. a U.S. trade name for a drug combina-
are symptoms of the disorder. [Morris Simmonds tion of levodopa and carbidopa, used in the
(1855–1925), German physician] treatment of Parkinson’s disease, the symptoms
simple depression a less common name for of which are due to lack of striatal dopamine.
mild depression. Carbidopa inhibits the action of the enzyme
dopa decarboxylase in peripheral tissues,
simple deteriorative disorder in DSM–IV– thereby enabling levodopa to be administered in
TR, a disorder in which the essential feature is lower doses to achieve an effective concentra-
the development over the course of at least 1 tion in the brain, where it is converted by striatal
year of prominent negative symptoms, which enzymes into dopamine.
represent a clear change from a preestablished
baseline and are severe enough to result in a sig- Sinequan n. a trade name for doxepin.
nificant deterioration in occupational or aca- single blind see blind.
demic functioning. The individual gradually single-case experimental design an experi-
loses emotional responsivity, ambition, and in- mental design involving only a single partici-
terest in self-care and becomes socially with- pant or other sampling unit. The individual
drawn or isolated. positive symptoms, if they serves as his or her own control, and typically
appear, are not prominent. Historically, and in a number of observations are obtained at differ-
other classifications, this disorder is known as ent times over the course of treatment. Also
simple schizophrenia. called intrasubject replication design; N-
simple effect in an experimental design involv- of-1 experimental design; n=1 research;
ing multiple independent variables, the consis- single-subject design.
tent total effect on a dependent variable of a single-case methods and evaluation a
particular level (quantity, magnitude, or cate- type of psychotherapy research based on sys-
gory) of one independent variable at a particular tematic study of one client before, during, and
level of another independent variable. after intervention.
simple factorial design an experimental de- single-episode depression a major depres-
sign in which the two or more levels of each in- sive episode in an individual who does not have
dependent variable or factor are observed in a history of major depressive episodes. It is
combination with the two or more levels of thought that the effects of treatment in people
every other factor. See also factorial design. having single episodes may be different from
simple phobia see specific phobia. those in individuals who have a history of de-
pression.
simple schizophrenia one of the four major single-gene disorder a disease or condition
types of schizophrenia described by German psy-
that is due to the presence of a single mutated
chiatrist Emil Kraepelin (1856–1926) and Swiss
gene. Single-gene disorders are relatively rare;
psychiatrist Eugen Bleuler (1857–1939), charac-
many diseases exhibit multifactorial inheri-
terized primarily by gradual withdrawal from so-
tance and are also influenced by environmental
cial contact, lack of initiative, and emotional
factors. Huntington’s disease and sickle-cell dis-
apathy. The current psychiatric diagnosis is sim-
ease are examples of single-gene disorders. Gen-
ple deteriorative disorder.
erally, the single mutation causes a failure to
simple stepfamily a stepfamily in which synthesize a normally functioning enzyme that
only one of the parents brings a child or children is required for a specific step in building body tis- S
from a previous union to the new family unit. sue or for a vital stage in the metabolism of a
food component.
simulated family a technique used in training
and therapy in which hypothetical family situa- single-nucleotide polymorphism (SNP) a
tions are enacted. In training, the enactment is common, tiny variation in human dna, occur-
by clinicians or other professionals. In family ring roughly every 1000 bases along the mole-
therapy, one or more members of the family cule and affecting single nucleotides. Such
may participate with others, who play the roles variations can be used as genetic markers to
of other family members. See also role play. track the inheritance of particular defective
genes in families.
simulation n. 1. an experimental method used
to investigate the behavior and psychological single parent a person who rears a child with-
processes and functioning of individuals in so- out the assistance of a partner.
cial and other environments, often those to single photon emission computed to-
which investigators cannot easily gain access, by mography (SPECT) a functional imaging
reproducing those environments in a realistic technique that uses gamma radiation from a ra-
way. 2. the artificial creation of experiment-like dioactive dye to create a picture of blood flow in
data through the use of a mathematical or com- the body. In the brain it can be used to measure
puter model of behavior or data. 3. resemblance cerebral blood flow, which is a direct measure of
or imitation, particularly the mimicking of cerebral metabolism and activity.
539
single-session therapy
single-session therapy (SST) therapy that of dangerous or destructive acts by patients with
ends after one session, usually by choice of the mental or emotional problems.
client but also as indicated by the type of treat- situational-stress test a situation test with
ment (e.g., ericksonian psychotherapy, so- stress as an integral component.
lution-focused brief therapy). Some clients
claim enough success with one hour of therapy situational test see situation test.
to stop treatment, although some therapists be- situational therapy see environmental
lieve that this claim represents a flight into therapy.
health or temporary relief from symptoms.
Preparation for the session (e.g., by telephone) situation awareness conscious knowledge of
increases the likelihood of the single-therapy the immediate environment and the events that
session being successful. are occurring in it. Situation awareness involves
perception of the elements in the environment,
single-subject design see single-case experi-
comprehension of what they mean and how
mental design.
they relate to one another, and projection of
sinistration n. leftward direction. mirror their future states. In ergonomics, for example, it
writing, for example, shows sinistration. refers to the operator’s awareness of the current
sissy behavior slang for effeminate behavior in status and the projected future status of a sys-
boys, which is often a source of ridicule by oth- tem. Situation awareness is influenced by a num-
ers. See role confusion; tomboyism. ber of factors, including stress.
SIT 1. abbreviation for smell identification situation test a test that places an individual in
test. 2. abbreviation for stress-inoculation a natural setting, or in an experimental setting
training. that approximates a natural one, to assess either
situational attribution the ascription of the individual’s ability to solve a problem that
one’s own or another’s behavior, an event, or an requires adaptive behavior under stressful condi-
outcome to causes outside the person con- tions or the individual’s reactions to what is be-
cerned, such as luck, pressure from other people, lieved to be a stressful experience. For example, a
or external circumstances. Also called environ- course of desensitization therapy aimed at re-
mental attribution; external attribution. ducing phobic reactions might begin with a situ-
Compare dispositional attribution. ation test in which the individual encounters
situational determinant an environmental the phobic object. The individual’s reactions are
condition that exists before and after an organ- then assessed and considered in relation to indi-
ism’s response and influences the elicitation of vidual needs or a specific therapy program. Also
this behavior: one of the four variables consid- called situational test. See also situational-
ered in behavioral analysis. See sorc. stress test.
situational homosexuality same-sex sexual Sixteen Personality Factor Question-
behavior that develops in a situation or environ- naire (16PF) the fifth edition (1993) of a com-
ment in which the opportunity for heterosexual prehensive self-report personality inventory.
activity is missing and where close contact with The instrument assesses personality on 16 key
individuals of the same sex occurs, such as a scales: warmth, vigilance, reasoning, abstracted-
prison, school, or military setting where individ- ness, emotional stability, privateness, domi-
uals are living together, segregated according to nance, apprehension, liveliness, openness to
their sex. Once away from this setting, the per- change, rule-consciousness, self-reliance, social
son typically returns to heterosexual activity. See boldness, perfectionism, sensitivity, and ten-
also occasional inversion. sion. The 16 factors (called source traits) are
S grouped into 5 “global factors”: extraversion, in-
situationally predisposed panic attack a
dependence, tough-mindedness, anxiety, and
panic attack that occurs in response to a spe-
self-control. [developed by British psychologist
cific situational trigger but is not invariably
Raymond B. Cattell (1905–1998) and his associ-
induced by it. Compare cued panic attack;
ates]
uncued panic attack.
situational orgasmic dysfunction the in- Sjögren–Larsson syndrome an autosomal re-
ability of a woman to experience orgasm with a cessive condition characterized by scaly skin,
particular sex partner or in a particular situation. spasticity, and mental retardation, caused by
See female orgasmic disorder. several different genetic factors. Sweat glands are
sparse or deficient. The scaliness varies in spe-
situational psychosis a severe but temporary cific cases among populations from different re-
reaction to a traumatic event or situation (such gions of the world. [reported in 1957 by Torsten
as imprisonment) involving such symptoms as Sjögren (1896–1974), Swedish physician, and
delusions and hallucinations. Also called reac- Tage Konrad Leopold Larsson (1905–1998),
tive psychosis; traumatic psychosis. Swedish scientist]
situational restraint the use of environmen-
tal arrangements (e.g., screens on windows, im-
sketchpad see working memory.
movable furniture), as opposed to physical skewness n. a measure of the degree or extent to
restraint of the individual, to minimize the risk which a batch of scores lack symmetry in their
540
sleep hygiene
distribution around their measure of central sleep n. a state of the brain characterized by par-
tendency. tial or total suspension of consciousness, mus-
skilled nursing facility (SNF) a licensed or cular relaxation and inactivity, reduced metab-
approved facility, whether freestanding or affili- olism, and relative insensitivity to stimulation.
ated with a hospital, that provides continuous Other mental and physical characteristics that
rehabilitation and medical care of a lesser inten- distinguish sleep from wakefulness include am-
sity than that provided in an acute-care hospital nesia for events occurring during the loss of
setting. See also continuing care unit; con- consciousness and unique sleep-related electro-
valescent center. encephalogram and brain-imaging patterns (see
sleep stages). These characteristics also help
skill learning learning to perform a task with distinguish normal sleep from a loss of con-
proficiency, as defined by ease, speed, and accu-
sciousness due to injury, disease, or drugs. See
racy of performance, acquired through a high
also dream state; nrem sleep; rem sleep.
degree of practice. Skills may be motor, percep-
tual, cognitive, or a combination of these (as in sleep apnea the temporary cessation of breath-
reading and playing music). ing while asleep, which occurs when the upper
airway briefly becomes blocked (obstructive
Skinner, Burrhus Frederic (1904–1990) U.S. sleep apnea) or when the respiratory centers in
psychologist. Skinner earned his doctorate from
the brain fail to stimulate respiration (central
Harvard University in 1931 and subsequently
sleep apnea). It can cause severe daytime sleepi-
taught at the University of Minnesota and Indi-
ness, and evidence is building that untreated se-
ana University before returning to Harvard in
vere sleep apnea may be associated with high
1948. He spent the rest of his career there. Argu-
blood pressure and risk for stroke and heart at-
ably the most famous experimental psychologist
tack.
of the 20th century, Skinner was best known as
the originator of operant conditioning, a dis- sleep cycle a recurring pattern of sleep stages
tinctive form of behaviorism that he called in which a period of slow-wave sleep is fol-
radical behaviorism. Operant conditioning, lowed by a period of rem sleep. In humans, a
which he contrasted with pavlovian condi- sleep cycle lasts approximately 90 min.
tioning, was based on the view that an organ- sleep deprivation deliberate prevention of
ism’s environment shapes its behavior; actions sleep, particularly for experimental purposes.
that are reinforced by the environment will Studies show that the loss of one night’s sleep
increase in frequency, while those that are pun- has a substantial effect on physical or mental
ished will decrease in frequency. Skinner in- functioning; participants score significantly
vented a laboratory method utilizing the Skinner lower on tests of judgment and simple reaction
box (operant conditioning chamber) to make de- time and show impairments in daytime alertness
tailed studies of the schedules of reinforce- and memory. Sleep loss also may be detrimental
ment that shape behavior in rats and pigeons. to the immune and endocrine systems.
Not content to confine himself to laboratory sleep disorder a persistent disturbance of typi-
research, Skinner initiated the field of applied cal sleep patterns, including the amount,
behavior analysis by applying his ideas to quality, and timing of sleep, or the chronic oc-
educational methods (programmed instruction), currence of abnormal events or behavior during
child rearing, language acquisition, psychother- sleep. In DSM–IV–TR sleep disorders are broadly
apy, and cultural analysis. His most famous writ- classified according to apparent cause, which
ings include his Behavior of Organisms (1938) and may be endogenous or conditioning factors (pri-
Verbal Behavior (1957) as well as more popular mary sleep disorders), another mental disorder,
works, such as Walden Two (1948), Beyond Free- a medical condition, or substance use. Primary S
dom and Dignity (1971), and About Behaviorism sleep disorders are subdivided into dyssomnias
(1974). Among Skinner’s many honors were his and parasomnias. A classification system intro-
election to the National Academy of Sciences duced in 1979 by the Association of Sleep Disor-
and the Society of Experimental Psychologists ders Centers groups sleep disorders according
and his receipt of both the Distinguished Scien- to individuals’ presenting symptoms: disor-
tific Contribution Award and the Lifetime Scien- ders of initiating and maintaining sleep;
tific Contribution Award from the American disorders of excessive somnolence; disor-
Psychological Association. See also descriptive ders of the sleep–wake cycle schedule; and
behaviorism. dysfunctions associated with sleep, sleep
skin popping slang for the injection of a substages, or partial arousals.
stance containing an opioid—usually heroin— sleep efficiency the ratio of total time asleep to
under the skin, as opposed to mainlining (i.e., total time in bed. Sleep efficiency can be reduced
injecting into a vein). in various psychological conditions (e.g., depres-
sl abbreviation for sublingual. sion, anxiety) as well as by the use of some
SLD abbreviation for specific learning disabil- pharmacological agents (e.g., certain antidepres-
ity. sants).
SLE abbreviation for systemic lupus ery- sleep enuresis see bed-wetting.
thematosus (see lupus erythematosus). sleep hygiene techniques for the behavioral
541
sleeping sickness
treatment of insomnia that involve instruction Sleep Disorders Clinic and Research Center to as-
given to the client to follow certain routines sess sleep behaviors and sleep disorders.
aimed at improving sleep patterns. Typical rec- sleep spindles characteristic spindle-shaped
ommendations to the client include using the patterns recorded on an electroencephalogram
bed only for sleeping and sex (e.g., the client is (EEG) during stage 2 sleep. They are short
instructed not to read in bed), not napping dur- bursts of waves with a frequency of about 15 Hz
ing the day, decreasing caffeine intake or elimi- that progressively increase then decrease in am-
nating it after a certain point in the day, going to plitude and they indicate a state of light sleep.
bed regularly at a set time, and keeping a sleep Sleep spindles are often accompanied by k com-
diary. plexes.
sleeping sickness an infection, found only in sleep stages the four-cycle progression in elec-
tropical Africa, caused by parasitic protozoans of trical activity of the brain during a normal
the genus Trypanosoma (T. gambiense and T. night’s sleep, as recorded on an electroencepha-
rhodesiense), which are transmitted by the bite of logram (EEG). The regular pattern of alpha
infected tsetse flies. Initial symptoms include waves characteristic of the relaxed state of the
fever, headaches, sweating, and swollen lymph individual just before sleep becomes intermit-
nodes, progressing—upon inflammation of the tent and attenuated in stage 1 sleep, which is
brain and its protective membranes —to leth- marked by drowsiness with rolling eyeball move-
argy, excessive sleepiness (see hypersomnia), ments. This progresses to stage 2 sleep (light
and confusion. If untreated, sleeping sickness sleep), which is characterized by sleep spindles
can result in coma and eventually death. In and k complexes. In stage 3 sleep and stage 4
DSM–IV–TR, the condition is categorized as sleep (deep sleep), delta waves predominate
sleep disorder due to a general medical condi- (see slow-wave sleep). These stages comprise
tion: hypersomnia type. Also called African nrem sleep and are interspersed with periods of
trypanosomiasis. dreaming associated with rem sleep. After a pe-
sleep inversion a tendency to sleep or be som- riod of deep sleep, the sleeper may return to ei-
nolent by day and to remain awake at night. ther light sleep or REM sleep or to both, and the
sleep laboratory a research facility designed to cycles can recur multiple times over the course of
monitor patterns of activity during sleep, such as the sleep period.
eye movement, breathing abnormalities, heart- sleep terror disorder a sleep disorder char-
beat, brain waves, and muscle tone. Sleep lab- acterized by repeated episodes of abrupt awaken-
oratories are typically found in neurology ing from nrem sleep accompanied by signs of
departments in hospitals and universities or in disorientation, extreme panic, and intense anxi-
sleep disorder clinics. ety. More intense than nightmares and occur-
sleep latency the amount of time it takes for an ring during the first few hours of sleep, these
individual to fall asleep once the attempt to do episodes typically last between 1 and 10 min and
so is made. Sleep latency is measured in the diag- involve screaming and symptoms of autonomic
nosis of sleep disorders. Sleeping pills (e.g., arousal, such as profuse perspiration, dilated pu-
benzodiazepines) are designed to decrease sleep pils, rapid breathing, and a rapidly beating heart.
latency so that the individual can fall asleep The individual is difficult to wake or comfort
more quickly. and does not have detailed recall of the dream
upon waking; complete loss of memory for the
sleeplessness n. see insomnia. episode is common. The disorder occurs most
sleep-onset insomnia a dyssomnia character- often in children and generally resolves itself
S ized by persistent difficulty initiating sleep. Also during adolescence. In adults, it is often associ-
called onset insomnia. See also insomnia; pri- ated with psychopathology and a more chronic
mary insomnia. course. See also parasomnia.
sleep paralysis brief inability to move or speak sleep–wake cycle the natural, brain-controlled
just before falling asleep or on awakening often bodily rhythm that results in alternate periods
accompanied by terrifying hallucinations. It of sleep and wakefulness. The sleep–wake cycle
may occur in any individual but is seen espe- may be disrupted by a number of factors, such as
cially in individuals with narcolepsy and may flight across time zones, shift work, drug use, or
be due to a temporary dysfunction of the stress (see circadian rhythm sleep disorder;
reticular activating system. disorders of the sleep–wake cycle sched-
sleep pattern a habitual, individual pattern of ule). Also called sleep rhythm; sleep–wake-
sleep, such as two 4-hour periods, daytime nap- fulness cycle. See also monophasic sleep;
ping, various forms of insomnia (e.g., initial or polyphasic sleep.
intermittent insomnia), or excessive sleep. See sleep–wake schedule disorder see circa-
also sleep–wake cycle. dian rhythm sleep disorder.
Sleep Questionnaire and Assessment of sleepwalking disorder a sleep disorder
Wakefulness (SQAW) an extensive question- characterized by persistent incidents of complex
naire developed in 1979 by U.S. physician motor activity during slow-wave nrem sleep.
Laughton E. Miles at the Stanford University These episodes typically occur during the first
542
smoothing
hours of sleep and involve getting out of bed and is controlled by serotonin-rich cells in the
walking, although the individual may also per- brainstem: Increased levels of serotonin stimu-
form more complicated tasks, such as eating, late slow-wave sleep, whereas abnormally low
talking, or operating machinery. While in this levels of serotonin result in insomnia. Slow-wave
state, the individual stares blankly, is essentially sleep has a restorative function that helps elimi-
unresponsive, and can be awakened only with nate feelings of fatigue. See also sleep stages.
great difficulty; he or she does not remember Smell Identification Test (SIT) a 40-item
the episode upon waking. Also called noctam- test of odor-identification ability for individuals
bulation; somnambulism. See also para- aged 5 years and older. It is used to assess olfac-
somnia. tory sensitivity and diagnose or evaluate olfac-
slip n. an error, such as a slip of the tongue, tory impairment, which has been recognized as
that is committed unintentionally, even while an important clinical indicator of neurological
knowing that it is an error. It implies a momen- and psychiatric disorders (e.g., Alzheimer’s
tary loss of conscious control. disease, Parkinson’s disease). Test participants
slip of the pen see freudian slip; parapraxis. scratch and sniff a scent-impregnated patch and
slip of the tongue a minor error in speech that then identify the odor from a list of four answer
is episodic and not related to a speech disorder choices, repeating the procedure for all 40 test
or a stage of second-language acquisition. Psy- stimuli. A brief version of the test (B–SIT) using
choanalysts have long been interested in the sig- 12 odorant stimuli determines gross dysfunction
nificance of such slips, referring to them as of olfactory sensitivity. The SIT, initially devel-
freudian slips and believing them to reveal un- oped in 1981, is now in its third edition. Also
conscious associations, motivations, or wishes. called University of Pennsylvania Smell
Also called lapsus linguae; speech error. See Identification Test (UPSIT). [developed by
also freudian slip; parapraxis; verbal leak- U.S. psychologist Richard L. Doty (1944– )]
age. smile n. a bilateral upturning of the lips, typically
slippage n. see cognitive slippage. taking place when greeting another or sharing
certain states of pleasure with another. See also
slope n. the steepness or slant of a line on a graph, duchenne smile; endogenous smile.
measured as the change of value on the y-axis as-
sociated with a change of one unit of value on Smith–Lemli–Opitz syndrome an auto-
the x-axis. In a regression equation, slope is somal recessive disorder marked by micro-
represented by the variable b, with +b indicating cephaly, a broad, short nose, syndactyly (fused
an upward slope to the line and –b indicating a digits) or polydactyly (extra digits), and mental
downward slope. retardation. Nearly all affected males have ure-
thral or other genital anomalies, whereas fe-
slow learner a child of lower-than-average in-
males have no obvious abnormalities of the
telligence. Such children are so designated de-
external genitalia, a factor that led early investi-
spite the fact that a somewhat lower-than-
gators to believe erroneously that the syndrome
average IQ does not necessarily imply slow learn-
affected only males. This disorder may be caused
ing. Slow learners are estimated at 15–17% of the
by mutations in the sterol delta-7-reductase gene
average school population. They do not show
(DHCR7), on chromosome 11 (locus 11q12–13).
marked variations from physical, social, and
Also called RSH syndrome (from the names of
emotional norms and are usually placed in regu-
the three affected families originally reported);
lar classes. The term “slow learner” is often im-
Smith syndrome. [reported in 1964 by David
precisely applied to children with mild mental
W. Smith (1926–1981), U.S. pediatrician; Luc
retardation as well as to children of normal
Lemli (1935– ), Belgian pediatrician; and John S
capacity whose intellectual progress is slow.
M. Opitz (1935– ), U.S. geneticist]
slow-release preparation a drug preparation
that is formulated in such a way that the active smoking n. the act of drawing the smoke of
ingredient is released over an extended period. burning tobacco or other substances, such as
For example, drugs may be administered in the marijuana, into the mouth or lungs. See canna-
form of transdermal patches, which are applied bis; nicotine; tobacco.
to skin, through which they slowly release their smoking cessation treatment interventions
contents; or as extended-release capsules, which to help people quit smoking that typically in-
contain quantities of the active drug surrounded volve behavioral techniques (e.g., reinforce-
by separate coatings that dissolve at different ment), social support, environmental change,
rates in stomach and intestines. Injectable slow- and healthy activity substitution (e.g., exercise),
release forms (depot preparations) are often oil which may be used in conjunction with nicotine
based; these are taken up into fat stores in the replacement therapy or other drugs. Group treat-
body and released over extended periods of days ment is often offered in community settings.
to weeks. Also called extended-release prepa- smoothing n. a collection of techniques used to
ration; sustained-release preparation. reduce the irregularities (random variation) in a
slow-wave sleep deep sleep that is character- batch of data or in a plot (curve) of that data, par-
ized by delta waves on the electroencephalo- ticularly in time series analyses, so as to more
gram, corresponding to stages 3 and 4 of sleep. It clearly see the underlying trends.
543
snake phobia
snake phobia a persistent and irrational fear of older people. Symptoms include withdrawal, ap-
snakes, formerly called ophidiophobia. This type athy, submissiveness, and progressive social and
of fear is classified as a specific phobia, animal vocational incompetence. Previously considered
type. See also animal phobia. to be symptomatic of mental illness, this decline
SNF abbreviation for skilled nursing facility. is now attributed to internalized negative stereo-
types, such as identification with the sick role
snow n. slang for cocaine or, sometimes, her-
and the impact of labeling (see labeling the-
oin or amphetamine.
ory), the absence of social support, and such
SNP abbreviation for single-nucleotide poly- institutional factors as a lack of stimulation,
morphism. overcrowding, unchanging routine, and disin-
SNRI serotonin and norepinephrine reuptake interest on the part of the staff. Also called
hibitors: any of a class of antidepressants that chronicity; institutionalism; institutional
exert their therapeutic effects by interfering with neurosis; social disability syndrome.
the reabsorption of both serotonin and norepi- social casework see casework.
nephrine by the neurons that released them.
They include venlafaxine and duloxetine. social cognition cognition in which people
perceive, think about, interpret, categorize, and
sociability n. the tendency to seek out compan- judge their own social behaviors and those of
ionship, engage in interpersonal relations, and others. The study of social cognition involves as-
participate in social activities. —sociable adj. pects of both cognitive psychology and social
sociability rating an evaluation of an individ- psychology. Major areas of interest include at-
ual’s degree of sociability based on the amount tribution theory, social influence, and the
of time devoted to social activities. cognitive processes involved in moral judg-
social age (SA) a numerical scale unit expressing ments.
how mature a person is in terms of his or her in- social-cognitive theory a theoretical frame-
terpersonal skills and ability to fulfill the norms work in which the functioning of personality is
and expectations associated with particular so- explained in terms of cognitive contents and
cial roles, as compared to others of the same processes acquired through interaction with the
chronological age. SA is similar to mental sociocultural environment. [advanced by Albert
age and is derived from ratings gathered from bandura and U.S. personality psychologist Wal-
the individual or, in the case of young children, ter Mischel (1930– )]
from parents or caregivers using instruments
social cohesion see cohesion.
such as the Vineland Adaptive Behavior Scales.
social agency a private or governmental organi- social comparison theory the proposition
zation that supervises or provides personal ser- that people evaluate their abilities and attitudes
vices, especially in the fields of health, welfare, in relation to those of others (i.e., through a pro-
and rehabilitation. The general objective of a so- cess of comparison) when objective standards
cial agency is to improve the quality of life of its for the assessment of these abilities and attitudes
clients. are lacking. The way people compare themselves
with others (their comparison group or refer-
social animal the concept that some animals ence group) was most fully described by Leon
are inherently social creatures with interper- festinger in 1954. He also held that those cho-
sonal needs and wants. When referring to hu- sen as the comparison group are generally those
mans, the term social man is sometimes used. whose abilities or attitudes are relatively similar
Also called social being; zoon politikon. See to the person’s own abilities or views.
also social instinct.
social competence effectiveness or skill in in-
S social anxiety fear of social situations (e.g., terpersonal relations and social situations, in-
making conversation, meeting strangers, or dat- creasingly considered an important component
ing) in which embarrassment may occur or there of mental health. Social competence involves
is a risk of being negatively evaluated by others the ability to evaluate social situations and deter-
(e.g., seen as stupid, weak, or anxious). Social mine what is expected or required; to recognize
anxiety involves apprehensiveness about one’s the feelings and intentions of others; and to se-
social status, role, and behavior. When the anxi- lect social behaviors that are most appropriate
ety causes an individual significant distress or for that given context. It is important to note,
impairment in functioning, a diagnosis of so- however, that what is required and appropriate
cial phobia may be warranted. for effective social functioning is likely to vary
social anxiety disorder see social phobia. across settings.
social bond an affective relation between indi- social constructivism the school of thought
viduals, such as the connection between two that recognizes knowledge as embedded in social
friends or the emotional link between family context and sees human thoughts, feelings, lan-
members. guage, and behavior as the result of interchanges
social breakdown syndrome a symptom with the external world. Social constructivism
pattern observed primarily in institutionalized argues that there is no separation between sub-
individuals with chronic mental illness but also jectivity and objectivity and that the dichotomy
in such populations as long-term prisoners and between the person and the situation is false: the
544
social interest
person is intimately and intricately bound to the relationship). [proposed by Austrian soci-
within social, cultural, and historical forces and ologists George C. Homans (1910–1989) and
cannot be understood fully without consider- Peter Blau (1918–2002)]
ation of these social forces. According to social social facilitation the improvement in an in-
constructivism, not only knowledge but reality dividual’s performance of a task that often oc-
itself is created in an interactive process and thus curs when others are present. This effect tends to
people are solely what their society shapes them occur with tasks that are uncomplicated or have
to be. been previously mastered through practice.
social deficit inability, unwillingness, or poor There is some disagreement as to whether the
judgment in the performance of social activities improvement is due to a heightened state of
commensurate with chronological age, intelli- arousal, a greater self-awareness, or a reduced at-
gence, or physical condition. Such a deficit is tention to unimportant and distracting periph-
presumed to reduce a person’s ability to obtain eral stimuli. By contrast, the presence of other
social support and is therefore a target of treat- people is frequently an impediment to effective
ment, especially in behavior therapy and with performance when the task is complicated, par-
severely disturbed individuals. ticularly if it is not well learned. See also audi-
social deprivation 1. limited access to soci- ence effect.
ety’s resources due to poverty, discrimination, social factors factors (e.g., attitudes) that affect
or other disadvantage. See cultural depriva- thought or behavior in social contexts or that af-
tion. 2. lack of adequate opportunity for social fect self-concept vis-à-vis other individuals or
experience. groups.
social desirability 1. the extent to which social growth the development of the individ-
someone or something (a trait, attribute, or the ual’s knowledge and ability with regard to deal-
like) is admired or considered valuable within a ings with other individuals and groups. Social
social group. 2. the bias or tendency of individu- growth is not limited to conformity; much social
als to present themselves in a manner that will growth can lie outside the range of cultural ex-
be viewed favorably by others. In an experiment, pectations.
for example, it manifests as the social desirability social hunger a desire to be accepted by others.
response set, which is the tendency of partici-
social identity 1. the personal qualities that
pants to give answers that are in accordance with
one claims and displays to others so consistently
social norms or the perceived desires of the re-
that they are considered to be part of one’s essen-
searcher rather than genuinely representative of
tial, stable self. This public persona may be an ac-
their views. This is a confound to be controlled
curate indicator of the private, personal self, but
for in certain research, as it often reduces the va-
it may also be a deliberately contrived image.
lidity of interviews, questionnaires, and other
2. see collective self.
self-reports. See impression management.
social imperception disorder a condition
social determinism the theory or doctrine
characterized by a lack of awareness of common
that individual behaviors are determined by
social interaction and interpersonal behaviors,
societal events and other interpersonal experi-
difficulty in recognizing and understanding
ences. See also cultural determinism; deter-
other people’s feelings and emotions, and a very
minism.
limited awareness of typical social interpersonal
social disability syndrome see social issues.
breakdown syndrome.
social influence 1. any change in an individ-
social drift see drift hypothesis. ual’s thoughts, feelings, or behaviors caused by S
social drinker an imprecise categorization gen- other people, who may be actually present,
erally agreed to signify an individual who tends imagined, expected, or only implied. 2. those in-
to drink alcohol only in a social setting and usu- terpersonal processes that can cause individuals
ally in moderation. to change their thoughts, feelings, or behaviors.
Social–Emotional scale see bayley scales of social instinct 1. the desire for social contact
infant and toddler development. and a feeling of belonging, as manifested by the
tendency to congregate, affiliate, and engage in
social exchange theory a theory envisioning group behaviors. 2. in the individual psychol-
social interactions as an exchange in which the ogy of Alfred adler, an innate drive for co-
participants seek to maximize their benefits operation that leads normal individuals to
within the limits of what is regarded as fair or incorporate social interest and the common
just. Intrinsic to this hypothesis is the reciproc- good into their efforts to achieve self-realization.
ity norm: People are expected to reciprocate for
the benefits they have received. Social exchange social intelligence the ability to understand
theory is similar to equity theory, which also people and effectively relate to them. It is often
maintains that people seek fairness in social rela- contrasted with abstract intelligence and
tionships and that fairness exists when each concrete intelligence.
party in the relationship has the same ratio of social interest in the individual psychology
outcomes (benefits) to inputs (resources brought of Alfred adler, communal feeling based on a
545
social intervention
recognition that people live in a social context; as thinking and judgment, on the individual’s
are an integral part of their family, community, behavior and on the environment that influ-
humanity, and the cosmos itself; and have a nat- ences him or her. [developed by Albert ban-
ural aptitude for acquiring the skills and under- dura]
standing necessary to solve social problems and social maladjustment 1. inability to develop
to take socially affirmative action. Adler be- relationships that satisfy affiliative needs. 2. lack
lieved, however, that social interest is only par- of social finesse or tact. 3. a breakdown in the
tially inherent in adaptive development and process of maintaining constructive social rela-
needs to be actively cultivated in any individual. tionships.
social intervention social action programs de- social maturity scale an instrument that
signed to increase some type of social goods or assesses the degree to which an individual per-
services. forms age-appropriate behaviors. These behav-
social introversion a behavioral trait mani- iors are primarily concerned with functioning in
fested by shy, inhibited, and withdrawn atti- the family and community and are sometimes
tudes. considered in conjunction with measures of in-
tellectual impairment to establish the presence
social isolation voluntary or involuntary ab-
of retardation.
sence of contact with others. See also isolate;
loneliness. social need see love need.
sociality n. the tendency to live as part of a social-network therapy a form of psycho-
group with clear organization of social interac- therapy in which various people who maintain
tions and the ability to cooperate with and adapt significant relationships with the patient or cli-
to the demands of the group. ent in different aspects of life (e.g., relatives,
friends, coworkers) are assembled with the client
sociality corollary a concept proposing that present in small or larger group sessions. See also
an individual’s ability to communicate or other- network therapy.
wise interact with another individual is based on
an understanding of the other’s personal con- social norm any of the socially determined con-
struct. [proposed by U.S. psychologist George sensual standards that indicate (a) what behav-
A. Kelly (1905–1967)] iors are considered typical in a given context
(descriptive norms) and (b) what behaviors are
socialization n. 1. the process by which indi- considered proper in the context (injunctive
viduals acquire social skills, beliefs, values, and norms). Whether implicitly or explicitly, these
behaviors necessary to function effectively in so- norms not only prescribe the socially appropri-
ciety or in a particular group. 2. the process by ate way to respond in the situation (the “nor-
which employees adjust to the organizational mal” course of action) but also proscribe actions
culture and learn the knowledge, skills, atti- that should be avoided if at all possible. Unlike
tudes, and values expected of them by superiors, statistical norms, social norms of both types in-
peers, subordinates, customers, and others. 3. clude an evaluative quality such that those who
the process whereby individuals become aware do not comply and cannot provide an acceptable
of alternative lifestyles and behaviors. It enables explanation for their violation are evaluated
individuals to learn the social or group value- negatively. Social norms apply across groups and
system behavior pattern and what is considered social settings, whereas group norms are specific
normal or desirable for the social environment to a particular group.
in which they will be members. —socialize vb.
social ossification ingrained social behavior
socialized delinquency violations of the law that is difficult to change, for example, when a
S by individuals under age 18 that result from person moves to a new environment with differ-
their adherence to the attitudes and values of a ent social rules and standards.
subculture, such as a gang, that glorifies criminal social phobia an anxiety disorder that is char-
or antisocial conduct. Also called subcultural acterized by extreme and persistent social anx-
delinquency. iety or performance anxiety that causes
socialized drive any primary drive that has significant distress or prevents participation in
been modified through social learning so that everyday activities. The feared situation is most
drive satisfaction is achieved through socially ac- often avoided altogether or else it is endured
ceptable behaviors, for example, sexual gratifica- with marked discomfort. Also called social
tion achieved through mutually consensual anxiety disorder.
adult sex. social psychology the study of how an individ-
social learning theory the general view that ual’s thoughts, feelings, and actions are affected
learning is largely or wholly due to imitation, by the actual, imagined, or symbolically repre-
modeling, and other social interactions. Behav- sented presence of other people. Psychological
ior is assumed to be developed and regulated (a) social psychology differs from sociological social
by external stimulus events, such as the influ- psychology in that the former tends to give
ence of other individuals; (b) by external rein- greater emphasis to internal psychological pro-
forcement, such as praise, blame, and reward; cesses, whereas the latter focuses on factors that
and (c) by the effects of cognitive processes, such affect social life, such as status, role, and class.
546
social work
social quotient the ratio between social age gram is operated by the U.S. Social Security
and chronological age. A social quotient is a Administration.
parallel concept to an iq, where a score of 100 in- social self 1. the aspects of the self that are im-
dicates average performance for age and scores portant to or influenced by social relations. See
less than 100 indicate below average function- also collective self; public self; social iden-
ing. tity. 2. a person’s characteristic behavior in so-
social recovery restoration of an adaptive, cial situations. 3. the facade that an individual
highly functional mental state through social may exhibit when in contact with other people,
therapy and improvement in social skills. [first as contrasted with his or her real self.
described by U.S. psychiatrist Harry Stack social services 1. services provided by govern-
Sullivan (1892–1949)] ment and nongovernment agencies and organi-
social rehabilitation 1. the achievement of a zations to improve social welfare for those in
higher level of social functioning in individuals need, including people with low income, illness
with mental disorders or disabilities through or disability, older adults, and children. Services
group activities and participation in clubs and might include health care, insurance, subsidized
other community organizations. 2. the achieve- housing, food subsidies, and the like. 2. govern-
ment of a higher level of independent function- ment services to improve standards of living for
ing in individuals with physical impairments or all citizens, including such services as roads and
disabilities through provision of assistance with public transportation, clean water, electricity,
activities of daily living as well as other more telecommunications, and public health institu-
social aspects of living, such as employment and tions.
the need for transportation and appropriate social skills training (SST) a form of individ-
housing, that often present barriers to participa- ual or group therapy for those who need to over-
tion for those with disabilities. 3. services and as- come social inhibition or ineffectiveness. It uses
sistance provided to help criminal offenders many techniques for teaching effective social
establish new, noncriminal ways of life and be- interaction in specific situations (e.g., job inter-
come productive members of the community. views, dating), including assertiveness train-
social reinforcement a positive interpersonal ing and behavioral and cognitive rehearsal.
stimulus, such as verbal praise, a smile, touch, or social support the provision of assistance or
other sign of approval, that increases the fre- comfort to others, typically in order to help
quency of the behavior that immediately pre- them cope with a variety of biological, psycho-
cedes it. See reinforcement. logical, and social stressors. Support may arise
social representation a system, model, or from any interpersonal relationship in an indi-
code for unambiguously naming and organizing vidual’s social network, involving family mem-
values, ideas, and conduct, which enables com- bers, friends, neighbors, religious institutions,
munication and social exchange (i.e., at the lev- colleagues, caregivers, or support groups. It may
els of language and behavior) among members take the form of practical help with chores or
of a particular group or community. money; informational assistance (e.g., advice or
social role valorization a principle, devel- guidance); and, at the most basic level, emo-
oped in succession to the normalization prin- tional support that allows the individual to feel
ciple, that stresses the importance of creating or valued, accepted, and understood. Social sup-
supporting socially valued roles for people with port has generally been shown to have positive
disabilities. According to this principle, fulfill- physical and psychological effects, particularly
ment of valued social roles increases the likeli- in protecting against the deleterious effects of
hood that a person will be socially accepted by stress. See also coping. S
others and will more readily achieve a satisfac- social therapy therapeutic and rehabilitative
tory quality of life. [formulated in 1983 by Ger- approaches that use social structures and experi-
man-born Canadian sociologist and special ences to improve the interpersonal functioning
educator Wolf Wolfensberger (1934–2011)] of individuals, for example, milieu therapy and
social schema a cognitive structure of orga- the therapeutic community.
nized information, or representations, about so- social withdrawal retreat from society and in-
cial norms and collective patterns of behavior terpersonal relationships, usually accompanied
within society. Whereas a self-schema involves by an attitude of indifference, detachment, and
a person’s conception of herself or himself as aloofness. Social withdrawal is often associated
an individual and in terms of a particular per- with such disorders as schizophrenia, autism,
sonal role (or roles) in life, social schemata and depression. See also withdrawal reac-
often underlie behavior of the person acting tion.
within group—particularly larger-group or soci- social work a profession devoted to helping in-
etal—contexts. dividuals, families, and other groups deal with
Social Security a comprehensive social pro- personal and practical problems within the
gram providing basic retirement income and larger community context of which they are a
insurance, as well as disability, survivor, and part. Social workers address a variety of prob-
medicare benefits. Established in 1935, the pro- lems, including those related to mental or physi-
547
societal-reaction theory
cal disorder, poverty, living arrangements, child matization and role play. See also psycho-
care, occupational stress, and unemployment, drama.
especially through involvement in the provision sociogenic adj. resulting from social factors. For
of social services. example, a sociogenic hypothesis of schizophre-
societal-reaction theory see labeling the- nia posits that social conditions, such as living in
ory. impoverished circumstances, are major contri-
Society for Psychotherapy Research an butors to and causal agents of the disorder.
international, interdisciplinary organization ded- sociogram n. a graphic representation of the re-
icated to the scientific study of psychotherapy in lations among members of a social unit or group.
all of its various forms. It publishes the journal In most cases each member of the group is de-
Psychotherapy Research. picted by a symbol, such as a lettered circle or
square, and the types of relations among mem-
sociobiology n. the systematic study of the bio-
bers (e.g., communication links, friendship pair-
logical basis for social behavior. Sociobiologists
ings) are depicted by arrows. sociometry, as
believe that populations tend to maintain an
originally developed by Romanian-born U.S.
optimal level of density (neither overpopulation
psychiatrist and philosopher Jacob L. Moreno
nor underpopulation) by such controls as ag-
(1889–1974), uses objective data collected by ob-
gression, stress, fertility, emigration, predation,
servers or the self-reports provided by members
and disease. Such controls are held to oper-
of the group to generate sociograms. Moreno
ate through the Darwinian principle of natural
himself used four types of sociograms to repre-
selection. [pioneered by U.S. biologist Edward
sent any given situation: (a) an intuitive
Osborne Wilson (1929– )] —sociobiological
sociogram, based on relationships noted by the
adj.
therapist in the first session; (b) an observer’s
sociocentrism n. 1. the tendency to put the sociogram, consisting of the cotherapist’s im-
needs, concerns, and perspective of the social pressions; (c) an objective sociogram, based on a
unit or group before one’s individual, egocentric sociometric test; and (d) a perceptual sociogram,
concerns. See also allocentric. 2. the practice in which each member indicates which other
of perceiving and interpreting situations from members appear to accept or reject him or her.
the point of view of the social group rather than In practice, sociograms are used mainly to em-
from one’s own personal perspective. 3. the ten- phasize the patterns of liking and disliking (at-
dency to judge one’s own group as superior to traction relations) in a group.
other groups across a variety of domains. sociological measure 1. a formal measure of
Whereas ethnocentrism refers to the selective fa- aspects of society that may affect the develop-
voring of one’s ethnic, religious, racial, or na- ment or maintenance of normal behaviors
tional groups, sociocentrism usually means the or mental health problems. Sociological mea-
favoring of smaller groups characterized by face- sures may assess the interrelationships between
to-face interaction among members. Compare people or the structural components of a society,
egocentrism. —sociocentric adj. for example, and include both quantitative
sociocognitive bias a subtle bias in judgment and qualitative methods. See also sociometry.
to which evaluators may be susceptible. Unlike 2. see primary prevention.
values, sociocognitive biases are inaccurate judg- sociometry n. a field of research in which vari-
ments that result from shortcomings in cogni- ous techniques are used to analyze the patterns
tive processing; they appear to be universals that of intermember relations within groups and to
intrude regardless of values or ethics. summarize these findings in mathematical and
S sociocultural deprivation see psycho- graphic form. In most cases researchers ask the
social deprivation. group members one or more questions about
sociocultural factors environmental condi- their fellow members, such as “Whom do you
tions that play a part in healthy and adaptive most like in this group?”, “Whom in the group
behavior and well-being or in maladaptive be- would you like to work with the most?”, or
havior and the etiology of mental disorder and “Whom do you like the least?”. These choices
social pathology. Examples of sociocultural fac- can then be summarized in a sociogram, in
tors of a positive nature are a strong sense of fam- which each member is represented by a num-
ily and community support and mentorship, bered or lettered symbol and the various choices
good education and health care, availability of are identified by lines between them with arrows
recreational facilities, and exposure to the arts. indicating the direction of relationships. In most
Examples of a negative nature are slum condi- cases the diagram is organized into a meaningful
tions, poverty, extreme or restrictive occupa- pattern by placing those individuals who are
tional pressures, lack of good medical care, and most frequently chosen (stars) in the center of
inadequate educational opportunities. the diagram and the isolates about the periph-
ery. The method also yields various indices of
sociocultural mental retardation see cul- group structure and group cohesion, including
tural-familial mental retardation. choice status (the number of times a person is
sociodrama n. a technique for enhancing chosen by the other group members), rejection
human relations and social skills that uses dra- status (the number of times a person is rejected
548
somatic nervous system
by others), the relative number of mutual pairs sault that does not involve penile–vaginal pene-
in a group, and so on. [developed by Romanian- tration.
born U.S. psychiatrist and philosopher Jacob L. soft sign a clinical, behavioral, or neurological
Moreno (1889–1974)] —sociometric adj. sign that may reflect the presence of neurologi-
sociopath n. a former name for an individual cal impairment. Soft signs are subtle, nonspe-
with an antisocial personality disorder. cific, and ambiguous (because they are also seen
sociopathic behavior see dyssocial behav- in individuals without neurological impair-
ior. ment). Examples include slight abnormalities of
speech, gait, posture, or behavior; sleep distur-
sociopathic disorder see antisocial person-
bances; slow physical maturation; sensory or
ality disorder.
perceptual deficits; and short attention span.
sociopathic personality see antisocial per- Also called equivocal sign; soft neurologi-
sonality disorder. cal sign.
sociopathy n. see antisocial personality dis- Sohval–Soffer syndrome a rare, presumably
order. hereditary, disease characterized by mental re-
sociosexual assessment an assessment of an tardation and testicular deficiency, as well as
individual to identify or measure his or her skeletal anomalies and diabetes mellitus. A small
awareness of cultural standards regarding social number of affected individuals studied had psy-
relationships and sexual activity, knowledge of chotic disorder and low intelligence. The penis
facts about sexuality and the nature and conse- and testes are small, and facial and pubic hair is
quences of sexual interaction, and engagement sparse. [reported in 1953 by Arthur R. Sohval
(type and nature) in sexual activities. It may also (1904–1985) and Louis J. Soffer (1904– ), U.S.
include an assessment of risks that the individ- physicians]
ual may engage in culturally sanctioned sexual solution-focused brief therapy brief psy-
activities. chotherapy that focuses on problems in the
sociotherapy n. a supportive therapeutic ap- here and now, with specific goals that the cli-
proach based on modification of an individual’s ent views as important to achieve in a limited
environment with the aim of improving the in- time.
dividual’s interpersonal adjustment. The ap- solvent abuse see inhalant abuse.
proach may be used in a variety of contexts,
including working with parents and prospective soma n. 1. the physical body (Greek, “body”), as
foster parents, family counseling, vocational re- distinguished from the mind or spirit. See mind–
training, and assistance in readjusting to com- body problem. 2. in neuroscience, the cell
munity life following hospitalization for severe body of a neuron. 3. a plant regarded as sacred
mental illness. (and personified as the plant god Soma) by an-
cient Aryan peoples, which some experts have
sociotropy n. the tendency to place an inordi- hypothesized to be fly agaric (Amanita mus-
nate value on relationships over personal inde- caria).
pendence, thought to leave one vulnerable to
depression in response to the loss of relation- Soma n. a trade name for carisoprodol.
ships or to conflict. somatic concern worries about one’s bodily
Socratic dialogue a process of structured in- health, including concern over physical symp-
quiry and discussion between two or more peo- toms (e.g., chest pain, nausea, diarrhea, head-
ple to explore the concepts and values that aches, pain, shortness of breath) and distressing
underlie their everyday activities and judg- beliefs about bodily illness or dysfunction. See
hypochondriasis.
ments. In some psychotherapies, it is a tech- S
nique in which the therapist poses strategic somatic delusion a false belief related to one or
questions designed to clarify the client’s core be- more bodily organs, such as that they are func-
liefs and feelings and, in the case of cognitive tioning improperly or are diseased, injured, or
therapy, to enable the client to discover the dis- otherwise altered. Although standard tests do
tortions in his or her habitual interpretation of not confirm this belief, the individual nonethe-
a given situation. In psychotherapy, it is also less continues to maintain this conviction. Also
known as the Socratic-therapeutic method. called somatopsychic delusion.
Socratic-therapeutic method see socratic somatic depression a major depressive epi-
dialogue. sode in which physical symptoms are promi-
sodium Amytal interview see amobar- nent.
bital. somatic disorder an organic physical disorder,
sodium channel see ion channel. as distinguished from a functional disorder
or a psychogenic disorder.
sodomy n. 1. anal intercourse between
human beings or sexual intercourse of any kind somatic hallucination the false perception of
between a human being and an animal (see a physical occurrence within the body, such as
zooerasty). This word is derived from the name feeling electric currents.
of the corrupt town of Sodom described in Ge- somatic nervous system the part of the ner-
nesis 18–19. 2. in legal contexts, any sexual as- vous system comprising the sensory and motor
549
somatic obsession
neurons that innervate the sense organs and the social or occupational functioning. See
skeletal muscles, as opposed to the autonomic somatization disorder; undifferentiated
nervous system. somatoform disorder; conversion disor-
somatic obsession preoccupation with one’s der; pain disorder; hypochondriasis; body
body or any part of it. This concern may be asso- dysmorphic disorder.
ciated with compulsive checking of the body somatoform disorder not otherwise
part (e.g., in a mirror or by touch), comparison specified in DSM–IV–TR, a diagnostic category
with others, and seeking reassurance. Somatic reserved for disorders with unexplained physical
obsession is the central feature of body symptoms that do not meet the criteria for a
dysmorphic disorder but may also be a fea- more specific somatoform disorder. It should
ture of obsessive-compulsive disorder if not be confused with undifferentiated so-
other obsessive-compulsive symptoms are pres- matoform disorder.
ent. somatoform pain disorder see pain disor-
somatic therapy the treatment of mental dis- der.
orders by physical methods that directly influ- somatogenesis n. 1. the process by which germ-
ence the body, such as the administration of cell material develops into body cells. 2. the de-
drugs (pharmacotherapy) or the application velopment of behavioral or personality traits or
of a controlled, low-dose electric current disorders as a result of anatomical, physiological,
(electroconvulsive therapy). Also called so- or biochemical changes in the body. Also called
matotherapy. organogenesis. —somatogenic or somato-
somatic weakness the hypothesized vulnera- genetic adj.
bility, due to congenital susceptibility, of an somatognosia n. awareness of one’s own body
organ or organ system to the effects of psycho- or body parts. Denial of one’s body parts is called
logical stress. The organ is thus predisposed to asomatognosia and is commonly seen in indi-
becoming the focus of a psychosomatic disor- viduals with neglect.
der. somatophrenia n. a tendency to imagine or ex-
somatist n. a person who considers mental dis- aggerate bodily ills. See also hypochondriasis.
orders to be manifestations of organic disease. somatopsychic delusion see somatic delu-
somatization n. the expression of psychologi- sion.
cal disturbance in physical (bodily) symptoms. somatopsychology n. the study of the psycho-
The first use of the word has controversially been logical impact of physiological disease or disabil-
attributed to Austrian psychoanalyst Wilhelm ity: The term is little used, and the subject matter
Stekel (1868–1940) to describe what is now of the study is now largely included under the
called conversion. Some investigators use the rubric of health psychology.
word in reference not only to the physical symp- somatopsychosis n. 1. a psychosis marked by
toms that occur in almost every type of anxiety delusions that involve the person’s body or body
disorder but also to the expression of symptoms parts. 2. a psychosis that is due to a bodily (phys-
in such psychosomatic disorders as psycho- ical) disease. [defined by U.S. psychiatrist Elmer
genic asthma and peptic ulcers. Ernest Southard (1876–1920)]
somatization disorder in DSM–IV–TR, a somatosensory area either of two main areas
somatoform disorder involving a history of of the cerebral cortex that can be mapped
multiple physical symptoms (at least eight, one with evoked potentials to reveal points that
of which must be a pseudoneurological respond to stimulation of the various senses
symptom) of several years’ duration, for which
S medical attention has been sought but which are
related to touch (somatosense). Also called so-
matic sensory area; somatic area; somato-
apparently not due to any physical disorder or sensory cortex.
injury. The complaints are often described in
vague yet colorful or exaggerated terms by the somatosensory system the parts of the ner-
patient, who often appears anxious or depressed. vous system that serve perception of touch, vi-
Among the complaints are feelings of sickliness, bration, pain, temperature, and position. Also
difficulty in swallowing or walking, blurred vi- called somatic sensory system.
sion, abdominal pain, nausea, diarrhea, painful somatotherapy n. 1. treatment of bodily or
or irregular menstruation, sexual indifference, physical disorders. 2. see somatic therapy.
painful intercourse, pain in the back or joints, somatotonia n. the personality type that, ac-
shortness of breath, palpitations, and chest pain. cording to sheldon’s constitutional theory
somatoform disorder in DSM–IV–TR, any of a of personality, is associated with a meso-
group of disorders marked by physical symp- morphic physique (see mesomorph). Soma-
toms suggesting a specific medical condition for totonia is characterized by a tendency toward
which there is no demonstrable organic evi- energetic activity, physical courage, and love of
dence and for which there is positive evidence or power. —somatotonic adj.
a strong probability that they are linked to psy- somatotype n. the body build or physique of a
chological factors. The symptoms must cause person, particularly as it relates to his or her tem-
marked distress or significantly impair normal perament or behavioral characteristics (see con-
550
spatial neglect
stitutional type). Numerous categories of gressive cerebral disorder, mental retardation,

somatotypes have been proposed by various in- increased birth weight, and excessive growth
vestigators since ancient times. The classifica- during early childhood. Mild dilation of the ce-
tion of individuals in this way is called rebral ventricles, nonspecific EEG (electroen-
somatotypology. cephalogram) changes, and seizures have been
somesthetic disorder any dysfunction in- observed in affected individuals. Handicaps may
volving the senses involving touch (somato- be fewer than previously believed and tend to
senses), such as difficulty in maintaining improve with age. Also called cerebral gigant-
postural or positional awareness or lack of sensi- ism; Nevo syndrome. [reported in 1964 by J. F.
tivity to pain, touch, or temperature. Somes- Sotos (1927– ), U.S. pediatrician]
thetic disorders are usually related to parietal soul image in the analytic psychology of
lobe damage. Carl jung, the deeply unconscious portion of
somnambulism n. see sleepwalking disor- the psyche that is composed of the animus (or
der. male archetype) and anima (or female arche-
type).
somnambulistic state a state of mind in
which walking, talking, or other complex acts source amnesia impaired memory for how,
occur during sleep (see sleepwalking disor- when, or where information was learned despite
der). Historically, it refers to a hypnotic phase in good memory for the information itself. Source
which the individual in a deep trance may ap- amnesia is often linked to frontal lobe pathol-
pear to be awake and in control of his or her ac- ogy.
tions but is actually under the influence of the source confusion misattribution of the origins
hypnotist. of a memory. This may distort eyewitness ac-
somnolence n. excessive sleepiness or drowsi- counts of the events surrounding a crime. For ex-
ness, which is sometimes pathological. The con- ample, an eyewitness hearing from a police
dition may be due, for example, to medication, officer that the perpetrator carried a gun may
a sleep disorder, or a medical condition (e.g., later believe that he or she saw the gun at the
hypothyroidism). —somnolent adj. crime scene.
somnolentia n. unnatural drowsiness. source memory remembering the origin of a
somnophilia n. an obsolete term for sexual in- memory or of knowledge, that is, memory of
terest and arousal derived from intruding on a where or how one came to know what one now
sleeping person. It may involve fondling the per- remembers.
son or masturbating while watching the person source trait in cattell’s personality trait
sleep. theory, any of 16 personality traits, determined
Sonata n. a trade name for zaleplon. by factor analysis, that underlie and deter-
mine surface traits. Examples are social bold-
soporifics pl. n. agents that are capable of pro- ness, dominance, and openness to change. See
ducing sleep, particularly a deep sleep. Also also ability trait; dynamic trait; tempera-
called sopoforics. ment trait.
SOPS abbreviation for scale of prodromal SOV abbreviation for allport–vernon–lindzey
symptoms. study of values.
SORC n. an acronym for the four variables em- spasm n. a sudden, involuntary muscle contrac-
ployed in behavioral analysis: stimuli (see situation. It may be continuous or sustained (tonic)
tional determinant), organismic variables, or it may alternate between contraction and re-
responses, and consequences (reinforcement laxation (clonic). A spasm may be restricted to a
contingencies). A functional analysis of behav- S
particular body part; for example, a vasospasm
ior may seek to determine how the presentation involves a blood vessel, and a bronchial spasm
of certain stimuli leads to specific responses (per- involves the bronchi. —spasmodic adj.
haps influenced by individual, or organismic,
variables), which are followed by consequences spasmodic dysphonia a rare voice disorder
that may then reinforce the elicited responses. whose symptoms include momentary periods of
uncontrolled vocal spasms, stuttering, tightness
sorcery drugs a group of plant alkaloids that in- in the throat, and recurrent hoarseness. The
cludes belladonna, the opium alkaloids, man- cause is unknown, but the condition may be at-
drake, aconite, and hemlock. The substances tributed to a neurological or physiological
have been chewed, smoked, or brewed into po- disturbance or to psychological factors. Spas-
tions since ancient times for purposes of healing modic dysphonia (formerly known as spastic
or intoxication. Medicinal herbs were usually dysphonia) particularly affects public speakers.
grown and administered by shamans or native
healers; some, such as the opiates and spastic colitis see irritable bowel syndrome.
anticholinergics, are used in modern medical spastic dysphonia see spasmodic dys-
pharmacology. phonia.
Sotos syndrome an inherited condition char- spatial neglect a disorder in which individuals
acterized by macrocephaly, distinctive facial are unaware of a portion of their surrounding
features (including wide-set eyes), nonpro- physical, personal, or extrapersonal space, usu-
551
spatial-temporal reasoning
ally on the left side. For example, if approached specific developmental disorders in DSM–
on the left side, an individual with spatial ne- III, disorders in which some distinctive and cir-
glect may not notice the approaching person but cumscribed ability or area of functioning fails to
would respond normally when approached on develop properly from an early age, but difficul-
the right side. ties are not attributable to mental retardation,
spatial-temporal reasoning the ability to autism, or any other condition. In DSM–IV–TR,
conceptualize the three-dimensional relation- such disorders are categorized as learning dis-
ships of objects in space and to mentally manip- orders or communication disorders.
ulate them as a succession of transformations specific factor (symbol: s) a specialized ability
over a period of time. Spatial-temporal reasoning that is postulated to come into play in particular
is a cognitive ability that plays an important role kinds of cognitive tasks. Specific factors, such
in such fields as architecture, engineering, and as mathematical ability, are contrasted with
mathematics, among others, and in such basic the general factor (g), which underlies every
tasks as everyday movement of the body cognitive performance. Also called special fac-
through space. tor. [proposed in 1904 by British psychologist
speaking in tongues see glossolalia. and psychometrician Charles Edward Spearman
(1863–1945)]
Spearman rank correlation coefficient
(symbol: ρ) see rank correlation coeffi- specificity n. 1. the quality of being unique, of a
cient. [Charles Edward Spearman (1863–1945), particular kind, or limited to a single phenome-
British psychologist and psychometrician)] non. For example, a stimulus that elicits a part-
icular response or a symptom localized in a part-
special care unit (SCU) a unit in a health care icular organ (e.g., the stomach) is said to have
institution designed to provide specialized care specificity. 2. the probability that a test yields a
for people with severe problems, such as demen- negative diagnosis given that the individual
tia, head injuries, or spinal cord injuries. does not have the condition for which he or she
special child a child with special needs who is being tested. Compare sensitivity.
requires special education and training. Such specificity doctrine of traits the proposi-
children may have learning disabilities, mental tion that personality traits are expressed with re-
retardation, physical disabilities, or emotional spect to specific classes of social contexts rather
difficulties. See also exceptional child. than being expressed globally in all situations.
special education specially designed pro- specificity of behavior 1. the fact that certain
grams, services, and instruction provided to chil- behavior is elicited only by particular stimuli
dren with learning, behavioral, or physical and therefore does not generalize beyond spe-
disabilities (e.g., visual impairment, hearing loss, cific situations. 2. a fixed pattern of expected be-
or neurological disorders) to assist them in behavior in a situation.
coming independent, productive, and valued
specificity theory a theory holding that the
members of their communities.
mechanism of pain is—like vision and hearing—
special needs the requirements of individuals a specific modality with its own central and pe-
with physical, mental, or emotional disabilities ripheral apparatus. According to this theory,
or financial, community-related, or resource dis- pain is produced by nerve impulses that are gen-
advantages. Special needs may include special erated by an injury and are transmitted directly
education, training, or therapy. to a pain center in the brain. Compare gate-
special psychiatric rapid intervention control theory.
team (SPRINT) a multidisciplinary U.S. Navy specific language disability see language
S team, consisting of psychologists, psychiatrists, disability.
social workers, and chaplains, that provides specific learning disability (SLD) a substan-
short-term mental health and emotional sup- tial deficit in scholastic or academic skills that
port immediately after a crisis. The team may does not pervade all areas of learning but rather
also provide educational and consultative ser- is limited to a particular aspect, for example,
vices to local supporting agencies. reading or arithmetic difficulty. In U.S. federal
specific ability an ability used only for a partic- legislation, this term is used interchangeably
ular intellectual task or a single test in a battery with learning disability.
of tests. It does not correlate with other abilities, specific phobia an anxiety disorder, for-
as opposed to general ability, which correlates merly called simple phobia, characterized by a
at least moderately with other abilities. Also marked and persistent fear of a specific object,
called special aptitude. See also specific fac- activity, or situation (e.g., dogs, blood, flying,
tor. heights). The fear is excessive or unreasonable
specific-attitudes theory the viewpoint that and is invariably triggered by the presence or an-
certain psychosomatic disorders are associated ticipation of the feared object or situation; con-
with particular attitudes. An example is an asso- sequently, this is either avoided or endured with
ciation between the feeling of being mistreated marked anxiety or distress. In DSM–IV–TR, spe-
and the occurrence of hives. See also specific- cific phobias are classified into five subtypes: (a)
reaction theory. animal type, which includes fears of animals or
552
Spence, Kenneth Wartinbee
insects (e.g., cats, dogs, birds, mice, insects, or fects the expression or reception (comprehen-
snakes); (b) natural environment type, which in- sion) of ideas and feelings, potentially including
cludes fears of objects in the natural surround- such problems as reduced vocabulary, omissions
ings (e.g., heights, storms, water, or lightning); of articles and modifiers, understanding of
(c) blood-injection-injury type, which includes nouns but not verbs, difficulties following oral
fears of seeing blood or an injury and of receiv- instructions, and syntactical errors. Although
ing an injection or other invasive medical proce- speech disorders and language disorders are two
dure; (d) situational type, which includes fear of distinct entities, they often occur together and
public transportation, elevators, bridges, driv- thus generally are referred to together.
ing, flying, enclosed places (see claustropho- speech and language pathology 1. inade-
bia), and so forth; and (e) other type, which quate or maladaptive communication behavior
includes fears that cannot be classified under and disorders of speech, language, and hearing.
any of the other subtypes (e.g., fears of choking, 2. the clinical field that studies, evaluates, and
vomiting, or contracting an illness and chil- treats speech, voice, and language disorders.
dren’s fears of clowns or loud noises).
speech and language therapy the applica-
specific-reaction theory a concept that an tion of remedies, treatment, and counseling for
innate tendency of the autonomic nervous sys- the improvement of verbal or written communi-
tem to react in a particular way to a stressful situ- cation.
ation accounts for psychosomatic symptoms.
speech anxiety see public-speaking anxiety.
See also specific-attitudes theory.
speech derailment see derailment.
spectator effect the effect on performance
when a task is carried out in the presence of oth- speech impairment any problem that affects
ers. When an individual is confident of being the production of speech: an occasional syn-
able to perform the task, that is, has high task onym for speech disorder (see speech and lan-
confidence, spectators improve performance; guage disorder).
when task confidence is low, they worsen it. speech rehabilitation training to restore a
spectator role a behavior pattern in which lost or impaired speech function. Also called
one’s natural sexual responses are blocked by speech reeducation.
performance anxiety. It involves observing one- speech therapy the application of remedies,
self closely and worrying about how well or treatment, and counseling for the improvement
poorly one is performing sexually, rather than of speech and language.
participating fully in the sexual activity; this pre- speed n. slang for an amphetamine, especially
vents sexual arousal from occurring. [first de- methamphetamine.
scribed by U.S. gynecologist William H. Masters speedball n. a colloquial name for a mixture of
(1915–2001) and U.S. psychologist Virginia E. heroin and a powerful stimulant (e.g., cocaine
Johnson (1925– )] or an amphetamine).
spectator therapy the beneficial effect upon spell n. 1. a hypnotic influence or suggestion. 2. a
members of a therapy group of observing the lay term for an episode of a physical or mental
therapy of fellow members with similar or re- disorder.
lated problems.
spelling dyslexia see word-form dyslexia.
spectrum of consciousness 1. in trans-
personal psychology, the full range of human Spence, Kenneth Wartinbee (1907–1967)
psychological and spiritual experiences concom- U.S. psychologist. Spence received his PhD in
itant with states of being. 2. in neuroscience, the 1933 from Yale University, where he studied
full range of awareness. See consciousness. with Robert M. Yerkes (1876–1956). He spent the S
bulk of his career at the University of Iowa, head-
speech, language, and hearing center a ing its psychology department for 22 years.
professionally staffed clinic or center that pro- Spence was an experimental psychologist whose
vides diagnostic and treatment services to peo- research involved a skillfully designed series of
ple with communication impairments. Staff experiments on discrimination learning in
typically consists of experts in audiology, speech animals and Pavlovian eyeblink conditioning in
and language pathology, and speech and hear- humans. Together with Clark L. hull, he devel-
ing sciences. Also called community speech oped a version of neobehaviorism that was
and hearing center. very influential in the 1940s and 1950s. The
speech and language disorder any disorder Hull–Spence model offered a theoretical system
that affects verbal or written communication. that explained animal learning and motivation
A speech disorder is one that affects the produc- based on principles of pavlovian condition-
tion of speech, potentially including such ing, in contrast to Skinnerian (operant condi-
problems as poor audibility or intelligibility; un- tioning) principles. Spence was awarded many
pleasant tonal quality; unusual, distorted, or ab- honors, including election to the National Acad-
normally effortful sound production; lack of emy of Sciences and the Society of Experimental
conventional rhythm and stress; and inappro- Psychologists and receipt of the Distinguished
priateness in terms of age or physical or mental Scientific Contribution Award from the Ameri-
development. A language disorder is one that af- can Psychological Association in 1956. See also
553
Sperry, Roger Wolcott
associationism; contiguity learning the- ing and descending nerve fibers on either side of
ory; maze learning. the cord. The spinal cord is enveloped by protec-
Sperry, Roger Wolcott (1913–1994) U.S. psy- tive membraneous layers (meninges) and is the
chologist. Sperry earned his MA in psychology origin of the 31 pairs of spinal nerves.
from Oberlin College in 1937 and his PhD in zo- spinal cord injury any damage to the spinal
ology from the University of Chicago in 1941, cord caused by sudden or progressive external
studying under the neuroembryologist Paul forces. Spinal cord injuries include contusion
Weiss (1898–1989). He spent four postdoctoral (bruising), hemorrhage, laceration, transection,
years working with Karl lashley at the Yerkes spinal shock, and compression.
Laboratories of Primate Biology in Florida and spinal nerve any of the 31 pairs of nerves that
then several years on the faculty of the Univer- originate in the gray matter of the spinal cord
sity of Chicago. In 1954 he accepted a newly cre- and emerge through openings between the ver-
ated chair of psychobiology at the California tebrae of the spine to extend into the body’s der-
Institute of Technology, where he spent the re- matomes (skin areas) and skeletal muscles. The
mainder of his career. Sperry is best known for spinal nerves comprise 8 cervical nerves, 12 tho-
his nerve-regeneration theory and his research racic nerves, 5 lumbar nerves, 5 sacral nerves,
into the functions of the two hemispheres of the and 1 coccygeal nerve. Each attaches to the spi-
brain using the split-brain technique (see nal cord via two short branches, a dorsal root
commissurotomy). Throughout his career, and a ventral root.
Sperry sought answers to fundamental questions
spirit n. 1. the nonphysical part of a person: the
regarding the nature of consciousness and its in-
mental, moral, and emotional characteristics
teraction with the body. Representative works
that make up the core of someone’s identity
include “Neurology and the Mind–Brain Prob-
(e.g., a noble spirit; it broke her spirit). 2. a vital
lem” (American Scientist, 1952), “Hemispheric
force seen as animating the bodies of living crea-
Disconnection and Unity in Conscious Aware-
tures, sometimes identified with the soul and
ness” (American Psychologist, 1968), and his book
seen as surviving death. 3. an immaterial being,
Science and Moral Priority (1983). Sperry’s many
possessed of some permanence, to which are as-
honors included membership in the American
cribed many or most of the activities of a living
Academy of Arts and Sciences and receipt of the
person. 4. a supernatural being, such as a ghost
American Psychological Association’s Lifetime
or a deity. 5. in idealist philosophies, a universal
Achievement Award. In 1981 he received the
mind or idea seen as a fundamental reality and a
Nobel Prize for Physiology or Medicine.
moving force of events in the world. 6. the
sphincter control the ability to control the mood, temper, or disposition that temporarily or
muscles that open and close the openings of the permanently characterizes a person. 7. loyalty or
body, especially the anal and urinary sphincters. morale.
This ability is an important stage in physical de-
spiritual healing see faith healing.
velopment.
spirituality n. 1. a concern for or sensitivity to
sphincter morality in psychoanalytic theory, the things of the spirit or soul, especially as op-
personality characteristics and behaviors such as posed to material things. 2. more specifically, a
obstinacy, extreme orderliness, and parsimony, concern for God and a sensitivity to religious ex-
which are associated with an anal-retentive per- perience, which may include the practice of a
sonality. See also anal personality; anal stage. particular religion but may also exist without
sphingomyelin lipidosis see niemann–pick such practice.
disease. split brain a brain in which the cerebral hemi-
S spider phobia a persistent and irrational fear spheres have been separated by severence of the
of spiders. In DSM–IV–TR, spider phobia is classi- corpus callosum (see commissurotomy). Surgi-
fied as a specific phobia, animal type. Also cal transection of the corpus callosum is used to
called arachneophobia; arachnophobia. See create split-brain animals for experimental pur-
also animal phobia. poses and is also occasionally performed on hu-
spike-and-wave discharges a pattern of mans to alleviate some forms of severe epilepsy.
brain waves on an electroencephalogram (see Split brain can also occur without surgical inter-
electroencephalography) that is characteris- vention as a result of injury or disease of the cor-
tic of absence seizures. It consists of a sharp pus callosum. Study of individuals or animals
spike followed by a low-amplitude delta wave with split brain helps to define the roles of the
and occurs at a frequency of three per second. two hemispheres. Also called divided brain.
spinal cord the part of the central nervous split-half reliability a measure of the ability
system that extends from the lower end of the of a test to measure an attribute consistently, ob-
medulla oblongata, at the base of the brain, tained by correlating scores on one half of the
through a canal in the center of the spine as far test with scores on the other half. Also called
as the lumbar region. In transverse section, the split-half correlation.
cord consists of an H-shaped core of gray matter split personality a lay term for an individual
(see periaqueductal gray) surrounded by with dissociative identity disorder. It is
white matter consisting of tracts of long ascend- sometimes confused with schizophrenia,
554
SQUID
which means literally “splitting of the mind” but intervention, which may be temporary or per-
does not involve the formation of a second permanent. It most commonly refers to medical,
sonality. rather than psychological, conditions. See also
splitting n. 1. in kleinian analysis, the most waiting-list phenomenon.
primitive of all defense mechanisms, in which spontaneous speech speech that is not in re-
objects that evoke ambivalence and therefore sponse to a specific question or direction.
anxiety are dealt with by compartmentalizing spontaneous trait inference a judgment
positive and negative emotions (see part- about an individual’s personality traits that is
object), leading to images of the self and others made automatically, based on observed behav-
that are not integrated. In general, it results in ior. More specifically, it is the phenomenon by
polarized viewpoints that are projected onto dif- which people who hear others describe negative
ferent people. This mechanism is found not only or positive behaviors in individuals attribute the
in infants and young children, who are as yet in- qualities implied by those behaviors to the
capable of combining these polarized view- speaker.
points, but also in adults with dysfunctional
patterns of dealing with ambivalence; it is often sports hypnosis hypnosis used to assist partici-
associated with borderline personality dis- pants in sport to eliminate mind-sets that inter-
order and plays a central role in fairbairnian fere with athletic performance or to develop
theory. Also called splitting of the object. those that enhance it.
2. in cotherapy, an appeal by a client to one of spreading activation 1. in neuroscience, a
the therapists when he or she feels that that ther- hypothetical process in which the activation of
apist would be more sympathetic than the other. one neuron is presumed to spread to connected
Also called splitting situation. neurons, making it more likely that they will
SPMSQ abbreviation for short portable men- fire. 2. in cognitive psychology, an analogous
tal status questionnaire. model for the association of ideas, memories,
spontaneity test a type of sociometric test in and the like, based on the notion that activation
which an individual in a therapy group is en- of one item stored in memory travels through as-
couraged to improvise freely in reenactments of sociated links to activate another item. As each
typical life situations with other members of the item is activated, further activation may spread
group who have been judged to be emotionally through the network, making it more likely that
related, positively or negatively, to that individ- associated items will be recalled. Spreading acti-
ual. The object is to gain insight into interper- vation is a feature of some models of semantic
sonal relationships not revealed by the standard memory.
sociometric test, which deals only with attrac- spreading depression a propagating wave of
tion and repulsion. [devised by Romanian-born silence in neuronal activity accompanied by
U.S. psychiatrist Jacob Levi Moreno (1889– a relatively large negative electric potential.
1974)] Spreading depression occurs in regions of gray
spontaneity training a personality-training matter, including the cerebral cortex and hippo-
program in which a client learns to act naturally campus. It may occur spontaneously or be
and spontaneously in real-life situations by prac- evoked by intense local electrical, chemical, or
ticing such behavior in graduated sessions. Also mechanical stimuli. Cortical spreading depres-
called spontaneity therapy. [introduced by sion is related to migraine headaches.
Romanian-born U.S. psychiatrist Jacob Levi SPRINT acronym for special psychiatric
Moreno (1889–1974)] rapid intervention team.
spontaneous alternation the instinctive, SQAW acronym for sleep questionnaire and S
successive alternation of responses between al- assessment of wakefulness.
ternatives in a situation involving discrete squeeze technique a technique for overcom-
choices or exploration. For example, in a learning premature ejaculation. The penis is stim-
ing and memory experiment, a rat in a T-shaped ulated until the man is well aroused, then the
maze tends to choose the left arm on one trial, partner squeezes the penis briefly where the
the right arm on the next, the left arm again, and head of the penis joins the shaft. When the
so on. squeeze is released, a pause in stimulation is
spontaneous movement movement that re- taken for 30 s to 1 min. The squeeze and pause
sults from impulse, occurring without premedi- lowers arousal, and stimulation is then resumed.
tation or planning. Spontaneous movement After several stimulate–squeeze–pause–stimulate
decreases in some disorders, such as Parkinson’s cycles, the man is stimulated to ejaculation. This
disease. procedure conditions the man to maintain an
spontaneous regression a phenomenon in erection longer before ejaculation. [devised by
which a person suddenly relives an event from U.S. gynecologist William H. Masters (1915–
an earlier age (e.g., childhood) and may exhibit 2001) and U.S. psychologist Virginia E. Johnson
appropriate behavior for that age. (1925– )]
spontaneous remission a reduction or disap- SQUID acronym for superconducting quan-
pearance of symptoms without any therapeutic tum interference device.
555
SRI
SRI abbreviation for serotonin reuptake inhibitor. stage 2 sleep a stage of sleep that is defined by
See ssri. regular bursts of 14–18 Hz waves (called sleep
S sleep abbreviation for slow-wave sleep or spindles) that progressively increase and then
synchronized sleep, that is, nrem sleep. Com- decrease in amplitude. See sleep stages.
pare d sleep. stage 3 sleep a stage of slow-wave sleep that is
SSRI selective serotonin reuptake inhibitor: any defined by the sleep spindles seen in stage 2
of a class of antidepressants that are thought to sleep interspersed with larger amplitude delta
act by blocking the reuptake of serotonin into se- waves (slow waves of 1–4 Hz). See sleep stages.
rotonin-containing presynaptic neurons in the stage 4 sleep a stage of slow-wave sleep that
central nervous system (see also serotonin- is defined by the presence of high-amplitude
receptor agonists). The SSRIs have demon- delta waves (slow waves of 1–4 Hz). See sleep
strated efficacy in the treatment of not only de- stages.
pression but also panic disorder and obsessive- stages of change the five steps involved
compulsive disorder as well as eating disorders in changing health behavior proposed in the
and premenstrual dysphoric disorder. However, transtheoretical model: (a) precontempla-
the relationship of the reuptake mechanism to tion (not thinking about changing behavior), (b)
the therapeutic qualities of these agents has not contemplation (considering changing behav-
been clearly elucidated. SSRIs also block the ior), (c) preparation (occasionally changing be-
activity of certain subtypes of serotonin havior), (d) action (participating in the healthful
autoreceptors, and this may also be associated behavior on a regular basis, resulting in major
with their therapeutic effects. SSRIs have less benefits), and (e) maintenance (continuing the
adverse side effects than the tricyclic antide- behavior after 6 months of regular use). [devel-
pressants and the monoamine oxidase inhib- oped by U.S. clinical psychologist James O.
itors; common side effects include nausea, Prochaska (1942– )]
headache, anxiety, and tremor, and some pa-
tients may experience sexual dysfunction. SSRIs stages of grief a hypothetical model, originally
include fluoxetine, paroxetine, sertraline, described in 1969 by Swiss-born U.S. psychiatrist
citalopram, and fluvoxamine. Also called Elisabeth Kübler-Ross (1926–2004), depicting psy-
SRIs (serotonin reuptake inhibitors). chological states, moods, or coping strategies
that occur during the dying process or during
SST 1. abbreviation for self-statement train- periods of bereavement, great loss, or trauma.
ing. 2. abbreviation for single-session ther-
These begin with the denial stage, followed by
apy. 3. abbreviation for social skills training.
the anger stage, bargaining stage, depression
S-state n. the sleeping (or sleep) state, as opposed stage, and acceptance stage. The model is non-
to the D-state (see dream state) and the W-state linear in that the stages do not necessarily occur
(waking state). in the given sequence or for a set period of time;
stability n. 1. the absence of variation or mo- moreover, they can recur and overlap before
tion, as applied, for example, to genetics (in- some degree of psychological and emotional res-
variance in characteristics), personality (few olution occurs. Also called grief cycle model.
emotional or mood changes), or body position stagnation n. see generativity versus stag-
(absence of body sway). 2. in developmental nation.
psychology, the degree to which a person main-
STAI abbreviation for state–trait anxiety in-
tains over time the same rank order with respect
ventory.
to a particular characteristic (e.g., intelligence
test performance) in comparison with peers. 3. stalking n. a repeated pattern of following or ob-
S the property of a system, either open or closed, serving a person in an obsessional, intrusive, or
that regulates its internal environment and harassing manner. Often associated with a failed
tends to maintain a stable, constant condition. relationship with the one pursued, stalking may
involve direct threats, the intent to cause distress
stability–instability bipolar dimensions of
or bodily harm, and interpersonal violence. It
the single trait of emotional stability.
may alternatively follow from an instance of
Stablon n. a trade name for tianeptine. erotic delusion. See also domestic violence.
Stadol n. a trade name for butorphanol. standard n. 1. a criterion for evaluating the
stage fright an anxiety reaction associated with goodness or worth of a person, action, or event.
speaking or performing in public. The individual 2. any positive idea about how things might be,
becomes tense and apprehensive and may stut- such as an ideal, norm, value, expectation, or
ter, forget lines, or escape the situation. The ap- previous performance, that is used to measure
prehension may develop into panic symptoms and judge the way things are. Evaluation of the
or even a panic attack. See also performance self is often based on comparing the current real-
anxiety. ity (or perceptions of the current reality) against
stage 1 sleep the initial stage of sleep, which is one or more standards.
characterized by low-amplitude brain waves standard deviation (symbol: SD) a measure of
(4–6 Hz) of irregular frequency, slow heart rate, the variability of a set of scores or values within a
and reduced muscle tension. See sleep stages. group, indicating how narrowly or broadly they
556
standardized score
deviate from the mean. A small standard devia- strument will have a standard error of measure-
tion indicates data points that cluster around the ment of 0.00, which means that an individual
mean, whereas a large standard deviation indi- will have the same score upon repeated testings
cates data points that are dispersed across many with the instrument. Otherwise, the standard
different values. The standard deviation is ex- error of measurement will be between 0.00 and
pressed in the same units as the original values in 1.00 and the individual will have different scores
the sample or population, so that the standard on different occasions; the larger the error the
deviation of a series of measurements of weight greater the variation across administrations. In
would be in e.g. pounds. The standard deviation essence, the standard error of measurement pro-
is equal to the square root of the variance. If a vides an indication of how confident one may be
population of n values has a mean μ, then the that an individual’s obtained score on any given
2
standard deviation is √[Σ(Xi – μ) /n]. For
_ a sample measurement opportunity represents his or her
of the population, with a mean value X, the sam- true score. See also standard error.
ple standard_ deviation is taken to be standard error of the mean (symbol: σM) a
√[Σ(Xi –X)2/(n – 1)], statistic that indicates how much the average
that is, the divisor is (n – 1) rather than n. value (mean) for a particular sample is likely to
differ from the average value for the larger popu-
standard error (symbol: SE) in statistical analy- lation from which it is drawn. It is the stan-
sis, a quantification of the inherent inaccuracy dard deviation of the sampling distribution
of a calculated population value that is attrib- of the mean, equal to σ/√n, where σ is the stan-
utable to random fluctuations within the sam- dard deviation of the original distribution and n
ple data upon which it is based. Some degree of is the sample size. Less commonly called stan-
imprecision is present whenever a value for a dard error of the population mean.
large group (the population) is estimated by
studying a subset of that group (the sample), and standardization n. 1. the process of establish-
the standard error provides a numerical descrip- ing norms for a test. 2. the use of uniform proce-
tion of that variability. It is expressed as the dures in test administration to ensure that all
standard deviation of the sampling distri- participants take the same test under the same
bution. For example, the sample mean is the conditions and are scored by the same criteria,
usual estimator of a population mean yet differ- which in turn ensures that results can be
ent samples drawn from that same population compared to each other. 3. the transformation
nonetheless will yield different values for the of data into a distribution of standardized
mean. Thus, to determine how much sample scores having a mean of 0 and a standard de-
variability exists the standard error of the viation of 1, which produces derived measures
mean may be obtained by taking the standard of relative standing and allows comparison of
deviation of all of the means over all of the sam- raw scores from different distributions.
ples taken. Standard error is expressed in units, standardization group a sample used to es-
given in the same scale of measurement that was tablish reliable norms for the population that it
used for the sample data (e.g., for a set of means represents. This is done by analysing the results
that are given in weight the standard error unit is of the test administered to the sample and ascer-
also a weight). The more samples involved in de- taining the average performance level and the
termining the standard error, the smaller its relative frequency of each deviation from the
value; the smaller the standard error, the more mean. The normal distribution thus created
reliable the calculated population value. is then used for comparison with any specific fu-
standard error of estimate (symbol: SEE) for ture test score. It is important to note, however,
a relationship between two variables (X and Y) that the standardization group must be represen- S
given by a regression line or regression equa- tative of the intended population of test takers
tion, an index of how closely the predicted in order to yield valid information. Also called
value of Y for a specific value of X matches its ac- standardization sample.
tual value. If y′ is an estimated value from a re- standardized test 1. an assessment instru-
gression line and y is the actual value, then the ment whose validity and reliability have
standard error of estimate is √[Σ(y – y′)2/n], where been established by thorough empirical investi-
n is the number of points. The smaller the stan- gation and analysis. It has clearly defined norms,
dard error of estimate, the better the degree of re- such that a person’s score is an indication of how
lationship (correlation) between X and Y and well he or she did in comparison to a large group
the more confident one can be in the accuracy of of individuals representative of the population
the estimated (predicted) Y value. Also called for which the test is intended. Also called stan-
standard error of prediction. See also standardized measure. 2. an assessment instru-
dard error. ment administered in a predetermined manner,
standard error of measurement (symbol: such that the questions, conditions of adminis-
SEM) an index of the reliability of an assess- tration, scoring, and interpretation of responses
ment instrument, representing the variation of are consistent from one occassion to another.
an individual’s scores across multiple admin- standardized score a value derived from a raw
istrations of the same test. A perfectly reliable in- score by subtracting the mean value of all scores
557
standards of practice
in the set and dividing by the standard deviation, such as closing the eyes, frowning by draw-
tion of the set. The advantage of standardized ing the eyebrows together, compressing the lips,
scores is that they are not reflective of the units lowering the head, hunching the shoulders, and
of the measuring device from which they were bending the trunk and knee. The reaction can be
obtained and thus can be compared to one an- neutralized by context, inhibition, and habitua-
other regardless of the device’s scale values. Sev- tion. Also called startle reaction.
eral types of standardized score exist, such as t starvation reactions physical and psycholog-
scores. Also called standard score. See also ical effects of chronic undernourishment, which
standardization. is experienced by perhaps well over one quarter
standards of practice a set of guidelines that of the world’s population. Common physical
delineate the expected techniques and proce- effects include general weakness or asthenia,
dures, and the order in which to use them, for in- hunger pangs, sluggishness, and susceptibility
terventions with individuals experiencing a to disease. Psychological effects include slowing
range of psychological, medical, or educational down of thought processes, difficulty in concen-
conditions. Standards of practice have been de- tration, apathy, irritability, reduced sexual de-
veloped by the American Psychological Associa- sire, and loss of care in appearance. Psychotic
tion and other professional associations to reactions seldom occur except when starvation
ensure that practitioners use the most researched is accompanied by infection or extreme stress.
and validated treatment plans. stasis n. a condition of stability, equilibrium,
Stanford–Binet Intelligence Scale (SB) a or inactivity, as opposed to a state of flux or
standardized assessment of intelligence and cog- change. Compare labile. —static adj.
nitive abilities for individuals aged 2 to 89 years. state n. the condition or status of an entity or sys-
It currently includes five verbal subtests and five tem at a particular time that is characterized by
nonverbal subtests that yield Verbal, Nonverbal, relative stability of its basic components or el-
and Full Scale IQs (with a mean of 100 and a ements. Although the components or elements
standard deviation of 15) as well as Fluid Rea- are essentially qualitatively stable, it is possible
soning, Knowledge, Quantitative Reasoning, Vi- for them also to be dynamic, as in a hyperactive
sual-Spatial Processing, and Working Memory state or a state of flux.
index scores. The Stanford–Binet test was so state anxiety anxiety in response to a specific
named because it was brought to the United situation that is perceived as threatening or
States by Lewis M. terman, a professor at Stan- dangerous. State anxiety varies in intensity and
ford University, in 1916, as a revision and exten- fluctuates over time. Compare trait anxiety.
sion of the original Binet–Simon Scale (the first [defined in 1972 and 1983 by U.S. psychologist
modern intelligence test) developed in 1905 by Charles D. Spielberger (1927– )]
Alfred binet and French physician Théodore
state-dependent behavior actions that are
Simon (1873–1961) to assess the intellectual
affected by one’s emotional state, for example,
ability of French children. The present Stanford–
saying something hurtful to another while in a
Binet Intelligence Scale (SB5), developed by U.S.
state of anger.
psychologist Gale H. Roid (1943– ) and pub-
lished in 2003, is the fourth revision of the test; state-dependent learning learning that oc-
the first and second revisions were made in 1937 curs in a particular biological or psychological
and 1960, respectively, by Terman and U.S. psy- state and is better recalled when the individual is
chologist Maud Merrill (1888–1978), and the subsequently in the same state. Recall may be di-
third in 1986 by U.S. psychologists Robert L. minished when the individual is in a different
Thorndike (1910–1990), Elizabeth P. Hagen state. For example, an animal trained to run a
S (1915–2008), and Jerome M. Sattler (1931– ). maze while under the influence of a psycho-
active drug (e.g., pentobarbital) may not run it
Stanford Hypnotic Susceptibility Scale a successfully without the drug. Also called disso-
standardized 12-item scale used to measure hyp- ciated learning. See also context-specific
notic susceptibility by means of the partici- learning.
pant’s response to such suggestions as falling
forward, closing the eyes, or lowering an out-
state-dependent memory a condition in
which memory for a past event is improved
stretched arm for mild hypnosis and hallucinat-
when the person is in the same biological or psy-
ing a fly or posthypnotic amnesia for deeper
chological state as when the memory was ini-
hypnosis. [developed at Stanford University by
tially formed. Thus, alcohol may improve recall
Ernest R. hilgard]
of events experienced when previously under
stanolone n. a semisynthetic analog of di- the influence of alcohol (although this level of
hydrotestosterone used in the treatment of some recall is lower than recall under conditions
breast cancers because of its tumor-suppressing where both encoding and retrieval occur in
capabilities. sober states). A distinctive state may arise from a
startle response an unlearned, rapid, reflexlike drug, a mood, or a particular place. See con-
response to sudden, unexpected, intense stimuli text-specific learning; mood-dependent
(loud noises, flashing lights, etc.). This response memory; state-dependent learning.
includes behaviors that serve a protective func- statement validity analysis a collection of
558
stereotyped behavior
techniques used to assess the truth of statements conduit or passage. Carotid stenosis is narrowing
given during investigations, such as the truth of of a carotid artery, for example by atherosclero-
allegations made by children during interviews sis, which limits blood flow to the brain; aortic
concerning sexual abuse. The focus is on the stenosis is narrowing of the aortic valve leading
words themselves, independent of case facts. from the left ventricle, thereby restricting blood
Such analysis is based on the assumption that flow from the heart to the general circulation;
the current and quality of truthful statements is pyloric stenosis restricts the flow of stomach
different from fabricated ones and involves ex- contents into the small intestine; spinal stenosis
amining such things as the use of nouns, pro- is a narrowing of the opening in the spinal col-
nouns, and verbs; the inclusion of extraneous umn, thereby restricting the space needed for
information; the use of phrases like “I think,” the spinal cord and resulting in numbness and
which indicate lack of connection; and the bal- pain in the lower back and legs. —stenotic adj.
ance between descriptions of activities before,
during and after the event in question. These stepfamily n. a family unit formed by the union
provide various criteria enabling interviewers to of parents one or both of whom brings a child or
distinguish between plausible and implausible children from a previous union (or unions) into
accounts. See also criterion-based content the new household. Also called blended fam-
analysis. ily; reconstituted family.
state of consciousness see consciousness; stepwise regression a group of regression
altered state of consciousness. techniques that enter predictor (independent)
State–Trait Anxiety Inventory (STAI) a variables into (or delete them from) the regres-
self-report assessment device that includes sepa- sion equation one variable (or block of vari-
rate measures of state anxiety and trait an- ables) at a time according to some predefined
xiety. The state anxiety items measure the criterion. It is contrasted with ordinary least
intensity of anxiety experienced by participants squares regression, which enters all variables si-
in specific situations; the trait anxiety items as- multaneously.
sess the frequency with which respondents expe- stereotaxy n. determination of the exact loca-
rience anxiety in the face of perceived threats in tion of a specific area within the body (e.g., the
the environment. [devised in 1970 by U.S. psy- exact location of a nerve center in the brain)
chologist Charles D. Spielberger (1927– ) and by means of three-dimensional measurements.
colleagues] Stereotaxy is used for positioning micro-
static marriage see closed marriage. electrodes or other devices in the brain for diag-
statistical association see association. nostic, experimental, or therapeutic purposes
statistical control the use of statistical meth- and for locating an area of the brain prior to sur-
ods to reduce the effect of factors that could not gery. It involves the coordinated use of a
be eliminated or controlled during an experi- stereotactic atlas, a map of the brain featuring
ment. a coordinate system and consisting of images
and schematic representations of nerve fibers
statistical error any error of sampling, mea- and other structures and serial sections of the
surement, or analysis that interferes with draw- brain, and a stereotactic instrument, a device
ing a valid conclusion from the data so obtained, that prohibits damage to neighboring tissues
for example, in the context of experimental re- by holding the individual’s head absolutely still
sults. in the appropriate position. Also called stereo-
statistical significance the degree to which a tactic localization; stereotactic tech-
result cannot reasonably be attributed to the op- nique. —stereotactic or stereotaxic adj.
eration of chance or random factors alone. S
status comparison the comparison of one’s stereotype n. a set of cognitive generalizations
(e.g., beliefs, expectations) about the qualities
own abilities and status with those of others.
and characteristics of the members of a particu-
STD abbreviation for sexually transmitted lar group or social category. Stereotypes, like
disease. schemas, simplify and expedite perceptions and
steady state a condition of stability or equilib- judgments, but they are often exaggerated, nega-
rium. For example, in behavioral studies it is a tive rather than positive, and resistant to revi-
state in which behavior is practically the same sion even when perceivers encounter individuals
over repeated observations in a particular con- with qualities that are not congruent with the
text. In pharmacology, it refers to a state in the stereotype (see prejudice). Unlike individually
body in which the amount of drug administered held expectations about others based on their
is equal to that excreted. category memberships, stereotypes are widely
steatopygia n. the presence of large quantities shared by group members. See negative ste-
of fat in the buttocks. In some cultures stereotype; positive stereotype. See also gender
atopygia is considered an element of female stereotype; instance theory; kernel-of-
beauty. truth hypothesis. —stereotypic adj.
Stelazine n. a trade name for trifluoperazine. stereotyped behavior 1. inflexible behavior
stenosis n. the abnormal narrowing of a body that follows a particular pattern and does not
559
stereotyped movement
alter with changing conditions. 2. see stereo- In psychology, the term usually refers to the cns
typy. stimulants (or psychostimulants).
stereotyped movement a repeated move- stimulus n. (pl. stimuli) 1. any agent, event, or
ment or gesture, such as a tic, rocking, or head situation—internal or external—that elicits a re-
banging. sponse from an organism. See conditioned
stimulus; unconditioned stimulus. 2. any
stereotypic movement disorder in DSM– change in physical energy that activates a sen-
IV–TR, a disorder characterized by repetitive, sory receptor.
nonfunctional, and often self-injurious behav-
iors, such as head banging, biting or hitting parts stimulus-bound adj. 1. relating to a perception
of the body, rocking, or hand waving. It may be that is largely dependent on the qualities of the
associated with mental retardation and can arise stimulation and thus involves little or no inter-
at any age. Stereotypic movement disorder is dis- pretation. 2. describing behavior that occurs in
tinguished from other disorders marked by ste- response to the presence of a specific stimulus
reotyped movements, such as tic disorders (e.g., hungering for and eating a specific food
and pervasive developmental disorders. after seeing it). 3. characterizing an individual
whose behavior tends to be inflexible and deter-
stereotypy n. persistent repetition of the same mined primarily by the nature of the stimulus.
words, movements, or other behavior, particu- 4. describing a person, usually a child, who has a
larly as a symptom of disorder (e.g., autism, poor attention span, is distracted by irrelevant
obsessive-compulsive disorder, schizophrenia). stimuli, and therefore performs below his or her
Stereotypy is also seen in nonhuman animals intellectual capacity.
under conditions of social isolation, early social
deprivation, or neglect. See stereotypic move-
stimulus evaluation checks (SECs) assess-
ments made on several dimensions when an in-
ment disorder.
dividual evaluates the impact of an event and
sterility n. 1. the condition of being incapable of hence its emotional intensity and quality. Exam-
producing offspring, either because of infertil- ples of SECs include checks for novelty, goal rele-
ity or surgical or medical intervention. 2. the vance, and congruity–incongruity of actions or
condition of being incapable of supporting mi- events with social expectations. [proposed by
crobial life because of treatment with chemicals, Swiss psychologist Klaus Scherer (1943– ) in his
radiation, or heat. —sterile adj. theory of appraisal]
Stevens–Johnson syndrome a condition stimulus overload the condition in which the
marked by eruptions of fluid-filled blisters on environment presents too many stimuli to be
the skin, mucous membranes, eyes, and genitals. comfortably processed, resulting in stress and
It has a fatality rate of 1–5% and may be asso- behavior designed to restore equilibrium.
ciated with an adverse reaction to anti- stimulus sampling a procedure for increasing
convulsant and antibiotic agents. Also called the generalizability of research results by using
erythema multiforme bullosum; ery- multiple stimuli within a category as representa-
thema multiforme exudativum; erythema tive of an experimental condition, as opposed to
multiforme major. [Albert M. Stevens (1884– selecting a single stimulus whose unique charac-
1945) and Frank C. Johnson (1894–1934), U.S. teristics may distort results. For example, a study
pediatricians] investigating the effects of gender on monetary
stigma n. the negative social attitude attached to generosity would demonstrate stimulus sam-
a characteristic of an individual that may be re- pling if it employed a variety of different males
garded as a mental, physical, or social deficiency. and females to elicit donations from partici-
S A stigma implies social disapproval and can lead pants, instead of using a single male and a single
unfairly to discrimination against and exclusion female.
of the individual. stimulus situation all the components of an
stigmatophilia n. sexual interest in and occurrence or experience that, taken as a whole,
arousal by a partner who is tattooed or has scars, comprise a stimulus to which an organism
or by having oneself tattooed, particularly in the responds. The term is used to highlight the com-
genital area. plexity of behavior-arousing events that are uni-
tary patterns comprising many elements (e.g., a
stilted speech formal, affected, or pompous concert, an athletic competition). This approach
speech. It may be characteristic of a particular differs from that of traditional behavior analysts,
individual, but is also observed as a speech dis- who tend to break down stimuli into smaller,
turbance in some individuals with particular dis- separate elements.
orders, such as schizophrenia or certain forms of
stimulus word a word presented to a partici-
aphasia.
pant with the object of eliciting a response.
stimulant n. any of various agents that excite STM abbreviation for short-term memory.
functional activity in an organism or in a part of
an organism. Stimulants are usually classified ac- stochastic variable see random variable.
cording to the body system or function excited Stockholm syndrome a mental and emo-
(e.g., cardiac stimulants, respiratory stimulants). tional response in which a captive (e.g., a hos-
560
stress
tage) displays seeming loyalty to—even affection used to assess quality of attachment in infants
for—the captor. The captive may come to see law and young children (up to the age of 2). The pro-
enforcement or rescuers as the enemy because cedure subjects the child to increasing amounts
they endanger the captor. The name derives of stress induced by a strange setting, the en-
from the case of a woman who in 1973 was held trance of an unfamiliar person, and two brief
hostage at a bank in Stockholm, Sweden, and be- separations from the parent. The reaction of
came so emotionally attached to one of the rob- the child to each of these situations is used to
bers that she broke her engagement to another evaluate the security or insecurity of his or her
man and remained faithful to her former captor attachment to the parent. See ambivalent at-
during his prison term. [term coined by Swedish tachment; avoidant attachment; disorga-
psychiatrist and criminologist Nils Bejerot nized attachment; insecure attachment;
(1921–1988)] secure attachment. [devised in 1978 by Ca-
stocking anesthesia a sensory conversion nadian-born U.S. psychologist Mary D. Salter
symptom in which there is a loss of sensitivity in Ainsworth (1913–1999)]
the foot and in part of the calf (i.e., areas that strangulated affect in psychoanalytic theory,
would be covered by a stocking) that cannot be an inhibition or retention of the normal dis-
explained by a general medical condition or or- charge of emotion, leading to a substitute dis-
ganic dysfunction. Also called foot anesthesia; charge in the form of physical symptoms. This
shoe anesthesia. See also glove anesthesia. theory was advanced in Sigmund freud’s early
storm-and-stress period a period of emo- formulations to explain the dynamics of con-
tional turmoil. The phrase was used by G. Stan- version hysteria; it was later supplanted by the
ley hall to characterize adolescence, which he concept of repression. See also affect.
believed to correspond to the turbulent transi- strategic family therapy a group of ap-
tion from savagery to civilization. It is a trans- proaches to family therapy in which the focus
lation of the German Sturm und Drang, which is on identifying and applying novel interven-
was the title of a 1776 drama by Friedrich tions to produce behavioral change rather than
Maximilian von Klinger and was subsequently on helping the family gain insight into the
applied to a German literary movement. Also sources of their problems. Also called strategic
called Sturm und Drang period. intervention therapy.
storytelling n. 1. the recounting by a client of strategic intervention therapy see strate-
the events, concerns, and problems that led him gic family therapy.
or her to seek treatment. Therapists can learn stratified sampling a technique in which a
much about the motives and origins of conflicts population is divided into subdivisions (strata)
by attending carefully (see active listening) to and individuals or cases are selected for study
the stories that clients bring to the session. 2. the from each strata. The sample obtained (called a
use of symbolic talk and allegorical stories by the stratified sample) thus includes a number of in-
therapist to aid the client’s understanding of is- dividuals representing each stratum (e.g., young
sues. Also called therapeutic storytelling. and old or men and women), the goal being to
STP see dom. reproduce as accurately as possible their propor-
straight 1. adj. a colloquial term for heterosex- tional representation in the population of in-
ual. 2. n. slang for a heterosexual person. terest. Typically, random sampling is used to
select the cases from each stratum, in which case
straitjacket n. an article of clothing that was
the technique is referred to as stratified random
formerly used to restrain patients in mental hos-
sampling.
pitals from injuring themselves or others and, in
some cases, for punishment. It consisted of a stream of consciousness the concept of con- S
canvas shirt with long sleeves that could be fas- sciousness as a continuous, dynamic flow of
tened behind the patient’s back after folding his ideas and images rather than a static series of dis-
or her arms in front of the body. If a means of crete components. It emphasizes the subjective
physical restraint for a mental patient is needed quality of conscious experience as a never-
now, a system of belts that limit the patient’s ending and never-repeating stream. Also called
range of motion is used. Also called camisole. stream of thought. [introduced in 1890 by
William james]
stranger anxiety the distress and apprehen-
sion experienced by young children when they street hustlers see male homosexual prosti-
are around individuals who are unfamiliar to tution.
them. Stranger anxiety is a normal part of cogni- strephosymbolia n. 1. a perceptual disorder
tive development: Babies differentiate caregivers characterized by the mirrorlike reversal of ob-
from other people and display a strong prefer- jects. 2. a reading difficulty characterized by a
ence for familiar faces. Stranger anxiety usually tendency to transpose or reverse letters while
begins around 8 or 9 months of age and typically reading or writing (e.g., tap for pat or p for q).
lasts into the second year. Also called fear of Also called twisted symbols. [defined in 1937
strangers; stranger fear. See also separa- by U.S. psychiatrist Samuel Torrey Orton (1879–
tion anxiety; xenophobia. 1948)]
Strange Situation an experimental technique stress n. a state of physiological or psychological
561
stress casualty
response to internal or external stressors. Stress role playing, and real-life situations until the in-
involves changes affecting nearly every system dividual is able to cope with the original stress-
of the body, influencing how people feel and be- inducing situation or event. [developed by U.S.
have. For example, it may be manifested by pal- psychologist Donald Meichenbaum (1940– )]
pitations, sweating, dry mouth, shortness of stress management the use of specific tech-
breath, fidgeting, faster speech, augmentation of niques, strategies, or programs—such as relax-
negative emotions (if already being experi- ation training, anticipation of stress reactions,
enced), and longer duration of stress fatigue. and breathing techniques—for dealing with
Severe stress is manifested by the general adap- stress-inducing situations and the state of being
tation syndrome. By causing these mind–body stressed. See also preventive stress manage-
changes, stress contributes directly to psycho- ment.
logical and physiological disorder and disease
and affects mental and physical health, reducing stressor n. any event, force, or condition that re-
the quality of life. [first described in the context sults in physical or emotional stress. Stressors
of psychology around 1940 by Canadian physi- may be internal or external forces that require
cian Hans Selye (1907–1982)] adjustment or coping strategies on the part of
the affected individual.
stress casualty a member of the armed forces
who is unable to perform his or her duties be- stress reaction maladaptive or pathological be-
cause of exposure to operational stresses or risk havior resulting from conditions of pressure or
factors. Such stress may result in somatic and strain. Examples are extreme feelings of tension
behavioral symptoms. The primary cause is an or panic, disorganized speech patterns, and acci-
imminent external threat to life, leading to in- dents caused by the effects of alcohol, drugs, or
ability to cope with the threat and a consequent emotional stress.
overwhelming feeling of helplessness. stress test 1. an examination or evaluation de-
stress-decompensation model a concept of signed to ascertain an individual’s capacity to
the development of abnormal behavior as a re- perform a relatively complex task under pur-
sult of high levels of stress that lead to the grad- posefully stressful conditions. 2. a medical eval-
ual but progressive deterioration of normal uation designed to assess the effects of stress,
behavior to a level that is highly disorganized typically induced by physical exercise, on car-
and dysfunctional. diac function. The most common of such proce-
dures is a test in which the patient walks or runs
stress immunity 1. a highly developed capac- on a treadmill while cardiac, respiratory, or other
ity to tolerate emotional strain. 2. failure to react physiological processes are monitored.
to stressful situations or events.
stress tolerance the capacity to withstand pres-
stress immunization the concept that mild sures and strains and the consequent ability to
stress early in life makes an individual better able function effectively and with minimal anxiety
to handle stress later in life. under conditions of stress. See also stress immu-
stress incontinence 1. a type of urinary in- nity.
continence that occurs during exertion or stress training activities designed to help indi-
other physical activities, such as laughing or viduals understand the causes of stress and learn
coughing, that apply increased pressure to the strategies for managing and preventing it. Realis-
abdomen and bladder. 2. any form of inconti- tic training and simulation (e.g., water survival,
nence whose origin is a high level of stress. escape training, firefighting) are seen as neces-
stress-induced analgesia a reduced sensitiv- sary instructional strategies to prepare personnel
ity to pain that an organism may experience in certain types of work to operate in stressful en-
S when exposed to extreme physical trauma. For vironments.
example, soldiers in combat may ignore injuries stress–vulnerability model in schizophrenia
and instead respond to other threats to their and mood disorders, the theory that a genetic or
lives, and injured animals fleeing predators may biological predisposition to these illnesses exists
ignore their injuries in order to avoid capture. and that psychological and social factors can in-
The precise mechanism is uncertain but may be crease the likelihood of symptomatic episodes.
related to the production of large quantities of See also diathesis–stress model.
endorphins.
stridor dentium see bruxism.
stress-inoculation training (SIT) a four-
phase training program for stress-management striving for superiority in the individual
often used in cognitive behavior therapy. psychology of Alfred adler, the idea that
Phase 1 entails the identification of reactions to human beings are motivated by an innate, sover-
stress and their effects on functioning and psy- eign drive for realizing their full potential. This
chological well-being; phase 2 involves learning drive is defined as the urge for completion and
relaxation and self-regulation techniques; phase perfection rather than for superiority in the
3 consists of learning coping self-statements (see sense of social status or domination over others.
self-statement training); phase 4 involves as- stroke n. disruption of blood flow to the brain,
sisted progression through a series of increas- which deprives the tissue of oxygen and nutri-
ingly stressful situations using imagery, video, ents, causing tissue damage and loss of normal
562
structural model
function and, potentially, tissue death. A stroke mined form but instead can only be directed to-
may result from a hemorrhage of a blood vessel ward a fairly well-defined area of functioning.
in the brain (see hemorrhagic stroke) or an For example, a structural family therapist work-
embolism or thrombus blocking an artery in ing with a family whose daughter is anorexic
the brain (see embolic stroke; thrombotic would examine such family issues as the frame-
stroke). This term is often used interchangeably work of authority, the rules that govern the
with cerebrovascular accident. See also ce- assumption of roles, the various functions mem-
rebral infarction; cerebrovascular dis- bers perform, and the coalitions created by the
ease; transient ischemic attack. bonding of certain family members, and then
Stroop Color–Word Interference Test a encourage the mother, daughter, and father to
three-part test in which (a) color names are read use this information to develop more productive
as fast as possible; (b) the colors of bars or other patterns of functioning. Also called structural
shapes are rapidly named; and, most impor- therapy.
tantly, (c) color hues are named quickly when structural group a therapeutic group made up
used to print the names of other colors (such as of individuals selected for those characteristics
the word green printed in the color red). The de- that would make them most likely to be success-
gree to which the participants are subject to in- ful in achieving the goals sought in the therapy.
terference by the printed words is a measure of People of different types, temperaments, person-
their cognitive flexibility and selective attention. alities, and educational levels are combined in
Also called Stroop test. [John Ridley Stroop a group, based on the concept that their inter-
(1897–1973), U.S. psychologist] action will maximize each other’s benefits in
Stroop effect the finding that the time it takes a the therapeutic process. Also called structured
participant to name the color of ink in which a group. [devised by Romanian-born U.S. psychi-
word is printed is longer for words that denote atrist Jacob Levi Moreno (1889–1972)]
incongruent color names than for neutral words structural hypothesis see structural mo-
or for words that denote a congruent color. For del.
example, if the word blue is written in red ink structural integration see rolfing.
(incongruent), participants take longer to say
structuralism 1. a movement considered to be
“red” than if the word glue is written in red ink
the first school of psychology as a science, inde-
(neutral) or if the word red is written in red ink
pendent of philosophy. Usually attributed to
(congruent). See stroop color–word inter-
Wilhelm wundt, but probably more strongly
ference test. [John Stroop]
and directly influenced by Edward Bradford
structural analysis 1. in psychology, any the- titchener, structuralism defined psychology as
ory of the organization of mind or personality the study of mental experience and sought to in-
that attempts to differentiate between compo- vestigate the structure of such experience
nent parts and to define the relationship of part through a systematic program of experiments
to part and part to whole. Such an analysis can based on trained introspection. Also called
be contrasted with one based on function, dy- structural psychology. 2. a movement in
namics, or behavior. See personality struc- various disciplines that study human behavior
ture; structural model. 2. any analysis based and culture that enjoyed particular currency in
on the ideas or methods of structuralism. the 1960s and 1970s.
structural approach see structural model. structuralist 1. n. a therapist who believes that
structural equation modeling (SEM) a sta- changing the organizational structure of a group
tistical modeling technique that includes la- or system, such as a family, will change and im-
tent variables as causal elements. SEM is an prove its patterns of interaction. 2. n. an adher- S
advanced statistical method for testing causal ent of structuralism. 3. adj. of or relating to
models involving constructs that cannot be di- structuralism.
rectly measured but are, rather, approximated structural matrix see structured inter-
through several measures presumed to assess actional group psychotherapy.
part of the given construct. structural model in psychoanalytic theory,
structural family therapy a type of family the view that the total personality comprises
therapy that assesses the subsystems, bound- three divisions or functions: (a) the id, which
aries, hierarchies, and coalitions within a family represents instinctual drives; (b) the ego, which
(its structure) and focuses upon direct interac- controls id drives and mediates between them
tions between the family members (enactment) and external reality; and (c) the superego, which
as the primary method of inducing positive comprises moral precepts and ideals. Sigmund
change. Structural family therapy assumes the freud proposed this model in 1923 to replace
competence and uniqueness of families with his earlier topographic model, in which the
problems, stressing that when appropriately in- mind was divided into three regions: the un-
duced to do so families will discover their own conscious, preconscious, and conscious.
alternatives to their ineffective patterns of relat- Also called structural approach; structural
ing to one another and that this process of hypothesis; structural theory. See also dy-
discovery cannot proceed in a specific predeter- namic model; economic model.
563
structural therapy
structural therapy 1. see structural family behavior, is given feedback regarding the
therapy. 2. a system of treatment for children performance of the behavior, and completes
with autistic disorder, which provides a homework assignments that encourage the use
structured environment emphasizing physical of the behavior in real-world situations. [devel-
and verbal stimulation in a gamelike setting. The oped in the mid-1970s by U.S. psychologists Ar-
purpose is to increase the amount and variety of nold P. Goldstein (1933– ), Robert P. Sprafkin
stimuli received by the children, thereby helping (1940– ), and N. Jane Gershaw (1945– )]
them to relate to their environment in a more re- structured stimulus a well-defined, well-
alistic manner. organized stimulus.
structured autobiography see autobiog- structuring n. 1. the explanation by a coun-
raphy. selor or therapist, usually during the first session
Structured Clinical Interview for DSM– of a course of treatment, of the specific proce-
IV Axis I Disorders (SCID-I) an instrument dures and conditions of the process. This in-
used by clinicians to make standardized and reli- cludes the intended results of treatment, time
able diagnoses of the 37 most frequently seen restrictions, fees, and the function and responsi-
DSM–IV Axis I clinical disorders and avoid the bilities of both client and counselor or therapist.
common problem of premature focus on one di- See also contract. 2. in education, the use of
agnostic possibility. Assessment involves a stan- behavioral instructions to a student to decrease
dard set of questions asked in an interview with disruptions in the classroom.
the patient.
strychnine n. an alkaloid derived from nux
Structured Clinical Interview for DSM– vomica. It is a stimulant of the central nervous
IV Axis II Personality Disorders (SCID- system (see cns stimulant)—through its ability
II) an instrument used by researchers and cli- to antagonize the inhibitory neurotransmitter
nicians to make standardized and reliable di- glycine—and a powerful convulsant, with death
agnoses of the 10 DSM–IV personality (Axis II) usually resulting from paralysis of muscles of res-
disorders, as well as depressive personality dis- piration. Strychnine has long been used as a
order, passive-aggressive personality dis- rodenticide, and this use continues to the pres-
order, and personality disorder not otherwise ent; there are, however, no clinical applications
specified. Assessment involves a set of questions for strychnine. No marked tolerance develops
asked in an interview with the patient. for strychnine, and increased susceptibility to
structured group see structural group. poisoning is likely from repeated exposure.
structured interactional group psycho- student counseling see educational coun-
therapy a form of group therapy in which seling.
the therapist provides a structural matrix for the student’s disease the condition of individuals
group’s interactions. This is usually achieved by who believe they have the symptoms of a disease
selecting a different member of the group to be or mental disorder that they have been studying
the focus of the interaction—the target pa- or that they have read or heard about.
tient—in each session. [developed by U.S. psy-
chiatrists Harold I. Kaplan (1928–1998) and Student’s t distribution see t distribution.
Benjamin J. Sadock (1933– )] [Student, pseudonym of William S. Gosset
(1876–1937), British statistician]
structured interview an interview consisting
of a predetermined set of questions or topics. Study of Values see allport–vernon–lindzey
Structured interviews are popular in marketing study of values.
research because they produce data that can be stupor n. 1. a state of lethargy and impaired
S easily tabulated; they may also be used in per- consciousness, in which an individual is unre-
sonnel selection and other fields. Compare pat- sponsive and immobile and experiences disori-
terned interview; unstructured interview. entation. 2. inability to speak (see mutism).
See also standardized interview schedule.
Sturge–Weber syndrome a congenital dis-
structured item a response item with fixed op- order marked by malformation of meningeal
tions. blood vessels (hemi- or leptomeningeal an-
structured learning a complex system of psy- gioma), a facial port-wine stain, glaucoma, and
chotherapy based on the idea of psychological focal-motor seizures. Skin pigmentation may
skills training, that is, teaching individuals the occur on one or both sides of the face or extend
skills and behaviors associated with leading into the scalp area. About half of affected indi-
healthy and satisfying lives and then helping viduals have mental retardation, and others may
them gain the ability to consistently and reliably have specific cognitive difficulties or disabilities
apply these skills outside of the therapeutic set- detected by neuropsychological testing. Other
ting. This approach involves four essential com- characteristics may include contralateral hemi-
ponents: modeling, role play, performance plegia, intracranial calcification, and emotional
feedback, and the influence of prior learning on or behavioral disorders. Also called enceph-
new learning (transfer of training). The individ- alofacial angiomatosis; Kalischer syn-
ual is provided with examples of specific behav- drome; Parkes–Weber syndrome; Sturge–
ior to be imitated, is allowed to practice that Weber–Dimitri syndrome. [William A.
564
subliminal learning
Sturge (1850–1919) and Frederick Parkes Weber also be administered subcutaneously in the form
(1863–1962), British physicians; Vicente Dimitri of slowly absorbed pellets. Also called hypoder-
(1885–1955), Austrian physician; S. Kalischer, mic injection. See also administration.
German physician] subdelirious state the precursor of full de-
Sturm und Drang period see storm-and- lirium, marked by restlessness, headache, irri-
stress period. tability, hypersensitivity to sound and visual
stuttering n. in DSM–IV–TR, a disturbance in stimuli, and emotional instability. Also called
the normal fluency and time patterning of subdelirium.
speech. It is characterized by frequent repetition subgoal n. a goal that serves as an intermediary
or prolongation of sounds, syllables, or words, step to attaining an ultimate goal (i.e., the goal
with hesitations and pauses that disrupt speech. object). For example, completing an outline of
The disorder occurs in about 1% of all children. an essay may be a subgoal of completing the
Mild cases usually recover spontaneously by essay itself—the ultimate goal.
the age of 16; chronic stuttering is exacerbated in subject n. the individual human or nonhuman
situations where communication is important animal that takes part in an experiment or re-
or stressful. Also called stammering. See also search study and whose responses or perfor-
primary stuttering; secondary stuttering. mance are reported or evaluated. participant is
—stutter vb., n. now often the preferred term for human sub-
stuttering gait a gait characterized by hesi- jects, because the word “subject” is depersonaliz-
tancy in taking steps: a walking pattern observed ing and implies passivity and submissiveness on
in certain patients with schizophrenia or conver- the part of the experimentee.
sion disorder. In some cases it is neurological in subjective adj. 1. taking place or existing only
origin, as with parkinson’s disease. within the mind. 2. particular to a specific per-
style n. a typically stable characteristic mode or son and thus intrinsically inaccessible to the ex-
manner of expressing oneself or acting. Various perience or observation of others. 3. based on or
psychological researchers have examined partic- influenced by personal feelings, interpretations,
ular areas of human activity to identify and or prejudices. Compare objective.
classify modal differences, as for example in subjective well-being a judgment that people
bception
cognitive style and leadership style. make about the overall quality of their lives by
subception n. a reaction to an emotion- summing emotional ups and downs to deter-
provoking stimulus that is not clearly enough mine how well their actual life circumstances
perceived to be reportable, although its effects match their wishes or expectations concerning
may be observed indirectly by the electrodermal how they should or might feel.
response or by a longer than expected reaction subject of consciousness the observing ego,
time. the “I,” or an individual’s subjectivity. See also
subconscious 1. adj. denoting mental processes self as agent. Compare object of conscious-
that occur outside consciousness but can easily ness.
be brought into awareness. 2. n. in Sigmund sublimation n. in psychoanalytic theory, a de-
freud’s structural model, the concept of the fense mechanism in which unacceptable sexual
mind beneath the level of consciousness, com- or aggressive drives are unconsciously channeled
prising the preconscious. into socially acceptable modes of expression.
subcortical center any region of the brain at a Thus, the unacceptable drives and energies are
level below the cerebral cortex that has a par- redirected into new, learned behaviors, which
ticular function or functions. Subcortical centers indirectly provide some satisfaction for the origi- S
include the thalamus, hypothalamus, and nal instincts. For example, an exhibitionistic im-
basal ganglia. Within each subcortical struc- pulse may gain a new outlet in choreography; a
ture may be several special centers, such as nu- voyeuristic urge may lead to scientific research;
clei of the hypothalamus that regulate sleep, and a dangerously aggressive drive may be ex-
water balance, protein metabolism, and sexual pressed with impunity on the football field. As
activity. well as allowing for substitute satisfactions, such
outlets are posited to protect individuals from
subcortical dementia dementia caused by the anxiety induced by the original drive. —sub-
damage to or dysfunction of the subcortical
limate vb.
(deeper) structures of the brain that may be due,
for example, to Parkinson’s disease. It is marked Sublimaze n. a trade name for fentanyl.
by cognitive slowing, memory impairment, subliminal consciousness a level of con-
visuospatial abnormalities, and mood and affect sciousness in which a stimulus may affect behav-
disturbances. Compare cortical dementia. ior even though the person is not aware of it. See
subcutaneous injection injection of a drug subliminal perception.
beneath the skin, often in the upper arm or subliminal learning information, habits, or
thigh, where there is an adequate layer of subcu- attitudes acquired from exposure to stimuli that
taneous tissue. Although the subcutaneous route were presented below the threshold for con-
is used mainly to inject fluids, medications may scious awareness (i.e., subliminally).
565
subliminal perception
subliminal perception the registration of Health Services, the Center for Substance Abuse
stimuli below the level of awareness, particularly Prevention, and the Center for Substance Abuse
stimuli that are too weak (or too rapid) to affect Treatment. See also alcohol, drug abuse and
the individual on a conscious level. It is ques- mental health administration.
tionable whether responses to subliminal stimuli substance abuse treatment inpatient and
actually occur and whether it is possible for sub- outpatient programs for individuals diagnosed
liminal commands or advertising messages to with substance dependence (i.e., dependence on
influence behavior. Evidence indicates that sub- alcohol or any other drug) to achieve abstinence.
liminal commands do not directly affect behav- These include but are not limited to short- and
ior but may influence responses via subliminal long-term residential programs (colloquially
priming. known as “rehab”), clinic- and hospital-based
subliminal priming unconscious (below the outpatient programs, methadone maintenance
threshold of awareness) stimulation that in- therapy, and twelve-step programs. Also
creases the probability of the later occurrence of called drug abuse treatment. See also alco-
related cognitive tasks. See priming. holism treatment.
subliminal stimulation stimulation that is substance dependence a cluster of cognitive,
below the threshold intensity required to elicit behavioral, and physiological symptoms indi-
a response (see subliminal perception). Also cating continued use of a substance despite sig-
called subliminal stimulus. nificant substance-related problems. There is a
submission n. compliance with or surrender to pattern of repeated substance ingestion resulting
the requests, demands, or will of others. Com- in tolerance, withdrawal symptoms if use is sus-
pare dominance; assertiveness. pended, and an uncontrollable drive to continue
submissiveness n. a tendency to comply with use. dsm–iv–tr identifies 10 drug classes associ-
the wishes or obey the orders of others. —sub- ated with dependence: alcohol, amphetamines,
missive adj. cannabis, cocaine, hallucinogens, inhalants, nic-
otine, opioids, phencyclidines, and sedatives,
subscale n. a scale that taps some specific con-
hypnotics, or anxiolytics. This term currently is
stituent or otherwise differentiated category of
preferred over the equivalent addiction. See
information as part of a larger, overall scheme.
also substance abuse.
For example, the current version of the wechs-
ler adult intelligence scale consists of substance-induced anxiety disorder cli-
several subscales (or subtests) assessing such cog- nically significant anxiety (e.g., generalized an-
nitive abilities as verbal comprehension, pro- xiety, panic attacks, phobic symptoms, or obses-
cessing speed, and working memory. sive-compulsive symptoms) caused by the direct
substance n. in psychopathology, a drug of physiological effects of exposure to a drug, toxin,
abuse (e.g., alcohol, cannabis, cocaine, an inhal- or other substance. The anxiety symptoms may
ant), a medication (e.g., a sedative or anxiolytic), be associated with substance intoxication (e.g.,
or a toxin that is capable of producing harmful alcohol, amphetamines, caffeine), substance
effects when ingested or otherwise taken into withdrawal (e.g., alcohol, cocaine, sedatives),
the body. See substance-related disorder. medication use (e.g., anesthetics, anticho-
linergics, thyroid medication), or exposure to
substance abuse a pattern of compulsive sub- heavy metals and toxins (e.g., gasoline, paint,
stance use manifested by recurrent significant
carbon dioxide).
social, occupational, legal, or interpersonal ad-
verse consequences, such as repeated absences substance-induced mood disorder in
from work or school, arrests, and marital difficul- DSM–IV–TR, significant and persistent mood dis-
S ties. dsm–iv–tr identifies nine drug classes turbance (with depressive symptoms, manic
associated with abuse: alcohol, amphetamines, symptoms, or both) believed to be caused di-
cannabis, cocaine, hallucinogens, inhalants, opi- rectly by the physiological effects of a substance,
oids, phencyclidines, and sedatives, hypnotics, which may be a drug of abuse, a medicinal drug,
or anxiolytics. This diagnosis is preempted by or a heavy metal or toxin (e.g., gasoline, paint,
the diagnosis of substance dependence: If the an organophosphate insecticide). When caused
criteria for substance abuse and substance de- by a drug of abuse, the mood disturbance must
pendence are both met, only the latter diagnosis occur during or within a month of intoxication
is given. or withdrawal and must be more severe than
Substance Abuse and Mental Health that normally experienced as part of a sub-
Services Administration (SAMHSA) an stance intoxication or substance with-
agency of the U.S. Department of Health and drawal syndrome. Medications that can cause
Human Services (HHS), established in 1992, mood disturbance include antihypertensives,
charged with improving the quality and avail- steroids, psychotropic drugs, and many others.
ability of prevention, treatment, and rehabilita- substance-induced persisting amnestic
tive services in order to reduce illness, death, disorder a disturbance in memory due to the
disability, and cost to society resulting from sub- persisting effects of a substance (see amnestic
stance abuse and mental illness. SAMHSA has disorder). The ability to learn new information
three program divisions: the Center for Mental or to recall previously learned information is im-
566
subthalamus
paired severely enough to interfere markedly also has a role in sexual behavior and has been
with social or occupational functioning and implicated in the regulation of mood.
torepresent a significant decline from a previous
substance-related disorder any of various
level of functioning. See alcohol-induced
disorders caused by the effects of a drug or
persisting amnestic disorder; sedative-, hyp-
a toxin. This dsm–iv–tr category encompasses
notic-, or anxiolytic-induced persisting am-
the substance use disorders (substance abuse and
nestic disorder.
substance dependence) and the substance-
substance-induced persisting dementia induced disorders (e.g., intoxication).
multiple cognitive deficits due to the persist-
substance withdrawal a syndrome that de-
ing effects of substance abuse. The most notable
velops after cessation of prolonged, heavy con-
feature is impaired memory, but there may also
sumption of a substance. Symptoms vary by
be aphasia (impaired expression or understand-
substance but generally include physiological,
ing of language), apraxia (inability to perform
behavioral, and cognitive manifestations, such
skilled or complex movements), agnosia (im-
as nausea and vomiting, insomnia, mood alter-
paired ability to interpret sensations correctly),
ations, and anxiety. dsm–iv–tr identifies six
and executive dysfunction. See also alco-
drug classes associated with withdrawal: alcohol,
hol-induced persisting dementia.
amphetamines, cocaine, nicotine, opioids, and
substance-induced psychotic disorder sedatives, hypnotics, or anxiolytics.
prominent hallucinations or delusions due to
substantia nigra a region of gray matter in the
the direct physiological effects of a substance.
midbrain, named for its dark pigmentation, that
Also called hallucinosis. See alcohol-induced
sends dopaminergic neurons to the basal gan-
psychotic disorder; amphetamine-induced
glia. Depletion of dopaminergic neurons in this
psychotic disorder; cannabis-induced psy-
region is implicated in parkinson’s disease.
chotic disorder; hallucinogen-induced psy-
chotic disorder. substitute formation see symptom forma-
substance intoxication a reversible syn- tion.
drome due to the recent ingestion of a specific substituting n. in group therapy, providing
substance, including clinically significant be- social support by such behavior as a smile, a pat,
havioral or psychological changes, as well as one or a hug, rather than by words.
or more signs of physiological involvement. Al-
substitution n. the replacement of one thing
though symptoms vary by substance there are
with another. More specifically, particularly in
some common manifestations, for example, per-
psychoanalytic theory, it denotes the replace-
ceptual disturbances; mood changes; impair-
ment of unacceptable emotions or unattainable
ments of judgment, attention and memory;
goals with alternative satisfactions or feelings.
alterations of heartbeat and vision; and speech
Substitution may be viewed as a positive adapta-
and coordination difficulties. dsm–iv–tr iden-
tion or solution (e.g., adoption when one cannot
tifies 10 drug classes associated with intoxica-
have a child of one’s own) or as a negative,
tion: alcohol, amphetamines, caffeine, canna-
maladaptive response (e.g., emotional eating
bis, cocaine, hallucinogens, inhalants, opioids,
after a frustrating day at the office). See also de-
phencyclidines, and sedatives, hypnotics, or
fense mechanism.
anxiolytics.
substrate n. 1. a basis or foundation, such as the
substance intoxication delirium a revers-
physical medium on which an animal or plant
ible substance-specific syndrome that develops
lives or grows. 2. a chemical compound that is
over a short period of time (usually hours to
days) following heavy consumption of the sub-
acted on by an enzyme. The substrate binds spe- S
cifically to the enzyme’s active site, thereby low-
stance. It includes disturbance of consciousness
ering the energy required for the reaction, which
(e.g., reduced ability to focus, sustain, or shift at-
therefore can proceed much faster. When the
tention), accompanied by changes in cognition
process is over, the enzyme is unchanged but the
(e.g., memory deficit, disorientation, or lan-
substrate has been changed into different mole-
guage disturbance) in excess of those usually as-
cules called reaction products. The released en-
sociated with intoxication with that substance.
zyme then repeats the process with another
See alcohol intoxication delirium; am-
substrate of the same composition.
phetamine intoxication delirium; cocaine
intoxication delirium; pcp intoxication subthalamic nucleus a part of the sub-
delirium. thalamus that receives fibers from the globus
pallidus as a part of the descending pathway
substance P a neuropeptide that functions as a
from the basal ganglia. It forms part of the
neurotransmitter in both peripheral and central
extrapyramidal tract.
nervous systems. It belongs to the neurokinin
family of transmitters. High concentrations of subthalamus n. a part of the diencephalon of
neurons containing substance P are localized in the brain, wedged between the thalamus and
the dorsal horn of the spinal cord, where they the hypothalamus. It contains the subthalamic
play a role in the modulation of pain. In periph- nucleus and functions in the regulation of move-
eral tissues, substance P acts as a vasodilator. It ments controlled by skeletal muscles, together
567
subtherapeutic dose
with the basal ganglia and the substantia beliefs, attitudes, or actions of others are readily
nigra. —subthalamic adj. and uncritically adopted. 2. an occasional syn-
subtherapeutic dose a dose of a drug that onym for hypnotic susceptibility.
does not achieve a particular therapeutic effect. suggestion n. 1. the process of inducing accep-
Although this is generally not desired, drugs in- tance of an idea or course of action in an ind-
tended for one purpose may be administered ividual through indirect means. Suggestion is
in subtherapeutic doses to achieve a different usually expressed in words but may also be picto-
effect. For example, the tricyclic antidepres- rial, as in advertisements, or subliminal. 2. an
sants are rarely used in current practice in doses idea or potential course of action presented to
sufficient to alleviate depression; however, they another for consideration. See also autosug-
are often used in low (subtherapeutic) doses to gestion; prestige suggestion.
promote sleep or alleviate pain. suggestion therapy a type of psychotherapy
successful aging avoidance of disease and disin which distressing symptoms are alleviated by
ability, maintenance of cognitive capacity, con- direct suggestion and reassurance. The tech-
tinued active engagement in life, and adaptation nique is sometimes used in hypnotherapy. A
to the aging process through such strategies as suggestion may be accompanied by an explana-
selective optimization with compensation. tion of the meaning and the purpose of the
succinimide n. any of a group of chemically re- symptoms, but no attempt is made to modify the
lated drugs that are effective in the treatment of client’s basic personality.
absence seizures. Discovered in a search for an suicidal crisis a situation in which suicide is
antidote for drug-induced convulsions, they threatened or attempted.
produce a sedative effect and may cause behav- suicidal gesture an attempted suicide or
ioral changes. Ethosuximide is an example of a similar self-destructive behavior, especially one
succinimide and is sold in the United States where the risk of death is quite low.
under the trade name Zarontin.
suicidal ideation suicidal thoughts or a preoc-
succinylcholine n. a drug that relaxes skeletal cupation with suicide, often as a symptom of a
muscles, used intravenously in anesthesia and major depressive episode. Most instances of
before electroconvulsive treatment. It is a neu- suicidal ideation do not progress to attempted
romuscular blocking agent that does not relieve suicide.
pain or produce sedation. U.S. trade name
(among others): Anectine. suicidality n. the risk of suicide, usually indi-
cated by suicidal ideation or intent.
succorance need in the personology of U.S.
psychologist Henry Alexander Murray (1893– suicide n. the act of killing oneself. Frequently,
1988), the need for protection, aid, and support. suicide occurs in the context of a major depres-
sive episode, but it may also occur as a result of a
sucking reflex a basic reflex in which the
substance-use or other disorder. It sometimes oc-
young of many mammals (including human in-
curs in the absence of any psychiatric disorder,
fants) grasp the nipple with their lips and draw
especially in untenable situations, such as be-
milk into their mouths by suction.
reavement or declining health. See also at-
sudden infant death syndrome (SIDS) the tempted suicide; passive suicide. —suicidal
sudden and unexpected death of a seemingly adj.
healthy infant during sleep for no apparent rea-
suicide attempt see attempted suicide.
son. The risk of SIDS is greatest between 2 and 6
months of age and is a common cause of death suicide-prevention center a crisis-inter-
in infants less than 1 year old. Also called cot vention facility dealing primarily with individ-
S uals who have suicidal thoughts or who have
death; crib death.
threatened or attempted suicide. Suicide-pre-
sudden insight sudden knowledge or under-
vention centers are usually staffed by social
standing of the truth or essential nature of some-
workers or paraprofessionals with mental health
thing, for example, a problem, an issue, or a
preparation who are trained to deal with such
complex situation. See aha experience; dis-
emergencies in person or over a telephone
continuity hypothesis; eureka task; inspira-
hotline. Suicide-prevention centers additionally
tion.
provide community education and outreach,
sufentanil n. a short-acting opioid that binds and staff may provide bereavement support for
to opioid receptors and is used as an analgesic the relatives and loved ones of an individual
supplement in the maintenance of balanced who has killed himself or herself.
general anesthesia. See also fentanyl. U.S. trade
name: Sufenta.
suicidology n. a multiprofessional discipline de-
voted to the study of suicidal phenomena and
suffering n. the experience of pain or acute dis- their prevention. Major groups involved are (a)
tress, either psychological or physical, in re- scientists (epidemiologists, sociologists, statisti-
sponse to a significant event, particularly one cians, demographers, and social psychologists),
that is threatening or involves loss (e.g., the (b) clinicians (clinical psychologists, psychia-
death of a loved one) or a physical trauma. trists, social workers, trained volunteers, and
suggestibility n. 1. a state in which the ideas, members of the clergy), and (c) educators (public
568
superstitious control
health educators and school and college person- vices must be used in rooms that are screened
nel). from all outside magnetic sources. They are use-
sukra prameha a culture-bound syndrome ful in the study of in vivo human brain pro-
found in Sri Lanka, with symptoms similar to cesses.
those of shen-k’uei. superconscious n. 1. a New Age term for trans-
suk-yeong n. see koro. personal awareness. 2. in certain Eastern trad-
itions, with variation (Buddhism; Hinduism;
Sullivan’s interpersonal theory a theory Taoism), a state in which the individual attains
that emphasizes social influences on develop- highest knowledge, freedom from pain, and per-
ment, focusing on key relationships and how fect spiritual insight because the mind is free
they develop and change over time. It proposes from passion and desire. At their most profound
that an individual’s concept of selfhood is a re- level, the practices of meditation and yoga
flection of others’ attitudes toward that person (among others) may be directed toward the ulti-
(i.e., arising out of interpersonal relationships mate achievement of the superconscious state.
and situations) and posits that, although per-
sonal self-concept develops slowly, the need for superego n. in psychoanalytic theory, the moral
personal security is present from the beginning component of the personality that represents so-
of existence. Sullivan hypothesized that threats ciety’s standards and determines personal stan-
to self-respect are experienced as anxiety and dards of right and wrong, or conscience, as well
that assaults on self-esteem emanate from as aims and aspirations (see ego-ideal). In the
sources outside the person, particularly those classic Freudian tripartite structure of the psy-
most intimately related to the individual across che, the ego, which controls personal impulses
early and adolescent development. The theory and directs actions, operates by the rules and
proposes three phases of relationship develop- principles of the superego, which basically stem
ment: (a) during preadolescence, intimacy with from parental demands and prohibitions. The
a same-sex friend; (b) in early adolescence, formation of the superego occurs on an uncon-
changes from same-sex cliques to mixed-sex scious level, beginning in the first 5 years of life
cliques; (c) in late adolescence, full participation and continuing throughout childhood and ado-
in intimate reciprocal relationships with a ro- lescence and into adulthood, largely through
mantic partner. [Harry Stack Sullivan (1892– identification with the parents and later with
1949), U.S. psychiatrist] admired models of behavior. See also hetero-
nomous superego; primitive superego.
sumatriptan n. see triptans.
superego anxiety in psychoanalytic theory,
summa libido see acme. anxiety caused by unconscious superego activity
summative evaluation 1. in educational that produces feelings of guilt and demands for
evaluation research, the appraisal of a student’s atonement. Compare ego anxiety; id anxiety.
achievement at the conclusion of an educational superego resistance in psychoanalytic theory,
program. Also called terminal assessment. 2. a type of resistance to the psychoanalytic pro-
in evaluation research, an attempt to assess the cess created by the superego. It generates a sense
overall effectiveness of a program after it is in op- of guilt and gives rise to the need for punish-
eration (in contrast to formative evaluation, ment in the form of persistent symptoms. Com-
which is used to help in the development of the pare repression-resistance; id resistance.
program). Also called ex post facto evalua-
tion. See also outcome evaluation. superego sadism in psychoanalytic theory, the
aggressive, rigid, and punitive aspect of the su-
summer depression an atypical variant of sea- perego, or conscience. Its energy is derived from
sonal affective disorder in which major de- the destructive forces of the id, and its intensity S
pressive episodes tend to occur in the summer and strength are dependent upon the violent
months. and sadistic fantasies of the child’s primordial
sum of squares the total obtained by adding strivings. See sadism.
together the squares of each deviation score superior function in the analytic psychol-
in a sample (i.e., each score minus the sample ogy of Carl jung, the dominating function
mean squared, and then added _ together)._ Thus, among the four basic functions—seeing, think-
2
for a set of variables Xi , Σ(Xi – X) , where X is the ing, intuiting, and feeling—that rules the con-
mean value of Xi. scious ego and dominates the other three, which
sundown syndrome the tendency, particu- become inferior functions in the uncon-
larly among older adults with dementia or indi- scious. The superior function determines the
viduals in institutional care, to experience functional type of the individual.
reduced levels of psychological functioning late superiority complex in the individual psy-
in the day. Also called sundowning. chology of Alfred adler, an exaggerated opin-
suo yang see koro. ion of one’s abilities and accomplishments that
superconducting quantum interference derives from an overcompensation for feelings
device (SQUID) a device used in magneto- of inferiority. See compensation. Compare in-
encephalography for detecting magnetic feriority complex.
waves in the brain. These highly sensitive de- superstitious control the illusion that one
569
supervalent thought
can influence outcomes through various prac- supported living a situation in which people
tices designed to protect oneself, alter the envi- with mental retardation live singly or in small
ronment, or affect a situation. Such practices groups in apartments or houses (usually rented
include following specific behavior patterns and but sometimes leased or purchased) where drop-
rituals. Some people maintain that superstitious in assistance in performing activities of daily liv-
control serves a positive psychological function ing and learning independent living skills is
in averting the development of learned help- available. Varying degrees of assistance are pro-
lessness. See faith healing; magical think- vided by staff, depending on the skills of the par-
ing. ticular residents.
supervalent thought an extreme preoccupa- supported retirement a daily or regular pro-
tion with a single topic. See obsession; rumina- gram or schedule of activity for an aging or aged
tion. person with mental retardation that emphasizes
supervised analysis see control analysis. socialization and recreational engagement,
supervision n. oversight: critical evaluation and rather than the habilitation activities and voca-
guidance provided by a qualified and experi- tional involvement typical of adult mental retar-
enced person—the supervisor—to another indi- dation day services.
vidual—the trainee—during the learning of a support group a group similar in some ways to
task or process. In psychotherapy and coun- a self-help group, in that members who share a
seling, supervision by a senior therapist or problem come together to provide help, com-
counselor is required while the trainee learns fort, and guidance. A primary distinguishing fea-
therapeutic techniques. A prescribed number of ture of support groups is in their leadership: a
hours of supervision is required by state licens- professional or agency-based facilitator who
ing boards as part of the requirements for obtain- often does not share the problem of members. In
ing a license in a mental health field. addition, support groups often last for only a
supervisory analysis see control analysis. limited predetermined number of sessions, and a
supervisory attentional system (SAS) a fee for attendance is sometimes charged.
theoretical higher level cognitive mechanism ac- supportive ego a member of an activity-
tive in nonroutine or novel situations, responsi- therapy group who helps a fellow member work
ble for troubleshooting and decision making out difficulties within his or her psyche, mind,
when habitual responses or automatic processes or personality. [first described by Russian-born
are ineffective or otherwise unsatisfactory. U.S. psychotherapist Samuel Richard Slavson
Thought to be involved in carrying out a variety (1890–1981)]
of other executive functions as well, it is con-
supportive-expressive psychotherapy a
sidered a network for the coordination and
form of brief psychodynamic psychotherapy
control of cognitive activity and intentional be-
that focuses on the therapist–client relationship
havior.
and on relationships outside of therapy to define
supplementary motor area an area of the a central relationship pattern that is the focus of
motor cortex with somatotopic organization treatment. [developed by U.S. clinical psycholo-
involved in planning and learning new move- gists Lester Luborsky (1920–2009) and Paul
ments that have coordinated sequences. In con- Crits-Christoph]
trast to the premotor area, neuronal input to
the supplementary motor area is triggered more supportiveness n. in psychotherapy and coun-
by internal representations than by external seling, an attitude or response of acceptance, en-
events. couragement, or reassurance displayed by the
S supplication n. in self-presentation theory, a
therapist or counselor.
strategy that involves depicting oneself as weak, supportive psychotherapy a form of therapy
needy, or dependent, so as to motivate others to that aims to relieve emotional distress and symp-
provide assistance or care. —supplicate vb. toms without probing into the sources of con-
supported employment a vocational re- flicts or attempting to alter basic personality
habilitation program that places individuals structure. Specific methods used include reassur-
with disabilities directly into the paid competi- ance, reeducation, advice, persuasion, environ-
tive working environment as quickly as possible. mental changes, pastoral counseling, bereave-
With an emphasis on matching an individual ment therapy, bibliotherapy, remotivation, and
with an appropriate employer and work envi- encouragement of desirable behavior. Such mea-
ronment rather than adapting the person to the sures are frequently applied to individuals
environment, it involves individualized, rapid with relatively minor or limited problems, as
placement and ongoing support, training, and well as to fragile or hospitalized patients, as a
assessment that integrates both vocational and means of maintaining morale and preventing
personal needs. Supported employment differs deterioration.
from a sheltered workshop in that the latter supportive services 1. programs ancillary to
occurs in a controlled, noncompetitive working the treatment or rehabilitation of people with ill-
environment. See also transitional employ- nesses or disabilities. 2. social service programs
ment. (e.g., child care or transportation) that are neces-
570
swinging
sary to enable an individual to participate in the law or a regulation permitting the appointment
workforce or function more independently. of a surrogate for a person, frequently a person
suppository n. a bullet-shaped medicinal prepa- with mental retardation, dementia, or a mental
ration for rectal administration. It dissolves in disorder, who is not competent to make specific
the rectum to release its active component, decisions regarding consent to medical, surgical,
which is absorbed through the rectal mucosa. or other health care procedures. The surrogate
Vaginal suppositories are available for treating makes these determinations on behalf of the per-
gynecological conditions. son.
suppression n. a conscious effort to put disturb- surrogate father see father surrogate.
ing thoughts and experiences out of mind, or to surrogate mother see mother surrogate.
control and inhibit the expression of unaccept- survival instinct see self-preservation in-
able impulses and feelings. It is distinct from the stinct.
unconscious defense mechanism of repres-
survivor guilt remorse or guilt for having sur-
sion in psychoanalytic theory. —suppress vb.
vived a catastrophic situation when others did
suppressive therapy a form of psychotherapy not or for not suffering the ills that others had to
directed toward the reinforcement of the client’s endure. It is a common reaction stemming in
defense mechanisms and the suppression (rather part from a feeling of having failed to do enough
than expression) of distressing experiences and to prevent the tragedy or to save those who did
feelings. Compare expressive therapy. not survive. Survivor guilt is also experienced by
surface dyslexia a form of acquired dyslexia family members who are found not to carry dele-
(see alexia) in which a person is overly reliant terious genetic mutations that have led to dis-
on spelling-to-sound correspondence and there- ease and, often, death in other family members
fore has difficulty reading irregularly spelled or simply by family or friends who feel that they
words. Surface dyslexia manifested as a form of did not do enough to succor their loved ones
developmental dyslexia has also been de- prior to death.
scribed. See also deep dyslexia. [first described survivorship n. 1. the state of having a typical
in 1973 by British neuropsychologists John C. life and life span after overcoming severe dis-
Marshall and Freda Newcombe (1925–2001)] eases (e.g., cancer), traumatic life events (e.g.,
surface therapy psychotherapy directed to- child abuse), or environmental disaster (e.g.,
ward relieving the client’s symptoms and earthquake). 2. the state of living into very old
emotional stress through such measures as reassur- age.
ance, suggestion, and direct attempts to modify susceptibility n. vulnerability: readily affected
attitudes and behavior patterns, rather than by or at increased risk of acquiring a particular
through exploration and analysis of uncon- condition, such as an infection, injury, or disor-
scious motivation and underlying dynamics. der.
Compare depth therapy. suspiciousness n. an attitude of mistrust to-
surface trait in cattell’s personality trait ward the motives or sincerity of others. Al-
theory, a characteristic manifested as a group of though a degree of suspiciousness in certain
interrelated observable behaviors. For example, situations can be natural and likely serves the pur-
arriving early for appointments and leaving the poses of self-preservation or survival, extreme,
office only after one’s work is complete are visi- pervasive suspiciousness is a common character-
ble verifications of the characteristic of conscien- istic of individuals with paranoid personality
tiousness. Surface traits appear consistently and disorder.
are thought to cluster and form source traits, sustained operations (SUSOPS) an extended S
which are regarded as the underlying building work schedule under demanding conditions. A
blocks of personality. sustained workload can combine with fatigue
surgency n. in trait psychology, a personality and reduced or fragmented sleep to degrade per-
trait marked by cheerfulness, responsiveness, formance, productivity, safety, and the effective-
spontaneity, and sociability, but at a level below ness of an operation.
that of extraversion or mania. [defined by sustained-release preparation see slow-
British psychologist Raymond Cattell (1905– release preparation.
1998)] —surgent adj. susto n. a culture-bound syndrome occurring
surprise n. an emotion typically resulting from among Latinos in the United States and popula-
the violation of an expectation or the detection tions in Mexico, Central America, and South
of novelty in the environment. According to var- America. After experiencing a frightening event,
ious theories, it is considered to be one of the individuals fear that their soul has left their
emotions that have a universal pattern of facial body. Symptoms include weight loss, fatigue,
expression. The physiological response includes muscle pains, headache, diarrhea, unhappiness,
raising or arching the eyebrows, opening the troubled sleep, lack of motivation, and low self-
eyes wide, opening the mouth wide in an oval esteem. Also called chibih; espanto; pasmo;
shape, and gasping. perdida del alma; tripa ida.
surrogate decision making a provision in swinging n. slang for uninhibited sexual expres-
571
switching
sion, for example, partner swapping, one-night ited to any of these meanings in particular. Carl
stands, group sex, and experimentation with jung maintained that the symbols of religion,
sexual activities. mythology, and art throw special light on the ra-
switching n. 1. in psychotherapy, changing the cial unconscious. See also sign. 2. in psychoana-
course of the discussion during a session. This lytic theory, a disguised representation of a
may be done by the client, either purposefully or repressed idea, impulse, or wish. See also sym-
unconsciously, when the discussion is too close bolism. —symbolic adj.
to sensitive issues. Switching may also be done Symbolic n. the realm of symbols or signifiers:
by the therapist to change the discussion to one of three aspects of the psychoanalytic field
more relevant therapeutic issues. 2. in multiple defined by French psychoanalyst Jacques Lacan
personality disorders, the often rapid movement (1901–1981). The achievement of symbolization
between one personality and another. marks the beginning of ego differentiation and is
switch process the process by which a person associated with the infant’s entrance into the
with a bipolar disorder experiences the transi- world of language, culture, law, and morality.
tion from a major depressive episode to a The other two realms are the imaginary and the
manic episode or vice versa. These processes real. See also mirror phase; name-of-the-
usually include brief periods of relatively unim- father.
paired functioning. symbolic action see symptomatic act.
symbiosis n. 1. in developmental psychology, symbolic consciousness awareness of events
the stage in infantile development when the in- whose meaning goes beyond their sensory con-
fant’s dependence is total and he or she is nei- tents.
ther biologically nor psychologically separated symbolic displacement the process of trans-
from the mother. See also separation–individ- ferring a response, usually emotional, from its
uation. [proposed by Hungarian-born U.S. psy- original stimulus to one that represents it. For
choanalyst Margaret S. Mahler (1897–1985)] 2. a example, a man who harbors homicidal im-
mutually reinforcing relationship in which one pulses might develop a morbid fear of knives or
individual is overdependent on another to sat- guns.
isfy needs. Such a relationship hampers the de-
symbolic interactionism a sociological the-
velopment or independence of both individuals
ory that assumes that self-concept is created
and usually results in dysfunction when the
through interpretation of symbolic gestures,
dominant individual is unwilling to provide for
words, actions, and appearances exhibited by
the dependent individual. Also called symbi-
others during social interaction. In contrast to
otic relationship. —symbiotic adj.
Freudian and other approaches that postulate
symbiotic infantile psychosis see symbi- extensive inner dispositions and regard social in-
otic psychosis. teraction as resulting from them, symbolic
symbiotic marriage a marriage or partnership interactionists believe that inner structures re-
of two individuals who are dependent upon each sult from social interactions. U.S. social thinkers
other for the gratification of certain psychologi- George Herbert Mead (1863–1931) and Charles
cal needs. Both partners may have neurotic or Horton Cooley (1864–1929) are recognized ex-
otherwise unusual needs that could not be satis- ponents of this view. See reflected appraisals.
fied easily outside of their relationship. Compare symbolic play a form of play in which the child
synergic marriage. uses objects as representations of other things.
symbiotic psychosis an obsolete name for a For example, a child may put a leash on a stuffed
condition, occurring in children between the animal, take it for a walk, and make it eat from a
S ages of 2 and 5, that is characterized by complete bowl. Symbolic play may or may not be social.
emotional dependence on the mother, inability See also imaginary companion.
to tolerate separation from her, reactions of symbolic process 1. in cognitive psychology,
anger and panic if any separation is threatened, any cognitive activity in which ideas, images, or
and developmental lag. Some of these features other mental representations serve as media-
are characteristic of separation anxiety dis- tors of thought. The term is often used to dis-
order. Also called symbiotic infantile psy- tinguish the higher mental processes from
chosis; symbiotic infantile psychotic either (a) lower cognitive functions, such as per-
syndrome. [first described by Hungarian-born ception, or (b) those neurophysiological pro-
U.S. psychoanalyst Margaret Mahler (1897– cesses that underlie processing at the symbolic
1985)] level. See also symbolic thinking; thinking.
symbiotic relationship see symbiosis. 2. in psychoanalysis, any operation in which a
symbol n. 1. any object, figure, or image that rep- symbol is substituted for a repressed thought or
resents something else, such as a flag, a logo, a impulse. See also symbolization.
pictogram, or a religious symbol (e.g., a cross). In symbolic realization the fulfillment of a
literature and art, symbols are generally sugges- blocked desire or goal through a substitute that
tive rather than explicit in their meaning: For ex- represents it. For example, a person who has not
ample, a rose may suggest ideas of beauty, love, been able to rebel against an authoritarian father
femininity, and transience without being lim- may rebel against all symbols of authority, such
572
symptomatic act
as the laws or customs of the society in which he sympathetic nervous system one of the two
or she lives. divisions of the autonomic nervous system
symbolic representation the process of rep- (ANS, which controls smooth muscle and gland
resenting experiences in the mind symbolically, functions), the other being the parasympa-
for example, through words and sounds: one thetic nervous system. Anatomically it con-
of three modes of representing knowledge. sists of preganglionic autonomic neurons whose
[proposed by U.S. developmental psychologist fibers run from the thoracic and lumbar regions
Jerome Seymour Bruner (1915– )] of the spinal cord to the chains of sympathetic
ganglia. From these arise the fibers of post-
symbolic reward something that has no in- ganglionic autonomic neurons, which innervate
trinsic value but is nevertheless prized because it organs ranging from the eye to the reproductive
represents something of value. For example, organs. It is defined functionally in terms of its
being listed in a city’s social register may be re- ability to act as an integrated whole in affecting
garded as a symbolic reward for attainment of a large number of smooth muscle systems simul-
high social standing. taneously, usually in the service of enhanc-
symbolic thinking the ability to think about ing “fight or flight” (see fight-or-flight
objects and events that are not within the imme- response). Typical sympathetic changes include
diate environment. It involves the use of signs, dilation of the pupils to facilitate vision, con-
symbols, concepts, and abstract relations, as evi- striction of the peripheral arteries to supply
denced by language, numeracy, and artistic or more blood to the muscles and the brain, secre-
ritual expression. Archaeological finds suggest tion of epinephrine to raise the blood-sugar level
that symbolic thinking may have evolved in hu- and increase metabolism, and reduction of
mans much earlier than previously thought, stomach and intestinal activities so that energy
possibly toward the end of the Lower Paleolithic can be directed elsewhere. Thus, the sympathetic
(i.e., over 70,000 years ago). See also symbolic nervous system tends to antagonize the effects of
process. the parasympathetic nervous system. Also called
symbolism n. 1. in psychoanalytic theory, the sympathetic division.
substitution of a symbol for a repressed impulse sympathetic vibration a state in which the
or threatening object in order to avoid censor- thoughts and feelings of two or more people are
ship by the superego (e.g., dreaming of a steeple in harmony.
or other phallic symbol instead of a penis). sympathism n. see sympathy seeking.
Also called symbolization. 2. the use of sym- sympathomimetic drug any pharmacologi-
bols in literature and the visual arts or in human cal agent that stimulates activity in the sympa-
culture generally. A specific, early modernist thetic nervous system because it potentiates the
movement, referred to as Symbolism, developed activity of norepinephrine or epinephrine or has
in France in the mid- to late 19th century. The effects similar to these neurotransmitters (hence
writing, primarily poetry and drama, was highly they are also known as adrenergic drugs).
evocative and made extensive use of indirect Sympathomimetic drugs include the amphet-
symbolic language to represent character, situa- amines and ephedrine.
tion, and action.
sympathy n. 1. feelings of concern or compas-
symbolization n. 1. see symbolism. 2. in Al- sion resulting from an awareness of the suffering
bert bandura’s social-cognitive theory, the or sorrow of another. 2. more generally, a capac-
ability to think about one’s social behavior in ity to share in and respond to the concerns or
terms of words and images. —symbolize vb. feelings of others. See also empathy. 3. an affin-
Symmetrel n. a trade name for amantadine. ity between individuals on the basis of similar S
symmetry compulsion a compulsion to ar- feelings, inclinations, or temperament. —sym-
range objects in a certain way (e.g., in a room) pathetic adj. —sympathize vb.
or in a particular order (e.g., on a desk). Symme- sympathy seeking the tendency to seek emo-
try compulsion is associated with obsessions tional support or elicit the assistance of others by
about neatness or perfection. It can be a symp- arousing sympathy. Also called sympathism.
tom of obsessive-compulsive disorder or, symphorophilia n. sexual interest and arousal
sometimes, of obsessive-compulsive person- derived from stage-managing the occurrence of a
ality disorder. disaster and then watching it. The person may
sympathectomy n. a surgical procedure in masturbate either while the disaster occurs or af-
which portions of the sympathetic nervous terward, with memories or pictures of the event.
system are excised, severed, or otherwise dis- —symphorophile n.
rupted. In chemical sympathectomy, this is ac- symptom n. any deviation from normal func-
complished by the administration of specific tioning that is considered indicative of physical
drugs. or mental disorder. A recognized pattern of
sympathetic induction the process in which symptoms is usually necessary in order for an in-
one person’s expressed emotion elicits a similar dividual to be judged as having a syndrome or
emotion in another person. See empathy; sym- psychological disorder. —symptomatic adj.
pathy. symptomatic act an action that appears to be
573
symptomatic treatment
intended for one purpose (or to have no particu- cleared up as a result of treatment. It is said to
lar purpose) but that betrays a hidden intention occur if the unconscious impulses and conflicts
or meaning. In psychoanalytic theory, such acts responsible for the original symptom are not
are thought to represent repressed impulses. See dealt with. Symptom substitution is often used
also freudian slip; parapraxis; symptom for- as an argument against therapies aimed at symp-
mation. tom removal alone, as in behavior therapy, sug-
symptomatic treatment treatment directed gestion, and some forms of hypnotherapy;
toward the relief of distressing symptoms, as op- however, this hypothesis has not been validated.
posed to treatment focused on underlying causes Synanon n. a residential drug treatment pro-
and conditions. Symptomatic treatment of gram that utilized confrontation and peer pres-
chronic migraines, for example, would involve sure to encourage its members to deal with their
the use of analgesics to relieve pain without at- addiction. Founded in California in 1958 by
tempting to discover why they are occurring. Charles Dederich (1914–1997), himself a recov-
symptomatology n. 1. the combined signs, ering alcoholic, Synanon was the first major
markers, or indications of a disease or disorder. drug treatment program in the United States,
2. the scientific study of the markers and indica- and its tough love approach to overcoming ad-
tions of a disease or disorder. diction was widely publicized as innovative and
effective. It evolved into an experimental com-
symptom bearer see identified patient.
mune that Dederich proclaimed as a religion in
Symptom Checklist-90-Revised (SCL-90- the mid-1970s. Thereafter, amid accusations of
R) a 90-item self-report inventory that measures authoritarian practices within the community
the psychological symptoms and distress of and Dederich’s no-contest plea to charges of at-
community, medical, and psychiatric respon- tempted murder, Synanon declined in promi-
dents along nine primary symptom dimensions nence and was eventually disbanded in 1991.
and three global indices. The SCL-90-R adds four
synapse n. the specialized junction through
dimensions to the five assessed in the hopkins
which neural signals are transmitted from one
symptom checklist, of which it is a direct out-
neuron (the presynaptic neuron) to another (the
growth: hostility, phobic anxiety, paranoid
postsynaptic neuron). In most synapses the
ideation, and psychoticism.
knoblike ending (terminal button) of the axon of
symptom cluster a group of related symptoms a presynaptic neuron faces the dendrite or cell
that usually occur together, as in a syndrome. body of the postsynaptic neuron across a narrow
symptom complex see syndrome. gap, the synaptic cleft. The arrival of a neural sig-
symptom-context method a system of gath- nal triggers the release of neurotransmitter
ering data as symptoms arise in vivo in the psy- from synaptic vesicles in the terminal button
chotherapy session as an aid to psychotherapy into the synaptic cleft. Here the molecules of
research, case formulation, and treatment. It is neurotransmitter activate receptors in the
similar to the core conflictual relationship postsynaptic membrane and cause the opening
theme method. [developed by U.S. clinical psy- of ion channels in the postsynaptic cell. This
chologist Lester Luborsky (1920–2009)] may lead to excitation or inhibition of the
postsynaptic cell, depending on which ion chan-
symptom formation 1. in psychoanalytic nels are affected. Also called synaptic junc-
theory, the development of a somatic or be- tion. —synaptic adj.
havioral manifestation of an unconscious im-
pulse or conflict that provokes anxiety. Also synaptic bouton see axon.
called substitute formation. 2. the process by synaptic cleft the gap within a synapse be-
S which the indications of physical or psychologi- tween the knoblike ending of the axon of one
cal illness or disease develop. neuron and the dendrite or cell body of a neigh-
symptom removal in psychotherapy, elimina- boring neuron. The synaptic cleft is typically 20–
tion of symptoms through direct treatment 30 nm wide. Also called synaptic gap.
without addressing underlying issues and un- synaptic pruning a neurodevelopmental pro-
conscious motivation. See also surface ther- cess, ocurring both before birth and up to the
apy. second decade of life, in which the weakest
symptom specificity a hypothesis stating that synapses between neurons are eliminated. In
people with psychosomatic disorders display schizophrenia research, it is hypothesized that
abnormal responses to stress in particular physi- premature or excessive pruning may account for
ological systems. According to this hypothesis, a some forms of the disease.
person’s complaints will center around a particu- synaptic transmission see neurotrans-
lar organ (e.g., the heart) and set of related symp- mission.
toms (e.g., cardiovascular symptoms) rather synchronicity n. in the analytic psychology
than involving a variety of complaints about dif- of Carl jung, the simultaneous occurrence of
ferent organs or systems. events that appear to have a meaningful connec-
symptom substitution in the classic psycho- tion when there is no explicable causal relation-
analytic theory of Sigmund freud, the develop- ship between these events, as in extraordinary
ment of a symptom to replace one that has coincidences or purported examples of telepa-
574
systemic
thy. Jung suggested that some simultaneous oc- synthetic opioids see opioid.
currences possess significance through their very syntonia n. a high degree of emotional respon-
coincidence in time. siveness to the environment. —syntonic adj.
synchronized sleep delta-wave sleep, when syphilis n. a contagious disease caused by infec-
electroencephalogram recordings show slow,
tion with the spirochete bacterium Treponema
synchronous waves. See also sleep stages.
pallidum. Syphilis is usually a sexually trans-
syncope n. fainting: a transient loss of conscious- mitted disease, but it can be transmitted
ness resulting from sudden reduction in the through a break or cut in the skin or mucous
blood supply to the brain. —syncopal adj. membrane; it can also be transmitted by an
syndrome n. a set of symptoms and signs that infected pregnant woman to an unborn child.
are usually due to a single cause (or set of related Untreated, syphilis progressively destroys body
causes) and together indicate a particular physi- tissues, particularly those of the heart and ner-
cal or mental disease or disorder. Also called vous system. See also cerebral syphilis; gen-
symptom complex. eral paresis.
synergic marriage a marriage or partnership system n. 1. any collective entity consisting of a
that is enhanced by the contributions the part- set of interrelated or interacting elements that
ners can make in satisfying each other’s psycho- have been organized together to perform a func-
logical needs in a positive manner. Compare tion. 2. an orderly method of classification or
symbiotic marriage. procedure (e.g., the Library of Congress system).
synergism n. the joint action of different ele- 3. a structured set of facts, concepts, and hypoth-
ments such that their combined effect is greater eses that provide a framework of thought or
than the sum of their individual effects, as, for belief, as in a philosophical system. See concep-
example, in drug synergism or sexual syner- tual system. 4. a living organism or one of its
gism. —synergistic adj. major bodily structures (e.g., the respiratory sys-
tem). —systematic adj.
synergy n. the coordination of forces or efforts to
achieve a goal, as when a group of muscles work systematic approach see topographic
together in order to move a limb. Also called model.
coordinative structure. —synergic adj. systematic desensitization a form of behav-
synesthesia n. a condition in which stimulation ior therapy in which counterconditioning
of one sensory system arouses sensations in an- is used to reduce anxiety associated with a partic-
other. For example, sounds (and sometimes ular stimulus. It involves the following stages: (a)
tastes and odors) may be experienced as colors The client is trained in deep-muscle relaxation;
while they are being heard, and specific sounds (b) various anxiety-provoking situations related
(e.g., different musical notes) may yield specific to a particular problem, such as fear of death or a
colors. Research suggests that about one in 2,000 specific phobia, are listed in order from weakest
people regularly experience synesthesia, and to strongest; and (c) each of these situations is
some experts suspect that as many as one in 300 presented in imagination or in reality, beginning
people have some variation of the condition. with the weakest, while the client practices mus-
Also called concomitant sensation; second- cle relaxation. Since the muscle relaxation is
ary sensation. incompatible with the anxiety, the client gradu-
ally responds less to the anxiety-provoking situ-
syntaxic mode the highest stage in experienc-
ations. See also covert desensitization; in
ing the world, characterized by consensual
vivo desensitization; reciprocal inhibition.
validation, the development of syntaxic think-
[introduced by South African-born U.S. psychol-
ing, and the expression of ideas in a commonly
ogist Joseph Wolpe (1915–1997)] S
accepted language. [defined by U.S. psychiatrist
Harry Stack Sullivan (1892–1949)] systematic error an error in data or in a con-
clusion drawn from the data that is regular and
syntaxic thinking the highest level of cogni-
repeatable as a result of improper collection
tion, which includes logical, goal-directed, real-
methods or statistical treatment of the data.
ity-oriented thinking. [defined by U.S.
psychiatrist Harry Stack Sullivan (1892–1949)] systematic rational restructuring a sys-
syntaxis n. a way of thinking and communicat- tem of psychotherapy in which the client is
ing that is logical and based on reality. See encouraged to imagine anxiety-provoking situa-
syntaxic mode; syntaxic thinking. —syn- tions while talking about them in a realistic
taxic adj. manner that reduces his or her anxieties. See also
implosive therapy.
synthesis n. the bringing together of disparate
parts or elements—whether they be physical systematized delusion a false, irrational be-
or conceptual—into a whole. For example, lief that is highly developed and organized, with
biosynthesis is the process by which chemical multiple elaborations that are coherent, consis-
or biochemical compounds are formed from tent, and logically related. Compare fragmen-
their constituents and mental synthesis involves tary delusion.
combining ideas and images into meaningful systemic 1. adj. concerning or having impact on
objects of thought. —synthetic adj. an entire system. For example, a systemic disor-
575
systemic lupus erythematosus
der affects an entire organ system or the body as systems of support a framework for identify-
a whole. 2. n. the interplay of reciprocal pro- ing the nature and profile of services and
cesses between interactional partners, as in a supports required by a person with mental retar-
family. dation. This is based on considerations of in-
tellectual functioning and adaptive skills,
systemic lupus erythematosus (SLE) see psychological and emotional factors, physical
lupus erythematosus. health and etiological factors, and environmen-
systemic mucopolysaccharidosis see ma- tal or situational factors.
roteaux–lamy syndrome. systems theory see general systems theory.
576
Tt
T3 abbreviation for triiodothyronine. Tactile Form Perception a test in which par-
T4 abbreviation for thyroxine. ticipants use one hand to feel a geometric figure
made of sandpaper, which is hidden from view,
TA abbreviation for transactional analysis.
and then identify it from among a set of 12 draw-
tabanka (tabanca) n. a culture-bound syn- ings. There is a total of 20 geometric figures; 10
drome found in Trinidad, with symptoms that are presented to one hand and 10 to the other.
include depression associated with a high rate of The test assesses nonverbal tactile information-
suicide. It is seen in men who have been aban- processing ability and is scored for the number
doned by their wives. of correct identifications. [developed in 1983
taboo (tabu) 1. n. a religious, moral, or social by U.S. neuropsychologist Arthur Lester Benton
convention prohibiting a particular behavior, (1909–2006) and colleagues]
object, or person. The word derives from tabu, tactile hallucination a false perception in-
the Polynesian term for “sacred,” which was volving the sense of touch. These sensations
used specifically in reference to objects, rites, occur in the absence of any external stimulus
and individuals consecrated to sacred use or ser- and may include itching, feeling electric shocks,
vice and, therefore, seen as forbidden, unclean, and feeling insects biting or crawling under the
or untouchable in secular contexts. 2. adj. pro- skin. Also called haptic hallucination; tac-
hibited or strongly disapproved. tual hallucination.
tachycardia n. see arrhythmia. tactual hallucination see tactile halluci-
tachyphemia n. a kind of speech that is charac- nation.
terized by persistent volubility and rapidity. See Tactual Performance Test (TPT) a neuro-
logorrhea. See also pressured speech. psychological test—part of the halstead–
tachyphylaxis n. a rapidly decreasing response reitan neuropsychological battery—that re-
to repeated administration of a drug. For exam- quires a blindfolded individual to place wooden
ple, the blood pressure of a patient might con- shapes (e.g., stars) into a formboard placed at a
tinue to rise despite repeated injections of a drug 45° angle to the vertical. Performances for the
that normally would lower the blood pressure. dominant, nondominant, and both hands si-
—tachyphylactic adj. multaneously are obtained, and then the blind-
tacit knowledge knowledge that is informally fold is removed and the individual is asked to
acquired rather than explicitly taught (e.g., draw the shapes and their relative positions on
knowledge of social rules) and allows a person to the formboard. The test measures motor skills,
succeed in certain environments and pursuits. It tactile perception, nonverbal memory, problem
is stored without self-reflective awareness and solving, and other executive functions.
therefore not easily articulated. practical in- taijin kyofusho a phobia, similar to social
telligence requires a facility for acquiring tacit phobia and unique to Japan, that is character-
knowledge. Also called implicit knowledge; ized by an intense fear that one’s body parts,
unconscious knowledge. See triarchic the- bodily functions, or facial expressions are embar-
ory of intelligence. [proposed by U.S. psy- rassing or offensive to others (e.g., in appear-
chologist Robert J. Sternberg (1949– )] ance, odor, or movement).
tacrine n. an acetylcholinesterase inhibitor talion n. retaliation, especially retaliation in
used for the treatment of mild to moderate de- kind, as in the biblical injunction “an eye for an
mentia associated with Alzheimer’s disease (see eye, a tooth for a tooth.” The talion principle or
nootropic). A common adverse reaction to ta- law plays an important part in psychoanalytic
crine is liver dysfunction, which limits its use. theory, because it includes the general idea of
U.S. trade name: Cognex. retribution for defying the superego and the
tactile agnosia loss or impairment of the abil- specific fear (talion dread) that all transgres-
ity to recognize and understand the nature of ob- sions, accidental or intentional, will be punished
jects through touch. Several distinct subtypes in kind. For example, a person wishing con-
have been identified, including amorphagnosia, sciously or unconsciously for the death of an-
impaired recognition of the size and shape of ob- other person might suffer extreme anxiety
jects; ahylognosia, impaired recognition of such caused by the fear that he himself or she herself
object qualities as weight and texture; and finger is dying.
agnosia, impaired recognition of one’s own or talking cure a colloquial expression used for
another person’s fingers. psychotherapy. The term is apt in that the very
577
talk therapy
essence of certain psychotherapeutic approaches the client, or both. The decision was based on a
is for the client to “talk out” his or her problems case in which an individual confided to his ther-
with the therapist. First used in the context of apist that he intended to kill a friend and later
psychoanalysis, the term was coined by the land- did so. See also duty to protect; duty to
mark patient anna o. warn.
talk therapy see psychotherapy. tardive adj. denoting delayed or late-arriving
taming of the instinct see neutralization. symptoms or disease characteristics, as in
tardive dyskinesia.
tandem therapy in marriage therapy (see cou-
ples therapy), a practice in which the therapist tardive dyskinesia a movement disorder as-
meets individually with each partner. sociated with the use of antipsychotics, par-
ticularly conventional antipsychotics that act
tangentiality n. a thought disturbance that is primarily as dopamine-receptor antago-
marked by oblique speech in which the person nists. It is more common with prolonged use
constantly digresses to irrelevant topics and fails (months or years), and older patients, females,
to arrive at the main point. In extreme form it is and patients with mood disorders are thought to
a manifestation of loosening of associations, be more susceptible. Symptoms include tremor
a symptom most frequently found in schizo- and spasticity of muscle groups, particularly
phrenia. Compare circumstantiality. orofacial muscles and muscles in the extremities.
tangential speech verbal communication that Onset is insidious and may be masked by contin-
repeatedly diverges from the original subject. ued use of the antipsychotic, only appearing
Often resulting from disorganized thought pro- when the drug is discontinued or the dose low-
cesses or a diminished ability to focus attention, ered. Its incidence is estimated at up to 40% of
these digressions may continue until the original long-term users of conventional antipsychotics;
subject is no longer the focus of the conversa- the incidence is lower with atypical anti-
tion. This type of conceptual disorganization is psychotics. No effective treatment is known.
often associated with schizophrenia and delir- tardive dysmentia a behavioral disorder asso-
ium. ciated with long-term use of antipsychotic drugs
tantric sex an approach to sex based on the Chi- and characterized by changes in affect, social
nese philosophical and religious system of Tao- behavior, and level of activity. Symptoms
ism. The approach highly values sex, with the may include an inappropriately loud voice and
belief that long life and even immortality can be loquaciousness, euphoria, intrusive behavior
reached by sexual activity. Sexual techniques are (including invasion of others’ privacy), and
aimed at mutual and equal sexual pleasure for thought disorder. In addition, the individual
each partner. Prolonged love-making sessions, may exhibit episodes of social withdrawal inter-
with much general body stroking, and tech- spersed with episodes of hyperactivity, as well
niques to prolong intercourse are stressed in the as excessive emotional reactivity and explosive
tantric approach. hostility. The condition is considered the be-
tapering n. in pharmacology, a gradual reduc- havioral equivalent of tardive dyskinesia. Also
tion in the dose of a drug in order to avoid unde- called iatrogenic schizophrenia; tardive
sirable effects that may occur with rapid psychosis.
cessation. Such effects may be extreme (e.g., con- target n. 1. an area or object that is the focus of a
vulsions) or relatively mild (e.g., head pain, mild process, inquiry, or activity. 2. the goal object in
gastrointestinal distress). Drugs that produce a task. For example, the target in a visual search
physiological dependence (e.g., opiates, benzo- might be to find a letter S in a randomly arranged
diazepines) must be tapered to prevent a with- array of letters. Where a search has more than
drawal syndrome; seizures can result from one item as its goal, these are known as the tar-
sudden cessation of benzodiazepines (see seda- get set. 3. a tissue, organ, or type of cell that is
T tive, hypnotic, or anxiolytic withdrawal). selectively affected by a particular hormone,
taphophilia n. a morbid attraction to cemeter- neurochemical, drug, or microorganism. 4. a
ies. neuron that attracts the growth of the den-
drites or axons of other neurons toward it.
Taractan n. a trade name for chlor-
prothixene.
target behavior the specific behavior or behav-
ioral pattern selected for modification in behav-
Tarasoff decision the 1976 California Su- ior therapy.
preme Court decision in Tarasoff v. Regents of the
target patient in structured interactional
University of California, which placed limits on a
group psychotherapy, the group member
client’s right to confidentiality by ruling that
who becomes the focus of attention and discus-
mental health practitioners who know or rea-
sion.
sonably believe that a client poses a threat to an-
other person are obligated to protect the target population the population that a study
potential victim from danger. Depending on the is intended to research and to which generaliza-
circumstances, that protection may involve such tions from samples are to be made.
actions as warning the potential victim, notify- target stimulus a specific stimulus to which
ing the police of the potential threat posed by participants in a test or experimental procedure
578
telepsychotherapy
must attend or respond. For example, in tests of ior, such as name-calling, insults, or repetitive
hearing the target stimulus may be a specific annoyances. Teasing can be playful and affec-
tone that must be identified. tionate or malicious and bullying.
TAS abbreviation for tellegen absorption technical eclecticism in integrative psy-
scale. chotherapy, the use of techniques from vari-
task n. any goal-oriented activity undertaken by ous theoretical frameworks to deal with the
an individual or a group. When such an activity complex issues of a client. Technical eclecticism
is the subject of observation in an experimental uses a systematic and carefully thought out ap-
setting (e.g., in problem-solving and decision- proach that balances theoretical perspectives
making studies or in studies of perception and and treatment processes. [developed by South
cognition), the researcher may set particular ob- African-born U.S. psychologist Arnold Allan Laz-
jectives and control and manipulate those ob- arus (1932– )]
jectives, stimuli, or possible responses, thus teeth grinding see bruxism.
changing task parameters to observe behavioral
teething n. the process in which the teeth erupt
adjustments.
through the gums, typically occurring between 4
TAT abbreviation for thematic apperception and 9 months of age. During this process, the in-
test. fant may exhibit several accompanying symp-
Tavistock Clinic a major British provider of toms, such as an increase in irritability, sleep
clinical mental health services, set up in disturbance, temporary rejection of breast or
Tavistock Square, London, England, in 1919. It bottle feeding, gum inflammation, and excessive
became a part of the National Health Service in drooling.
1947, when the separate Tavistock Institute of Tegretol n. a trade name for carbamazepine.
Human Relations was founded to relate the psy-
chological and social sciences to the needs of so- telecanthus-hypospadias syndrome a he-
ciety. In 1994 the Tavistock Clinic and the reditary disorder marked by widely spaced eyes,
portman clinic became a trust of the National a high nose bridge, and a urethral opening on
Health Service and its leading organization for the ventral side of the penis. Some affected indi-
providing postgraduate training in mental viduals also show mental retardation, with IQs
health. in the 40s and 50s. Recent research suggests that
the condition is genetically heterogeneous, with
Taylor Manifest Anxiety Scale a 65-item both X-linked and autosomal forms. Also called
self-report scale, derived from the minnesota BBBG (or GBBB) syndrome (from the names
multiphasic personality inventory, that was of the affected families originally reported);
first developed in 1951 and modified and short- Opitz–Frias syndrome.
ened to 50 items in 1953. The scale, consisting of
statements (e.g., “I cannot keep my mind on one telehealth n. the use of telecommunications
thing”) to which participants respond “true” or and information technology to provide access to
“false,” formerly enjoyed frequent use in re- health assessment, diagnosis, intervention, and
search as a general measure of anxiety symp- information across a distance, rather than face to
toms. It correlates with other anxiety measures face. Also called telemedicine.
and with physiological indicators of anxiety. telemedicine n. see telehealth.
Also called Manifest Anxiety Scale. See anxi- teleologic regression see progressive teleo-
ety scale. [devised by U.S. psychologist Janet logic regression.
Taylor Spence (1923– )]
telephone counseling 1. a method of treating
TBI abbreviation for traumatic brain injury.
and dealing with the problems of clients by tele-
TCA abbreviation for tricyclic antidepres- phone. The skills for telephone counseling in-
sant. clude (a) careful selection of problems that lend
themselves to the medium, (b) active listen-
T
T data test data: information about an individual
gathered from formal scientific measurement ing for cues to issues and ramifications of the
and objective testing. See also l data; o data; q problems, (c) good verbal skills that guide the cli-
data. ent appropriately, and (d) ability to respond
t distribution a theoretical probability dis- quickly to avoid gaps and awkward silences. 2.
tribution that plays a central role in testing hy- free hotline telephone services that provide lis-
potheses about population means among other tening and referral services rather than formal
parameters. It is the sampling distribution of the counseling. Hotline volunteers are trained to
statistic (M – μ0)/s, where μ0 is the population provide emotional support in serious situations,
mean of the population from which the sample especially those involving suicidal thoughts, but
is drawn, M is the data estimate of the mean of not to give formal advice. See also distance
the population, and s is the standard deviation therapy.
of the batch of scores. Also called Student’s t telephone scatologia a paraphilia in which
distribution. an individual obtains sexual pleasure by making
tease vb. to bother, provoke, or torment another obscene telephone calls. See scatophilia.
person through various types of irritating behav- telepsychotherapy n. see distance therapy.
579
telic
telic adj. purposeful or goal-directed in nature, as contains regions important for memory forma-
in telic behavior. tion.
Tellegen Absorption Scale (TAS) a measure temporal lobe amnesia a memory disorder,
of a person’s ability to become deeply involved secondary to injury of the temporal lobe (par-
in a task or other aspect of the environment. ticularly medial structures, such as the hippo-
Consisting of 34 statements (e.g., “I like to watch campus), that prevents the formation of new
cloud shapes change in the sky”) to which par- memories.
ticipants respond “true” or “false,” it is consid- temporal lobectomy the surgical excision of a
ered to be a reliable indication of the ease with temporal lobe or a portion of the lobe. It may be
which an individual can be hypnotized. See ab- performed in the treatment of temporal lobe epi-
sorption. [devised in 1974 by U.S. psychologist lepsy, the location and size of the lesion deter-
Auke Tellegen (1930– )] mining which tissues and related functions may
temazepam n. an intermediate-acting benzo- be affected.
diazepine used for the short-term treatment of temporal lobe illusions distorted percep-
insomnia. Temazepam is readily processed in the tions that may be associated with complex par-
liver to form an inactive metabolic product; it tial seizures arising from abnormal discharge
therefore has a relatively predictable half-life of neurons in the temporal lobe. They often in-
and does not accumulate in the body with re- clude distortions of the sizes or shapes of objects,
peated doses. However, as with other benzodiaz- recurring dreamlike thoughts, or sensations of
epine hypnotics, tolerance can occur with déjà vu. Hallucinations, such as the sound of
repeated use. U.S. trade name: Restoril. threatening voices, may also be experienced.
Also called temporal hallucinations; tem-
temper n. 1. a display of irritation or anger, or a
poral lobe hallucinations.
tendency to be quick to anger. 2. a personality
characteristic, disposition, or mood. temporal lobe syndrome a group of person-
ality and behavioral disturbances associated
temperament n. the basic foundation of per- with temporal lobe epilepsy in some individuals.
sonality, usually assumed to be biologically de- These may include a profound sense of righ-
termined and present early in life, including teousness, preoccupation with details, compul-
such characteristics as energy level, emotional sive writing or drawing, religiosity, and changes
responsiveness, demeanor, mood, response in sexual attitudes.
tempo, and willingness to explore. In animal be-
havior, temperament is defined as an individ- temporary commitment emergency invol-
ual’s constitutional pattern of reactions, with a untary hospitalization of a patient with a
similar range of characteristics. mental disorder for a limited period of observa-
tion or treatment.
temperament theory the belief that behav-
tend-and-befriend response a proposed
ioral tendencies are biologically based and pres-
physiological and behavioral stress regulatory
ent from birth, forming the disposition of the
system in females, in which tending involves
individual.
nurturant activities designed to protect the self
temperament trait 1. a biologically based, in- and offspring, to promote a sense of safety, and
herited personality characteristic. 2. a personal- to reduce distress, and befriending is expressed
ity trait that involves emotional qualities and in the creation and maintenance of social net-
affective styles of behavior. It is one of three works that aid in this process. This model has
classes of source traits in cattell’s person- been characterized as a human stress response in
ality trait theory, the other two being abil- females that is secondary to the classic fight-
ity traits and dynamic traits. or-flight response. Neuroendocrinal evidence
temperance n. any form of auspicious self- from animal and human research suggests an
T restraint, manifested as self-regulation in moni- underlying physiological mechanism mediated
toring and managing one’s emotions, motiva- by oxytocin and moderated by female sex hor-
tion, and behavior and as self-control in the mones and opioid peptide mechanisms.
attainment of adaptive goals. tendentious apperception the tendency to
perceive what one wishes to perceive in an event
temporal gradient a pattern of retrograde am-
or situation. See apperception. See also percep-
nesia characterized by greater loss of memory
tual set.
for events from the recent past (i.e., close to the
onset of the amnesia) than for events from the tender-mindedness n. a personality trait char-
remote past. See also ribot’s law. acterized by intellectualism, idealism, optimism,
dogmatism, religiousness, and monism. Com-
temporal lobe one of the four main lobes of pare tough-mindedness. [first described by
each cerebral hemisphere in the brain, lying William james] —tender-minded adj.
immediately below the lateral sulcus on the
lower lateral surface of each hemisphere. It con- Tenex n. a trade name for guanfacine.
tains the auditory projection and auditory asso- Tennessee Self-Concept Scale (TSCS) a self-
ciation areas and also areas for higher order report assessment currently consisting of de-
visual processing. The medial temporal lobe scriptive statements to which participants re-
580
terror management theory
spond using a 5-point scale, ranging from Achievement Test; and creation of question-
“always false” to “always true.” It is available in naires designed to reveal Psychological Factors in
two forms—Adult, containing 82 items for use Marital Happiness (1938). He is also noted for
with individuals aged 13 years and older, and developing a series of studies of gifted children
Child, containing 76 items for use with individ- and eminent adults (see genius; terman’s
uals aged 7 to 14 years—and yields measure- giftedness study).
ments on six substantive dimensions of self- terminal behavior 1. relatively unvaried be-
concept (Physical, Moral, Personal, Family, So- havior that is predominant in the period shortly
cial, Academic/Work) within three domains before reinforcement occurs during operant or
(Identity, Satisfaction, Behavior). The TSCS was instrumental conditioning. 2. a response that ei-
originally published in 1964; the most recent ther falls outside an organism’s current behav-
version is the TSCS–2, published in 1996. [origi- ioral repertoire or is not occurring at a desired
nally developed by U.S. psychologist William H. rate, strength, or magnitude. Increasing terminal
Fitts (1918– )] behavior is the aim of specific behavioral inter-
tense 1. adj. in a state of nervous activity. 2. adj. ventions.
stretched tight or strained. terminal button see axon.
tension n. 1. a feeling of physical and psycholog- terminal care services for people with terminal
ical strain accompanied by discomfort, uneasi- illness, now usually provided by hospices,
ness, and pressure to seek relief through talk or which may be either freestanding units or associ-
action. 2. the force resulting from contraction or ated with a hospital, nursing home, or extended
stretching of a muscle or tendon. care facility. The emphasis is on palliative
tension headache a persistent headache pro- care, pain control, supportive psychological
duced by acute or prolonged emotional tension services, and involvement in family and social
and usually accompanied by insomnia, irritabil- activities, with the goal of enabling patients to
ity, and painful contraction of the neck muscles. live out their lives in comfort, peace, and dignity.
tension reduction alleviation of feelings of terminal drop a rapid decline in cognitive abil-
tension. A variety of techniques may be used for ities immediately before death. The cognitive
this purpose, for example, relaxation ther- abilities that appear to be most prone to terminal
apy, tranquilizing drugs, muscle relaxants, hyp- drop are those least affected by normal aging (see
notic suggestion, periods of meditation, verbal hold functions). Also called terminal drop-
catharsis, or movement therapy. decline.
tenting n. lengthening and expansion of the va- terminal insomnia a form of insomnia in
gina and elevation of the uterus during the ex- which the individual habitually awakens very
citement and plateau phases of the female early, feels unrefreshed, and cannot go back to
sexual-response cycle. These changes facili- sleep. It is a common symptom of a major de-
tate entry of the penis and make intercourse pressive episode. Compare initial insomnia;
more pleasurable. middle insomnia.
ten–twenty system a standardized system termination n. in therapy, the conclusion of
of imaginary lines on the head that allows for treatment. Termination may be suggested by the
placement of electrodes during electroen- client or therapist or may be by mutual agree-
cephalography. ment. Termination can be immediate or pro-
longed; in the latter case, a date for the final
Tenuate n. a trade name for diethylpropion. session is established and sessions are sometimes
teratogen n. an agent that induces developmen- scheduled less frequently over a period. In pre-
tal abnormalities in a fetus. The process that re- mature termination, treatment is ended before
sults in such abnormal developments is called either the therapist or client considers the ther-
teratogenesis; a teratomorph is a fetus or off- apy complete. This may result, for example, T
spring with developmental abnormalities. from difficulties in the relationship between the
teratology n. the study of developmental abnor- therapist and client, misunderstanding of the re-
malities and their causes. —teratological adj. quired length of treatment, a change in the cli-
ent’s financial circumstances, or departure of the
Terman, Lewis Madison (1877–1956) U.S.
client to another location.
psychologist. Terman earned his doctorate at
Clark University in 1905, worked for 4 years at terror n. intense and overwhelming fear.
the Los Angeles Normal School, and then went terror management theory a theory propos-
to Stanford University, where he spent the re- ing that control of death-related anxiety is the
mainder of his career. Terman’s career was pri- primary function of society and the main mo-
marily devoted to the development and tivation in human behavior. Individual self-
application of psychological tests. He was re- esteem and a sense of being integrated into a
sponsible for validation and revision of the Binet powerful human culture are regarded as the
scales for use in the United States, resulting in most effective ways for human beings to defend
the stanford–binet intelligence scale; con- themselves against the frightening recognition
struction of the Army tests administered during of their own mortality (see death anxiety).
World War I; development of the Stanford [based on the work of U.S. cultural anthropolo-
581
tertiary care
gist Ernest Becker (1925–1974) and developed by struments in order to provide accurate diagnos-
U.S. psychologists Jeff Greenberg (1954– ), Shel- tic or other psychological information. Test se-
don Solomon (1953– ), and Tom Pyszczynski lection is made on the basis of psychological
(1954– )] history (often in conjunction with medical his-
tertiary care highly specialized care given to tory), interviews, other pretest knowledge of the
patients who are in danger of disability or death. individual or group to be tested, or some combi-
Tertiary care often requires sophisticated tech- nation of these.
nologies provided by highly specialized practi- tetrabenazine n. a drug used in the treatment
tioners and facilities, for example, neurologists, of huntington’s disease and other hyper-
neurosurgeons, thoracic surgeons, and intensive kinetic movement disorders. It acts by depleting
care units. Compare primary care; secondary brain stores of the monoamine neurotrans-
care. mitters dopamine, norepinephrine, and sero-
tertiary prevention intervention and treat- tonin and produces such side effects as par-
ment for individuals or groups with already es- kinsonism, sedation, and depression. U.S. trade
tablished psychological or physical conditions, name: Xenazine. Canadian trade name:
disorders, or diseases. Tertiary interventions in- Nitoman.
clude attempts to minimize negative effects, tetrahydrocannabinol (THC) n. one of a
prevent further disease or disorder related to number of cannabinoids occurring in the can-
complications, prevent relapse, and restore the nabis plant that is the agent principally respon-
highest physical or psychological functioning sible for the psychoactive properties of cannabis.
possible. Compare primary prevention; sec- THC is available in a synthetic pharmaceutical
ondary prevention. preparation known as dronabinol (U.S. trade
test anxiety tension and apprehensiveness as- name: Marinol) for use in the treatment of che-
sociated with taking a test (see performance motherapy-induced nausea and vomiting and as
anxiety). an appetite stimulant for the treatment of HIV-
test bias the tendency of a test to systematically related anorexia. Research suggests it may also be
over- or underestimate the true scores of individ- effective in reducing intraocular pressure and as
uals to whom that test is administered, for exam- an analgesic.
ple because they are members of particular TGA abbreviation for transient global amne-
groups (e.g., ethnic minorities, sexes, etc.). See sia.
also cultural test bias.
T-group n. training group: a type of experiential
testing the limits 1. a method used to study group, usually of up to a dozen or so people, con-
adult age differences in cognition in which re- cerned with fostering the development of “basic
search participants are required to perform a task skills,” such as effective leadership and commu-
to the best of their ability and are then tested nication, and attitude change. T-group training
after extensive practice on the task. [developed was developed by the National Training Labora-
by German psychologist Paul Baltes (1939–2006) tory in Group Development in the late 1940s
and his associates] 2. in psychological testing, and grew out of Kurt lewin’s work in the area
allowing a participant to proceed beyond time of small-group dynamics. Although sometimes
limits (or waiving other standardized require- used synonymously with encounter group,
ments) to see if he or she can complete an item the emphasis is less on personal growth and
or do better under alternate conditions. 3. in more on sensitivity training and practical in-
general psychology, attempts by an individual terpersonal skills, for example, as stressed in
to see how far he or she can test rules before management training. One of the goals of T-
the rules are enforced. An example would be groups is to foster greater understanding of
seeing how much talking one can get away with group dynamics and of the individual members’
T in a class before being reprimanded by the roles within the group or organization.
teacher.
thalamic lesion a loss of structure or function
test item a constituent part, or the smallest
of a part of the thalamus resulting in such ef-
scoreable unit, of a test.
fects as avoidance-learning deficits. Animals that
testosterone n. a male sex hormone and the have experienced a thalamic lesion take much
most potent of the androgens produced by the longer to learn to avoid an electric shock, al-
testes. It stimulates the development of male re- though they learn eventually. Effects vary some-
productive organs, including the prostate gland, what with the part of the thalamus affected.
and secondary sex characteristics, such as
beard, bone, and muscle growth. Women nor- thalamus n. (pl. thalami) a mass of gray mat-
mally secrete small amounts of testosterone ter, forming part of the diencephalon of the
from the adrenal cortex and ovary. brain, whose two lobes form the walls of the
third ventricle. It consists of a collection of
test–retest correlation a correlation that sensory, motor, autonomic, and associational
represents the stability of a variable over time. nuclei, serving as a relay for nerve impulses trav-
test selection the process of choosing the most eling between the spinal cord and brainstem and
useful or appropriate test or set of assessment in- the cerebral cortex. Specific areas of the body
582
theoretical integration
surface and cerebral cortex are related to specific Although thebaine lacks the analgesic effect of
parts of the thalamus. See also subthalamus. morphine, it can be converted to several impor-
—thalamic adj. tant opioid agonists and antagonists (e.g., bu-
thalidomide n. a drug reintroduced into the prenorphine, naloxone).
United States in 1998 as an immunosuppressant thema n. in the personology of U.S. psycholo-
for treatment of cutaneous manifestations of gist Henry Alexander Murray (1893–1988), a
erythema nodosum leprosum (a severe, acute unifying “theme,” or unit of interplay, between
form of leprosy). A derivative of the sedative an individual and the environment in which
glutethimide, it was originally (in the late a need and a press interact to yield satisfaction.
1950s and early 1960s) used to treat anxiety and
morning sickness in pregnancy until its associa- Thematic Apperception Test (TAT) a pro-
tion with severe, life-threatening birth defects jective test, developed by U.S. psychologist
became apparent. Numerous fetal abnormalities, Henry Alexander Murray (1893–1988) and his
including abnormal limb development and gas- associates, in which participants are held to re-
trointestinal, cardiac, and neurological deficits veal their attitudes, feelings, conflicts, and per-
were common, and the drug was withdrawn. sonality characteristics in the oral or written
Prescription requires special training by prescrib- stories they make up about a series of relatively
ers and pharmacists, and thalidomide must not ambiguous black-and-white pictures. Prior to ad-
be taken by women who are pregnant; both ministering the test, the examiner assures the
women and men who are taking thalidomide participant that there are no right or wrong an-
must comply with various mandatory condi- swers and indicates that the narratives should
tions and contraceptive measures. Its mecha- have a beginning, middle, and ending. At the
nism of action is unclear. U.S. trade name: end, the stories are discussed for diagnostic pur-
Thalomid. poses. Systematic coding schemes, with demon-
strated reliability and validity, have been
thanatology n. the study of death and death- developed to assess different aspects of person-
related behaviors, thoughts, feelings, and phe- ality functioning derived from TAT stories, in-
nomena. Death was mostly the province of the- cluding motivation for achievement, power,
ology until the 1960s, when existential thinkers affiliation, and intimacy; gender identity; de-
and a broad spectrum of care providers, educa- fense mechanisms; and mental processes influ-
tors, and social and behavioral scientists became encing interpersonal relations. The TAT is one of
interested in death-related issues. —thanatolo- the most frequently used and researched tests in
gist n. psychology, particularly in clinical settings for
thanatomania n. see voodoo death. diagnosis, personality description, and assess-
thanatophobia n. a persistent and irrational ment of strengths and weakness in personality
fear of death or dying. This fear may focus on the functioning.
death of oneself or others and is often associated thematic paralogia a speech characteristic
with hypochondriasis. —thanatophobic adj. marked by the incessant, distorted dwelling of
Thanatos n. the personification of death and the the mind on a single theme or subject.
brother of Hypnos (sleep) in Greek mythology,
thematic paraphasia incoherent speech that
whose name was chosen by Sigmund freud to
wanders from the theme or subject.
designate a theoretical set of strivings oriented
toward the reduction of tension and life activity thematic test any examination in which a par-
(see death instinct). In Freud’s dual instinct ticipant is required to tell a story from which in-
theory, Thanatos is seen as involved in a dialec- terpretations are made about the individual’s
tic process with eros (love), the striving toward psychological functioning, especially his or her
sexuality, continued development, and height- unconscious wishes and needs.
ened experience (see life instinct). See also
destrudo; nirvana principle; principle of
theobromine n. a methylxanthine alkaloid T
that occurs naturally in the seeds of Theobroma
inertia. cacao, the cocoa plant. Theobromine is struc-
THC abbreviation for tetrahydrocannabinol. turally similar to caffeine in coffee and
Theater of Spontaneity an experimental the- theophylline in tea but has less pharmacological
ater established in Vienna in 1921 by Romanian- potency than these methylxanthines.
born U.S. psychiatrist Jacob Levi Moreno (1889– theomania n. a delusion in which the person
1974). The process of playing unrehearsed, im- believes himself or herself to be inspired by or
provised parts in the theater proved to be not possessed of divinity.
only effective training for actors but frequently
had a beneficial effect on their interpersonal theophylline n. see methylxanthines.
relationships. This technique evolved into psy- theoretical integration the integration of
chodrama, which Moreno brought to the theoretical concepts from different approaches
United States in 1925. to produce meaningful frames of reference that
thebaine n. an opium alkaloid that is chemi- may help explain the dynamics or causes of
cally similar to morphine but has stimulatory ef- problems or the functioning of an individual
fects. It comprises about 0.2% of natural opium. when any single traditional theoretical approach
583
theory
individually fails to explain the behavior ade- cessful therapy. Derived from the concept of the
quately. psychoanalytic working alliance, the therapeu-
theory n. 1. a principle or body of interrelated tic alliance comprises bonds, goals, and tasks.
principles that purports to explain or predict a Bonds are constituted by the core conditions
number of interrelated phenomena. See con- of therapy, the client’s attitude toward the thera-
struct; model. 2. in the philosophy of science, pist, and the therapist’s style of relating to
a set of logically related explanatory hypotheses the client; goals are the mutually negotiated,
that are consistent with a body of empirical facts understood, agreed upon, and regularly re-
and that may suggest more empirical relation- viewed aims of the therapy; and tasks are the ac-
ships. —theoretical adj. tivities carried out by both client and therapist.
See therapist–patient relationship. [concept
theory of mental self-government a developed by U.S. psychologist Edward S. Bordin
model of cognitive styles that proposes sev- (1913–1992)]
eral dimensions to describe the preferred ways
in which individuals think or express their therapeutic atmosphere an environment of
cognitive abilities. The dimensions include (a) acceptance, empathic understanding, and un-
governmental—preferences in the legislative, conditional positive regard in which clients
executive, and judicial functions of cognition feel most free to verbalize and consider their
(i.e., in planning, implementing, and evaluat- thoughts, behaviors, and emotions and make
ing); (b) problem solving—styles labeled monar- constructive changes in their attitudes and reac-
chic (a tendency to pursue one goal at a time), tions.
hierarchic (multiple goals with different priori- therapeutic camp a camp that may provide
ties), oligarchic (multiple, equally important part-time care, therapeutic treatment, rehabilita-
goals), and anarchic (unstructured, random tion, or a combination of these for individuals,
problem solving); (c) global versus local think- often children and adolescents, with a variety
ing—preferring to think about large, abstract is- of conditions, disorders, and illnesses. Examples
sues on the one hand or concrete details on the include camps for children with learning disabil-
other; (d) internal versus external thinking—re- ities, for children and adolescents living with
lated to introversion–extraversion, social skills, HIV/AIDS, for school refusal adolescents, and
and cooperativeness; and (e) conservative or pro- for individuals with head injury.
gressive—rule-based leanings versus those that
therapeutic communication any comment
are creative and change-oriented. [proposed in
or observation by the therapist that increases the
1988 by U.S. psychologist Robert J. Sternberg
client’s awareness or self-understanding.
(1949– )]
therapeutic community a setting for in-
theory of mind the ability to imagine or make
dividuals requiring therapy for a range of
deductions about the mental states of other indi-
psychosocial problems and disorders that is
viduals: What does the other individual know?
based on an interpersonal, socially interactive
What actions is that individual likely to take?
approach to treatment, both among residents
Theory of mind is an essential component of
and among residents and staff (i.e., “community
attributing beliefs, intentions, and desires to
as method or therapy”). The term covers a vari-
others, specifically in order to predict their be-
ety of short- and long-term residential programs
havior. It begins to appear around 4 years of age
as well as day treatment and ambulatory pro-
in human beings; there has been considerable
grams. The staff is typically multidisciplinary
controversy about whether nonhuman animals
and may consist of human services professionals
have this ability. See also belief–desire reason-
and clinicians providing mental health, medical,
ing; mindblindness.
vocational, educational, fiscal, and legal ser-
theory verification the process of developing vices, among others. Originating as an alterna-
and citing empirical evidence to increase or de- tive to conventional medical and psychiatric
T crease the tenability of theories. approaches, therapeutic communities have be-
therapeutic 1. adj. pertaining to therapeutics, come a significant form of psychosocial treat-
the branch of medical science concerned with ment. See milieu therapy. [developed by 20th-
the treatment of diseases and disorders and the century British psychiatrist Maxwell Shaw Jones]
discovery and application of remedial agents or therapeutic crisis a turning point in the treat-
methods. 2. adj. having beneficial or curative ef- ment process, usually due to sudden insight or a
fects. 3. n. a compound that is used to treat spe- significant revelation on the part of the client or
cific diseases or medical conditions. patient. The crisis may have positive or negative
therapeutic agent any means of advancing implications and may lead to a change for the
the treatment process, such as a drug, occupa- better or the worse, depending on how it is han-
tional therapy, a therapist, or a therapeutic dled.
community. The therapeutic agent is presumed therapeutic factors curative factors that oper-
to be the causative agent in patient change. ate across models and techniques in group
therapeutic alliance a cooperative working therapy. Factors identified include altruism, ca-
relationship between client and therapist, con- tharsis, cohesion, family reenactment, feedback,
sidered by many to be an essential aspect of suc- hope, identification, interpersonal learning, re-
584
thienobenzodiazepine
ality testing, role flexibility, universality, and vi- isted for the tricyclic antidepressant nortrip-
carious learning. Therapeutic factors are often tyline. Few modern psychotropic drugs require
confused with common factors because both therapeutic monitoring, although lithium is a
delineate effective change factors across theoret- notable exception; it has a very narrow thera-
ical models and techniques of therapy; however, peutic range below which it has no therapeutic
common factors refer to individual psychother- effect and above which adverse effects and toxic-
apy, whereas therapeutic factors refer to group ity dominate. Therapeutic windows are increas-
psychotherapy. ingly becoming less significant in modern
therapeutic group a group of individuals who clinical psychopharmacology.
meet under the leadership of a therapist for the therapeutist n. a former name for a therapist.
express purpose of working together toward im- therapist n. an individual who has been trained
provement in the mental and emotional health in and practices one or more types of therapy to
of the members. treat mental or physical disorders or diseases:
therapeutic group analysis see group- often used synonymously with psychotherapist
analytic psychotherapy. (see psychotherapy).
therapeutic index any of several indices relat- therapist–patient relationship the rela-
ing the clinical effectiveness of a drug to its tionship formed in therapy between a psy-
safety factor, the most common being the ther- chotherapist and the patient (client) receiving
apeutic ratio. Other therapeutic indices in- therapy. There has been much theory and re-
clude the ratio of the minimum toxic dose to the search concerning this interaction: how it varies
minimum effective dose and the difference be- and changes over time and the significant impli-
tween the minimum effective dose and the mini- cations that the dynamic has for the way
mum toxic dose. in which treatment is offered and its outcomes.
therapeutic matrix in couples therapy, the The relationship has ethical dimensions that are
specific combination of therapist and clients often specified in practice guidelines. See also
that is used in the sessions, for example, a differ- therapeutic alliance.
ent therapist for each partner in collaborative therapy n. 1. remediation of physical, mental, or
therapy or seeing the couple together in con- behavioral disorders or disease. 2. see psycho-
joint therapy. therapy.
therapeutic process see psychotherapeutic therapy group climate see group climate.
process.
therapy puppet a puppet used for role play in
therapeutic ratio an index relating the clini- therapy with children. The use of a therapy pup-
cal effectiveness of a drug to its safety factor, cal- pet is sometimes more conducive to the child’s
culated by dividing the median lethal dose revelation of thoughts and feelings than direct
(LD50) by the median effective dose (ED50). A communication by the child with the therapist.
drug is often considered safe only if its therapeu-
therapy supervision see supervision.
tic ratio is at least 10. [introduced by German
bacteriologist and immunologist Paul Ehrlich there-and-then approach an historical ap-
(1854–1915)] proach to therapy, focusing on the roots of the
therapeutic recreation see recreational client’s difficulties in past experience, as opposed
therapy. to the here-and-now approach (see here and
now).
therapeutic relaxation see relaxation
therapy. theta wave in electroencephalography, a type
of brain wave with a frequency of 4–7 Hz. Theta
therapeutic role the functions of the therapist waves are observed in the rem sleep of animals,
or other therapeutic agent in treating psycho- stage 2 sleep in humans, and in the drowsiness
logical disorders, alleviating painful responses or state of newborn infants, adolescents, and young
symptoms resulting from a distressing condi- T
adults. Theta waves are also recorded in trances,
tion, or altering maladaptive thinking or behav- hypnosis, and deep daydreams. Neurologically,
ior. the hippocampus is one well-known source of
therapeutic soliloquy a procedure in which theta activity. Also called theta rhythm.
clients speak about themselves to a group with- thiazide diuretics a group of synthetic chemi-
out interruption. [developed by Romanian-born cals developed in the 1950s and widely used as
U.S. psychiatrist Jacob Levi Moreno (1889– diuretics in the treatment of hypertension.
1974)] Thiazides cause the excretion of approximately
therapeutic storytelling see storytelling. equal amounts of sodium and chloride with an
therapeutic touch see touch therapy. accompanying volume of water, thereby lower-
therapeutic window the range of plasma lev- ing blood pressure. Also called benzothia-
els of a drug within which optimal therapeutic diazides.
effects occur. Suboptimal effects may occur both thienobenzodiazepine n. any member of a
below and above the therapeutic window. Evi- class of chemically related compounds that in-
dence for true therapeutic windows was never clude olanzapine, an atypical antipsychotic
well established; possibly the best evidence ex- introduced into the U.S. market in 1996.
585
thinking
thinking n. cognitive behavior in which ideas, thenes include thiothixene (U.S. trade name:
images, mental representations, or other hy- Navane), flupenthixol, and zuclopenthixol.
pothetical elements of thought are experienced Only thiothixene is currently available in the
or manipulated. In this sense thinking includes United States.
imagining, remembering, problem solving, day- third-party administrator (TPA) in health
dreaming, free association, concept forma- insurance, a fiscal intermediary organization
tion, and many other processes. Thinking may that provides administrative services, including
be said to have two defining characteristics: (a) It claims processing and underwriting, for other
is covert, that is, it is not directly observable but parties (e.g., insurance companies or employers)
must be inferred from behavior or self-reports; but does not carry any insurance risk.
and (b) it is symbolic, that is, it seems to involve
third-party payer an organization, usually an
operations on mental symbols or representa-
insurance company, prepayment plan, or gov-
tions, the nature of which remains obscure and
ernment agency, that pays for the health ex-
controversial (see symbolic process).
penses incurred by the insured. The third party
thinking style see cognitive style. (to the agreement) is distinguished from the first
thinking through a typically multistage, mul- party, the individual receiving the services, and
tilayered thought process in which the individ- the second party, the individual or institution
ual attempts to understand and achieve insight providing the services.
into his or her own reactions, thought processes, third-person perspective a public, external,
or behavior, for example through consideration objective point of view on human behavior and
and analysis of cause and effect. experience. Compare first-person perspective;
thinking type in the analytic psychology of second-person perspective.
Carl jung, a functional type exemplified by Thomas S. class action a class action lawsuit
the individual who evaluates information or in North Carolina that established a special class
ideas rationally and logically. The thinking type of people with mental retardation who lived in
is one of Jung’s two rational types, the other state psychiatric hospitals. Many class members
being the feeling type. See also intuitive type; had both mental retardation and severe and per-
sensation type. sistent or recurring mental illness (MR/MI).
thiopental n. an ultrashort-acting barbiturate The court order specified required services and
used primarily as an anesthetic that can be ad- supports. Although the class was dissolved in
ministered intravenously to produce almost im- 1998, the case resulted in the establishment of a
mediate loss of consciousness. It may also be division that administers MR/MI services within
used as an antidote to overdosage of stimulants the state-led agency for mental retardation ser-
or convulsants. Formerly it was occasionally vices.
used in psychotherapy to induce a state of relax- Thorazine n. a trade name for chlorpro-
ation and suggestibility. In nonmedical circles, it mazine.
gained notoriety as a truth serum. U.S. trade thought n. 1. the process of thinking. 2. an
name: Pentothal. idea, image, opinion, or other product of think-
thioridazine n. a low-potency antipsychotic of ing. 3. attention or consideration given to some-
the piperidine phenothiazine class that, like thing or someone.
others of its class, causes sedation and significant thought avoidance the ability to evade or not
anticholinergic effects. Adverse effects unique consider unpleasant or dissonant mental events.
to thioridazine include the potential to cause It is a kind of psychological defense mechanism
retinal changes possibly leading to blindness as well as a means of therapeutic change.
(retinitis pigmentosum) at doses exceeding 800
thought broadcasting the delusion that one’s
mg/day. It can also cause severe disturbances in
thoughts are being disseminated throughout the
T heart rhythm: Its ability to prolong the Q-T in-
environment for all to hear.
terval may cause fatal arrhythmias (see electro-
cardiographic effect). It should not be taken thought deprivation see blocking.
by patients who have cardiac arrhythmias or thought derailment disorganized, discon-
who are taking other drugs that may prolong the nected thought processes, as manifested by a
Q-T interval. U.S. trade name: Mellaril. tendency to shift from one topic to another that
thioxanthenes pl. n. a group of antipsychotic is indirectly related or completely unrelated to
drugs, generally of intermediate potency, that the first. Thought derailment is a symptom of
resemble the phenothiazines in pharmaco- schizophrenia; the term is essentially equivalent
logical activity and molecular structure. Thi- to cognitive derailment. See derailment.
oxanthenes are used mainly in the treatment of thought disorder a disturbance in the cogni-
psychotic disorders. Like the phenothiazines, tive processes that affects communication, lan-
they are associated with cardiovascular and guage, or thought content, including poverty
anticholinergic side effects, as well as extra- of ideas, neologisms, paralogia, word salad,
pyramidal symptoms common to all dopa- and delusions. A thought disorder is consid-
mine-blocking agents. Their use has largely been ered by some to be the most important mark of
supplanted by newer antipsychotics. Thioxan- schizophrenia (see also schizophrenic think-
586
Thurstone, Louis Leon
ing), but thought disorders are also associated as a threat to the self, because it implies that the
with mood disorders, dementia, mania, and neu- recipient is incapable or inferior. In these
rological diseases (among others). Also called circumstances the recipient may respond nega-
thought disturbance. See content-thought tively.
disorder; formal thought disorder. threshold n. 1. in psychophysics, the magni-
thought echoing see écho des pensées. tude of a stimulus that will lead to its detection
thought experiment the process of imagining 50% of the time. 2. the minimum intensity of a
a theoretical research setup and what the result stimulus that is necessary to evoke a response.
might be of conducting the imagined experi- For example, an auditory threshold is the slight-
ment, in the hope that this process will lead to est perceptible sound; an excitatory threshold is
a better designed real experiment. In cases in the minimum stimulus that triggers an action
which the experiment cannot actually be per- potential in a neuron; a renal threshold is the
formed, the intent is to arrive at a well-reasoned concentration of a substance in the blood re-
conclusion. In physics, such experiments—also quired before the excess is excreted. Also called
called Gedanken experiments—are sometimes limen; response threshold.
held in high regard. threshold theory a hypothesis in group dy-
thought insertion a delusion in which the in- namics positing that conflict is beneficial and
dividual believes that thoughts are irresistibly useful provided it does not exceed the tolerance
forced into his or her mind and ascribes these threshold of the group members for too long.
thoughts to outside sources. [developed by U.S. communication theorist Er-
nest G. Bormann (1925–2008)]
thought intrusion interruption of the stream
of consciousness by unwanted mental contents. thrombosis n. the presence or formation of a
See intrusive thoughts. blood clot (thrombus) in a blood vessel, includ-
ing blood vessels in the heart (coronary throm-
thought obstruction see blocking. bosis). Formation of a blood clot in a vein is
thought pressure see pressure of ideas. called venous thrombosis. Thrombosis is likely
thought process any of the cognitive pro- to develop where blood flow is impeded by dis-
cesses involved in mental activities that are ease, injury, or a foreign substance. A thrombosis
beyond perception, such as reasoning, remem- in the brain (cerebral thrombosis) can cause a
bering, imagining, problem solving, and making thrombotic stroke or cerebrovascular ac-
judgments. See thinking. See also higher men- cident. —thrombotic adj.
tal process; symbolic process. thrombotic stroke the most common type of
thought-process disorder see formal stroke, occurring when blood flow to the brain
thought disorder. is blocked by a cerebral thrombosis. A throm-
thought stopping the skill of using a physical botic stroke typically results from narrowing or
or cognitive cue to stop negative thoughts and occlusion of a large blood vessel in the brain, es-
redirect them to a neutral or positive orienta- pecially the carotid or middle cerebral artery, by
tion. This skill is taught in some behavior thera- atherosclerosis. Onset of symptoms can be
pies, when the therapist shouts “Stop!” to gradual and is frequently preceded by transient
interrupt a trend toward undesirable thoughts ischemic attacks.
and trains clients to apply this technique to thrombus n. a blood clot that forms in a blood
themselves. vessel (see thrombosis). A thrombus that be-
comes detached from its point of origin and is
thought suppression the attempt to control
carried in the blood to obstruct another site is
the content of one’s mental processes and specif-
called an embolus (see embolism).
ically to rid oneself of undesired thoughts or im-
ages. thumb sucking a common though not univer-
thought withdrawal the delusion that one’s sal habit among infants and young children, for- T
merly classified as a habit disturbance when
thoughts are being removed from one’s mind by
persisting beyond 3 or 4 years. It is commonly
other people or forces outside oneself.
explained as a basic sucking impulse from which
threat n. 1. a condition that is appraised as a the child derives pleasure as well as comfort and
danger to one’s self or well-being or to a group. relaxation.
2. an indication of unpleasant consequences for
failure to comply with a given request or de- Thurstone, Louis Leon (1887–1955) U.S. psy-
mand, used as a means of coercion. 3. any event, chologist. After receiving a master’s degree in en-
information, or feedback that is perceived as gineering from Cornell University in 1912,
conveying negative information about the self. Thurstone began studying psychology at the
—threaten vb. —threatening adj. University of Chicago under James Rowland
angell and at the Carnegie Institute of Technol-
threat appraisal the cognitive and emotional ogy under Walter Van Dyke Bingham (1880–
processes involved in assessing the potentiality 1952). He was awarded his doctorate in 1917
and level of threat. from the University of Chicago. Thurstone is
threat to self-esteem model a theory stating best known as a pioneer in psychometrics, the
that help from another is sometimes perceived field of psychological tests and measurements.
587
thymus
He and his wife, Thelma Gwinn Thurstone mone produced by the thyroid gland: the prin-
(1897–1993), developed and maintained for cipal thyroid hormone. It helps regulate me-
more than 20 years the American Council of Ed- tabolism by controlling oxidation rate in cells.
ucation’s Examination for High School Gradu- See also triiodothyronine.
ates and College Freshmen, which was the TIA abbreviation for transient ischemic at-
forerunner of the Scholastic Assessment Test tack.
(SAT). His contributions to methodology include
his development of the statistical technique of tianeptine n. a novel antidepressant compound
factor analysis to tease out primary abilities. with a modified tricyclic structure that en-
Thurstone founded the Psychometric Society hances, rather than blocks, the presynaptic
in 1936 and launched the Society’s journal reuptake of serotonin (see ssri) and thus de-
Psychometrika. Among his many honors were his creases serotonin neurotransmission, unlike the
election to the National Academy of Sciences majority of anti depressants. Its efficacy com-
and the American Academy of Arts and Sciences. pares favorably to currently used antidepres-
sants, and it is being investigated for clinical use
thymus n. an organ, located in the lower neck rein the United States. French trade name:
gion, that is part of the immune system. The Stablon.
thymus reaches maximum size at puberty, then
shrinks. During infancy it is the site of formation tic n. a sudden, involuntary contraction of a small
of T lymphocytes. group of muscles (motor tic) or vocalization
(vocal tic) that is recurrent, nonrhythmic, and
thyroid gland an endocrine gland forming a stereotyped. Tics may be simple (e.g., eye blink-
shieldlike structure on the front and sides of ing, shoulder shrugging, grimacing, throat clear-
the throat, just below the thyroid cartilage. It ing, grunting, yelping) or complex (e.g., hand
produces the iodine-containing thyroid hor- gestures, touching, jumping, echolalia, copro-
mones (thyroxine and triiodothyronine) in res- lalia). Tics may be psychogenic in origin; alter-
ponse to thyroid-stimulating hormone from the natively, they may occur as an adverse effect of a
anterior pituitary gland. C cells (parafollicular medication or other substance or result from a
cells) in the thyroid produce the hormone head injury, neurological disorder, or general
calcitonin, which controls levels of calcium and medical condition.
phosphate in the blood.
tic disorder in DSM–IV–TR, any one of a group
thyroid hormones any of the hormones syn- of disorders characterized by the occurrence
thesized and released by the thyroid gland. many times a day of motor tics, vocal tics, or
The primary thyroid hormone, thyroxine (T4), both that is not due to a general medical condi-
is metabolized to triiodothyronine (T3) tion or the effects of a medication. The group in-
within target tissues. Plasma levels of T4 are cludes tourette’s disorder, chronic motor
much higher than those of T3, but T3 has the or vocal tic disorder, transient tic disor-
more potent physiological activity. Both hor- der, and tic disorder not otherwise speci-
mones play a central role in regulating basic met- fied.
abolic processes and the early development and
differentiation of the brain. Extremes in secre- tic disorder not otherwise specified in
tion of these hormones have major effects on DSM–IV–TR, a disorder characterized by the pres-
metabolism and cognitive function (see con- ence of tics that does not meet the diagnostic cri-
genital hypothyroidism; myxedema; thyro- teria for a specific tic disorder. Examples are
toxicosis). Calcitonin, a hormone released by bouts of tics lasting less than 4 weeks and tics
parafollicular cells of the thyroid gland, plays a that appear after the age of 18.
crucial role in calcium and phosphate metabo- time and rhythm disorders speech and lan-
lism. guage problems related to the timing of sounds
and syllables, including repetitions, prolonga-
T thyrotoxicosis n. a condition caused by an ex-
tions, and stuttering. The disorders are often
cess of thyroid hormones, which may be
produced by an overactive thyroid gland or ad- functional and may be complicated by feelings
ministered therapeutically. Endogenous thyro- of guilt. The condition may be treated with a
toxicosis may be familial and can involve an combination of psychotherapy and speech ther-
autoimmune reaction in which the patient’s an- apy, using such techniques as cancellation (in-
tibodies stimulate rather than destroy the cells terrupted stuttering), voluntary stuttering, or
producing thyroid hormone. Thyrotoxicosis is rewarding or reinforcing fluent speech.
characterized by nervousness, tremor, palpita- time disorientation loss of the ability to keep
tion, weakness, heat sensitivity with sweating, track of time or the passage of time. Inability to
and increased appetite with weight loss. accurately state the correct year, month, day, or
Thyrotoxicosis is frequently associated with hy- hour is a common symptom of mental disorder.
perplasia (enlargement) of the thyroid gland, as See disorientation.
in graves’ disease, or the development of thy- time distortion a type of perceptual distortion,
roid nodules (Plummer’s disease), which occurs sometimes experienced in altered states of con-
in older people. See also hyperthyroidism. sciousness, in which time appears to pass either
thyroxine (T4) n. an iodine-containing hor- with great rapidity or with extreme slowness.
588
Titchener, Edward Bradford
Perception of past and future may also be trans- eliminate stimulus effects of earlier behaviors or
formed. as a marker in a series of events.
time-extended therapy a form of group time sampling a strategy commonly used in di-
therapy in which prolonged sessions replace or rect observation that involves noting and re-
alternate with sessions of normal length. The ex- cording the occurrence of a target behavior
perience is usually highly emotional and reveal- whenever it is seen during a stated time interval.
ing since, due to fatigue and other reasons, the The process may involve fixed time periods (e.g.,
participants have insufficient energy for defen- every 5 min) or random time intervals. For ex-
sive games. See also accelerated interaction; ample, a researcher may observe a group of chil-
marathon group. dren for 10 s every 5 min for a specific 30 min
period each day, noting the occurrence or non-
time-lag design a type of quasi-experimental occurrence of particular behaviors. Observations
research in which participants of the same age taken during these periods are known as time
are compared at different time periods. For ex- samples.
ample, a time-lag study of intelligence might
compare a group of people who were 20 years time series a set of measures on a single attrib-
old in 2005 with groups who were 20 years old ute measured repeatedly over time.
in 2006, 2007, and 2008. Used in examining time-series design an experimental design
human developmental processes, time-lag de- that involves the observation of units (e.g., peo-
signs have the benefit of controlling for time of ple or countries) over a defined time period.
testing effects but the drawbacks of low inter- timidity n. 1. the tendency to take great caution
nal validity and the difficulty in separating coin approaching a perceived risk or to avoid the
hort effects from age effects. risk altogether. 2. see shyness. —timid adj.
time-lagged correlation the correlation of a tinnitus n. noises in one or both ears, including
measure at one point in time with the value of ringing, buzzing, or clicking sounds due to acute
that same measure at a different point in time; ear problems, such as Ménière’s disease, distur-
for example, the correlation of IQ scores of indi- bances in the receptor mechanism, side effects
viduals at 5 years of age with their IQ scores of drugs (especially tricyclic antidepressants), or
when they are 10 years of age. epileptic aura. Occasionally tinnitus is due to
timeless moment 1. an infinitely small dimen- psychogenic factors (see sensory conversion
sion of the present instant as conceptualized by symptoms).
traditional linear time. See psychological mo- tip-of-the-tongue phenomenon (TOT
ment; specious present. 2. an experience in phenomenon) the experience of attempting to
which one’s normal awareness of time dissolves retrieve from memory a specific name or word
and one feels a sense of holistic involvement but not being able to do so: The fact is ordinarily
with another person or thing or with the uni- accessible and seems to hover tantalizingly on
verse as a whole. Such peak experiences are of the rim of consciousness. See also retrieval
particular interest in humanistic psychology. block.
See being cognition. Titchener, Edward Bradford (1867–1927)
time-limited day treatment an outpatient British-born U.S. psychologist. A member of the
all-day therapeutic community approach used founding generation of American psychologists,
with clients diagnosed with personality disor- Titchener studied under Wilhelm wundt, earn-
ders that capitalizes on the positive attributes of ing his doctorate from the University of Leipzig
the clients as a group. [developed by Canadian in 1892. After a brief period at Oxford Uni-
psychologist William E. Piper (1945– )] versity, in 1895 Titchener became a professor
of psychology at Cornell University, where he
time-limited psychotherapy (TLP) therapy spent the remainder of his career. Determined to
that is limited to a predetermined and agreed-
make psychology a rigorously experimental sci- T
upon number of sessions over a specified period
ence, Titchener became the chief exponent of
of time. Also called limited-term psycho-
structuralism in America, emphasizing the
therapy. See also brief psychotherapy.
use of systematic introspection in a laboratory
time out (TO) 1. a technique, originating in be- setting to uncover the elements of experience
havior therapy, in which undesirable behavior (sensations, images, and feelings). He also deve-
is weakened and its occurrence decreased, typi- loped experimental techniques, which were more
cally by moving the individual away from the fully accepted than his atomistic approach. To
area that is reinforcing the behavior. For exam- promote further his vision of psychology as an
ple, a child may be temporarily removed from an experimental science, Titchener founded a club
area when misbehaving. The technique is used called The Experimentalists, which eventually
in schools and by parents to decrease the unde- became the Society of Experimental Psycholo-
sirable behavior by isolating the misbehaver for gists. His club was controversial among psychol-
a period. Also called time out from rein- ogists because of its exclusivity (membership was
forcement. 2. in operant conditioning, a by invitation only and did not include experi-
time interval during which a behavior does not mentalist women). Titchener’s multivolume text-
occur. A time-out procedure may be used to book, Experimental Psychology: A Manual of Labo-
589
titration
ratory Practice (1901–1905), was widely influen- in response to increasingly complex instruc-
tial. See also imageless thought. tions. The Token Test is used to identify and
titration n. a technique used in determining the evaluate receptive language dysfunction associ-
optimum dose of a drug needed to produce a de- ated with aphasia. [originally developed in
sired effect in a particular individual. The dosage 1962 by Italian neuropsychologists Ennio De
may be either gradually increased until a notice- Renzi and Luigi A. Vignolo]
able improvement is observed in the patient or tolerance n. 1. a condition, resulting from per-
adjusted downward from a level that is obvi- sistent use of a drug, characterized by a markedly
ously excessive because of unwanted adverse ef- diminished effect with regular use of the same
fects or toxicity. To avoid unpleasant side effects dose of the drug or by a need to increase the dose
when starting pharmacotherapy, some drugs markedly over time to achieve the same desired
must be slowly titrated upward to a therapeutic effect. Tolerance is one of the two prime indica-
dose. Likewise, many drugs should be slowly ti- tions of physical dependence on a drug, the
trated downward upon cessation of therapy both other being a characteristic withdrawal syn-
to avoid discontinuation side effects as well as to drome. Development of drug tolerance involves
monitor for the recurrence of symptoms. See ta- several mechanisms, including pharmacological
pering. ones (i.e., metabolic tolerance and pharma-
TLP abbreviation for time-limited psychother- codynamic tolerance) and a behavioral one
apy. (i.e., a behavioral conditioning process). Also
TM abbreviation for transcendental medita- called drug tolerance. See substance de-
tion. pendence. 2. acceptance of others whose ac-
TMA abbreviation for trimethoxyampheta- tions, beliefs, physical capabilities, religion,
mine. customs, ethnicity, nationality, and so on differ
from one’s own. 3. a fair and objective attitude
TMJ syndrome a disorder of muscles operating toward points of view different from one’s own.
the lower jaw at the temporomandibular joint 4. permissible or allowable deviation from a
(TMJ) just in front of the ear. The condition, specified value or standard. —tolerant adj.
which may be due to tension or stress, arthritis,
dislocation or other injury, or a tumor, is often Tolman, Edward Chace (1886–1959) U.S.
marked by facial pain, limited jaw movement, psychologist. Tolman earned his doctorate from
and clicking of the jaw during movement. Harvard University in 1915, studying under
TMS abbreviation for transcranial magnetic Hugo Münsterberg (1863–1916) After teaching
stimulation. for 3 years at Northwestern University, he joined
TO abbreviation for time out. the faculty of the University of California, Berke-
ley, where he remained for the rest of his career.
tobacco n. the dried leaves of the plant Nicotiana Tolman, along with Clark Leonard hull and
tabacum and other Nicotiana species (native to B. F. skinner, is known as a founder of neo-
tropical America but now cultivated worldwide), behaviorism who followed in the path set by
which are smoked, chewed, or sniffed for their John B. watson and his theory of behaviorism.
stimulant effects. The main active ingredient is Tolman differed from Hull, Skinner, and Wat-
nicotine. The leaves also contain volatile oils, son, however, in the importance that he gave
which give tobacco its characteristic odor and such mentalist concepts as purpose and cogni-
flavor. Tobacco has no therapeutic value but is tive maps. In his theory of purposive behavior-
of great commercial and medical importance ism, Tolman held that behavior, far from being
because of its widespread use and associated randomly initiated, was persistently directed to-
detrimental cardiovascular, pulmonary, and car- ward a goal until the goal was attained. Drawing
cinogenic effects. Indeed, smoking tobacco ciga- on the field theory of psychologist Kurt
rettes was first identified by the U.S. Surgeon lewin, Tolman also argued that behavior can be
T General in the 1960s as the major preventable described in terms of goal-directed vectors and
cause of death and disability. valences within a field. His selected papers are
tobacco dependence see nicotine depend- collected in two important books, Purposive Be-
ence. havior in Animals and Men (1932) and Behavior
Tofranil n. a trade name for imipramine. and Psychological Man (1951). Among Tolman’s
token economy in behavior therapy, a pro- many honors were election to the National
gram, sometimes conducted in an institutional Academy of Sciences (1937) and to the presi-
setting (e.g., a hospital or classroom), in which dency of the American Psychological Associa-
desired behavior is reinforced by offering tokens tion (1937). He also received the American
that can be exchanged for special foods, televi- Psychological Association’s Distinguished Scien-
sion time, passes, or other rewards. See also tific Contribution Award (1957).
backup reinforcer; behavior modification; toloache n. a plant, Datura innoxia, belonging to
operant conditioning therapy. the nightshade family and closely related to
Token Test a test of auditory-language process- jimsonweed, that contains numerous alkaloids
ing in which participants are asked to manipu- with powerful anticholinergic effects. The
late tokens of different shapes, sizes, and colors plant has been used by indigenous peoples of
590
Torrance Tests of Creative Thinking
North and Central America in religious ceremo- other tissue surface, such as a mucous mem-
nies and adolescent rituals. brane. The drug is absorbed through the surface
toluene n. a volatile solvent that, when chroni- and produces its effects on underlying tissues.
cally inhaled, can cause kidney failure and Some therapeutic drugs that are poorly absorbed
death. See inhalant. through the skin are formulated with inert sub-
stances with better penetrating powers, which
Tolvon n. a trade name for mianserin.
act as carriers.
tomato effect the rejection of an effective treat-
ment because it does not fit an established medi- topiramate n. an anticonvulsant drug that is
cal model or because it does not make sense in also used as a mood stabilizer in the treatment
light of currently accepted medical theories. It of bipolar disorders. Topiramate works by slow-
has been applied to biofeedback training. The ing neurotransmission through blockade of so-
tomato effect is so named because in America dium channels (see ion channel); it also
the tomato—known to be a member of the apparently facilitates the activity of the neuro-
nightshade family—was originally thought to be transmitter gamma-aminobutyric acid (GABA)
poisonous; for this reason, tomatoes were not and limits activity at glutamate receptors.
consumed in America until 1820, even though Psychomotor slowing and somnolence are com-
Europeans had been eating them for generations monly reported adverse effects. U.S. trade name:
without harm. Topamax.
tomboyism n. the tendency of girls to adopt be- topographical amnesia impairment in topo-
havior traditionally associated with boys. See graphical memory, that is, memory for places
also role confusion; sissy behavior. and spatial layouts.
tomomania n. a compulsive urge to undergo topographical psychology the process of
surgery. See also munchausen syndrome. mapping the mind, or locating the various men-
tal processes in different regions or systems of
tonic–clonic seizure a seizure characterized by
the mind. Carl jung, for example, divided the
both tonic and clonic motor movements (it was
mind into the conscious ego, the personal un-
formerly known as a grand mal seizure). In the
conscious, and the collective unconscious;
tonic phase the muscles go into spasm and the
Sigmund freud divided the mind into three lev-
individual falls to the ground unconscious;
els: conscious, preconscious, and unconscious.
breathing may be suspended. This is followed by
Also called mental topography.
the clonic phase, marked by rapidly alternating
contraction and relaxation of the muscles, re- topographic model the original division of
sulting in jaw movements (the tongue may be the psyche into three regions or systems as pro-
bitten) and urinary incontinence. Also called posed by Sigmund freud in 1913. The divisions
generalized tonic–clonic seizure. are: (a) the system unconscious (Ucs), made up
topalgia n. pain that is localized in one spot or of unconscious impulses clustering around spe-
small area without any lesion or trauma to ac- cific drives or instincts, such as hunger, thirst,
count for it. Topalgia often is a symptom of a and sex, as well as repressed childhood memo-
somatoform disorder, particularly in cases in ries associated with them; (b) the system con-
which the pain seems to occur in unlikely seg- scious (Cs), which enables the individual to
ments of nerve or circulatory patterns. adapt to society, distinguish between inner and
outer reality, delay gratification, and anticipate
Topamax n. a trade name for topiramate. the future; and (c) the system preconscious
topdog n. a set of internal moral standards or (Pcs), which stands between the conscious
rules of conduct that produce anxiety and con- and unconscious systems and is made up of logi-
flict in the individual when they are not fulfilled cal, realistic ideas intermingled with irrational
or carried out. The topdog is an ego state of supe- images and fantasies. Also called descriptive
riority over the underdog. [defined by Ger- approach; systematic approach; topo-
man-born U.S. psychiatrist Frederick (Fritz) R. graphic hypothesis. Compare dynamic
T
Perls (1893–1970)] model; economic model. See also structural
top-down analysis a deductive approach to model.
problem solving that begins with a hypothesis or torpor n. a condition of total inactivity or leth-
general principle and proceeds from this to an argy. Only a very strong stimulus can elicit a re-
examination of empirical data or specific in- sponse from an individual in such a condition.
stances. Compare bottom-up analysis. Also
Torrance Tests of Creative Thinking
called above-down analysis.
(TTCT) two batteries of pencil-and-paper test
topectomy n. a former psychosurgical proce- items—a verbal test (thinking creatively with
dure in which selected areas of the frontal cortex words) and a figural test (thinking creatively
were excised in cases of refractory mental illness with pictures)—that can be used at all stages
(e.g., schizophrenia) that had not responded to from kindergarten to graduate school. Typical
electroconvulsive therapy or other types of treat- “activities,” as they are called, involve listing
ment. possible consequences of the action in an in-
topical application the administration of a triguing picture, citing ways of improving a toy,
drug by applying it to the surface of the skin or and incorporating a curved line in drawing an
591
torsades de pointes
unusual picture. The object is to test for four opment of preterm infants and bringing about a
characteristics of creative thinking: fluency, flex- greater tolerance of touch by children with au-
ibility, originality, and elaboration. See creativ- tism, which has resulted in improved bonding
ity test. [originally devised in 1966 by Ellis Paul and communication with their parents. Also
Torrance (1915–2003), U.S. psychologist] called therapeutic touch. See also comple-
torsades de pointes see electrocardio- mentary and alternative medicine; mas-
graphic effect. sage.
torticollis n. a continuous or spasmodic con- tough love the fostering of individuals’ well-
traction of the neck muscles, resulting in rota- being by requiring them to act responsibly and
tion of the chin and twisting of the head to one to seek professional assistance when they find it
side. This form of dystonia may be neurological difficult to act in their own best interests. Often,
or congenital and may respond to drug treat- strict oversight and restrictions of personal free-
ment or biofeedback training. However, it dom and privileges must be willingly accepted
may also be psychogenic. Torticollis is sometimes by the target individual. Tough love is some-
classed as a complex (dystonic) tic. —torti- times seen as a stance taken by a therapist or
collar adj. counselor or in interventions by family and
torture n. the subjection of individuals to severe, friends of individuals with problem behaviors
painful physical abuse and violence, which (e.g. substance abuse, violent behavior).
often includes treatment that simulates death or ToughLove International a voluntary orga-
near-death experiences. Torture may also in- nization for parents, children, or communities
volve mental or psychological abuse. who seek help in dealing with the out-of-control
total institution 1. a highly organized and re- behavior of a family member. Parent support
strictive social institution that maintains a groups aim to help parents take a firm stand in
high degree of control over the activities of those helping their children take responsibility for
individuals who are members of, or confined to, their behavior.
it. Prisons, mental health facilities, and military tough-mindedness n. 1. a personality trait re-
bases are (in many cases) examples, because flecting the extent to which people demonstrate
nearly all the activities of prisoners, patients, low levels of compassion and high levels of
and personnel are regulated by the staff or offi- aggression in social interactions. [proposed by
cers. 2. a traditional social institution that be- Hans J. eysenck] 2. a personality trait character-
comes so rigid that it takes on many of the ized by empiricism, materialism, skepticism, and
qualities of a restrictive social institution. Mar- fatalism. Compare tender-mindedness. [first
riage, for example, has been characterized as a described by William james] —tough-minded
total institution because it often creates a high adj.
degree of uniformity in the lifestyles and choices
Tourette’s disorder a tic disorder character-
of adults.
ized by many motor tics and one or more vocal
total recall 1. the ability to remember an event tics, such as grunts, yelps, barks, sniffs, and in a
completely and accurately. 2. in a recall task, the few cases an irresistible urge to utter obscenities
total number of items recalled across conditions (see coprolalia). The tics occur many times a
or tests. day for more than a year, during which time any
totem n. 1. a revered animal, plant, natural force, period free of tics is never longer than 3 months.
or inanimate object that is conceived as the an- The age of onset for the disorder is before 18
cestor, symbol, protector, or tutelary spirit of a years; in most cases it starts during childhood
people, clan, or community. It is usually made or early adolescence. Also called Gilles de la
the focus of certain ritual activities and taboos, Tourette’s syndrome. [first described in 1885
typically against killing or eating it. 2. as inter- by Georges Gilles de la Tourette (1857–1904),
T preted by Sigmund freud in Totem and Taboo French physician]
(1912–1913), any symbol or representation of toxic delirium delirium resulting from the ac-
the primal father. —totemic adj. —totemism tion of a poison.
n.
toxicity n. the capacity of a substance to produce
toucherism n. sexual interest and arousal ob-
toxic (poisonous) effects in an organism. The
tained from touching a stranger on a erotic part
toxicity of a substance—whether a drug, an in-
of the body, particularly the breasts, buttocks,
dustrial or household chemical, or other agent—
or genitals. This is often done as an apparent
generally is related to the size of the dose per
accident, in doorways or hallways. See also
body weight of the individual, expressed in
frotteurism.
terms of milligrams of chemical per kilogram of
touch therapy treatment that involves touch- body weight. Toxicity also may be expressed in
ing or manipulating parts of an individual’s terms of the median lethal dose (LD50). See
body to ease physical pain or to promote relax- also behavioral toxicity.
ation and a general sense of well-being. Touch
therapy has been shown to have numerous ben- toxicomania n. 1. a morbid desire to consume
efits for children (among others), improving, for poisons. 2. a severe dependency on drugs.
example, the physical and psychological devel- toxic psychosis any psychosis resulting from
592
trait profile
ingestion of poisons or drugs or caused by toxins functions, particularly cognitive flexibility, at-
produced within the body. tention, sequencing, visual search, and motor
toy test any of a variety of projective tests for speed. The TMT, originally developed in 1938 by
children that make use of dolls, puppets, or other U.S. psychologists John E. Partington and Russell
toys. See projective technique. G. Leiter, was initially known as the Divided At-
tention Test and subsequently as Partington’s
TPA abbreviation for third-party administra- Pathways Test.
tor.
train 1. vb. to teach or condition an individual to
TPD abbreviation for trance and possession disor-
perform certain responses, behaviors, tasks, or
der (see dissociative trance disorder).
activities, particularly in a learning experiment.
TPT abbreviation for tactual performance 2. n. a succession of mild electrical impulses,
test. such as is given in brain stimulation.
trace n. see memory trace. trainable mentally retarded formerly, de-
tract n. 1. a bundle or group of nerve fibers scribing people, usually children or young
within the central nervous system. The name of adults, with moderate mental retardation (IQ 35
a tract typically indicates its site of origin fol- to 49) who did not appear to profit from aca-
lowed by its site of termination; for example, the demic education in special classes but were able
reticulospinal tract runs from the reticular for- to achieve a degree of self-care, social adjustment
mation of the brainstem to the spinal cord. at home, and vocational usefulness in such set-
Compare nerve. 2. a series of organs that as tings as sheltered workshops.
a whole accomplishes a specific function (e.g., trainer n. 1. in mental health, a professional
the digestive tract). 3. a region, passage, or path- leader or facilitator of a sensitivity-training
way. group (see t-group). 2. a teacher or supervisor
tractotomy n. the surgical interruption of a of individuals learning to practice psychother-
nerve tract in the brainstem or spinal cord. One apy.
form of tractotomy is of benefit in bipolar disor- training analysis psychoanalysis of a trai-
der that is resistant to other forms of treatment. nee analyst. Its purpose is not only to provide
trademark n. any word, phrase, name, symbol, training in the concepts and techniques of psy-
device, or combination thereof used by manu- choanalysis, but also to increase insight into per-
facturers or merchants to identify their products. sonal sensitivities or other emotional reactions
While a trademark identifies products, a trade that might interfere with the process of analyz-
name identifies the company that makes or sells ing patients in the form of a counter-
them. In the area of pharmacology, the two transference. Also called didactic analysis.
terms are often used interchangeably to refer to training group see t-group.
proprietary drugs.
training school formerly, a rehabilitation facil-
traditional marriage 1. a marriage according ity for children or adults with mental retar-
to the traditional norms of a given society, usu- dation, utilizing interdisciplinary teams of
ally for the primary purpose of establishing a therapists and allied health care practitioners to
family. Although prenuptial customs vary in dif- provide residential, health, training, vocational,
ferent cultures, a traditional marriage generally and leisure services. Although such facilities at-
follows a period of courtship, public announce- tempted to provide homelike settings, this was
ment of wedding plans, and a wedding cere- seldom achieved in practice. Their use, once
mony. Compare nontraditional marriage. common, greatly diminished in the late 20th
2. a marriage of husband and wife, wherein the century. See also public residential facility.
former is the primary or sole breadwinner and
the latter holds primary or sole responsibility for trait n. 1. an enduring personality characteristic
maintaining the home and managing child care. that describes or determines an individual’s be-
havior across a range of situations. 2. in genetics, T
tradition-directed adj. describing or relating an attribute resulting from a hereditary predis-
to individuals whose values, goals, and behavior position (e.g., hair color or facial features).
are largely determined by their traditional
cultural heritage, that is, by the social norms trait anxiety proneness to experience anxiety.
transmitted by their parents. Compare inner- People with high trait anxiety tend to view the
directed; other-directed. [introduced by U.S. world as more dangerous or threatening than
sociologist David Riesman (1909–2002)] those with low trait anxiety and to respond with
state anxiety to situations that would not elicit
Trail Making Test (TMT) a connect-the-dot this response in people with low trait anxiety.
task that forms part of the halstead–reitan [defined in 1972 and 1983 by U.S. psychologist
neuropsychological battery. Trails A re- Charles D. Spielberger (1927– )]
quires the connection in sequence of 25 dots
labeled by numbers. Trails B requires the connec- trait organization the way in which an indi-
tion in sequence of 25 dots labeled by alternat- vidual’s personal traits are related and comprise
ing numbers and letters (1–A–2–B–3–C). The a unique, integrated whole.
test, one of the most widely used for cognitive trait profile a graphic display of test scores in
impairment, is purported to measure several which each score represents an individual trait.
593
trait theory
These scores or ratings are often arranged on a and ultimately between the patient and other in-
common scale to enable them to be interpreted dividuals in his or her environment.
quickly. Also called psychogram. transactional analysis (TA) a theory of per-
trait theory approaches that explain personal- sonality and a form of dynamic group or individ-
ity in terms of traits, that is, internal character- ual psychotherapy focusing on characteristic
istics that are presumed to determine behavior. interactions that reveal internal ego states and
Some examples are allport’s personality the games people play in social situations. Spe-
trait theory, cattell’s personality trait cifically, the approach involves: (a) a study of
theory, and the five-factor personality three primary ego states (parent, child, adult)
model. and determination of which one is dominant in
trance n. 1. a state characterized by markedly the transaction in question; (b) identification of
narrowed consciousness and responsiveness to the tricks and expedients, or games, habitually
stimuli. 2. a state induced by hypnosis or auto- used in the client’s transactions; and (c) analysis
suggestion and characterized by openness, or of the total script (see script analysis), or un-
availability, to suggestion (see hypnotic sus- conscious plan, of the client’s life, in order to un-
ceptibility). The hypnotized person may expe- cover the sources of his or her emotional
rience a light trance, accepting such suggestions problems. [developed in the 1950s by Canadian-
as inability to open the eyes or rigidity or lack born U.S. psychologist Eric Berne (1910–1970)]
of sensation in a limb, or a medium trance, transactional psychotherapy psychother-
in which there might be partial amnesia, apy that emphasizes the daily interactions be-
posthypnotic amnesia, and posthypnotic tween the client and others in his or her life.
suggestion. A deep trance might be charac- transactional analysis is a specific type of
terized by such effects as an inability to open the therapy that is based on types of transactions
eyes without affecting the trance, complete that are considered dysfunctional.
somnambulism, positive and negative post- transcendence n. in metaphysics and in the
hypnotic hallucinations, and hyperesthesia study of consciousness, a state of existence or
(excessive sensibility). Also called hypnotic perception that exceeds—and is not definable in
trance. terms of—normal understanding or experience.
trance and possession disorder (TPD) see The term implies states that go beyond the phys-
dissociative trance disorder. ical world and the nature of material existence.
—transcendent adj.
trance disorder see dissociative trance dis-
order. transcendence need in the psychoanalysis of
Erich fromm, the human need to create so as to
trance logic the presumed tendency of hypno- rise above passivity and attain a sense of mean-
tized individuals to engage simultaneously in
ing and purpose in an impermanent and seem-
logically contradictory or paradoxical trains of
ingly random or accidental universe. Both
thought. It has been suggested that trance logic
creativity and destructiveness are considered by
represents evidence of parallel processing in
Fromm to be manifestations of the transcen-
that there appears to be simultaneous regis-
dence need.
tration of information at different levels of
awareness. See divided consciousness; neodis- transcendence therapy a form of therapy
sociative theory. that is spiritually oriented and intended to help
people achieve an inner sense of peace by first
tranquilizer n. a drug that is used to reduce understanding their role in the larger picture of
physiological and subjective symptoms of anxi- life and then using that understanding to over-
ety. In the past, distinctions were made between come disappointments, difficulties, and other
so-called major tranquilizers (antipsychotics) hardships. It is based on the concept of forma-
and minor tranquilizers (anxiolytics, e.g.,
T benzodiazepines).
tive spirituality, which postulates that humans
are not passive givers or receivers of information
tranquilizer chair a heavy wooden chair used or experience but, rather, active interpreters of
in early psychiatry in which patients were reality, engaging in an inner dialogue to recog-
strapped at the chest, abdomen, ankles, and nize, relate to, and modify individual construals
knees, with their head inserted in a wooden box. of existence. [developed by Dutch-born U.S. psy-
This method of restraint was preferred to the chologist Adrian van Kaam (1920–2007)]
straitjacket because it reduced the flow of transcendental meditation (TM) a technique
blood to the head and did not interfere with of concentrative meditation for achieving a
bloodletting, one of the standard treatments of transcendental state of consciousness. Based
the time. [devised by U.S. physician and psychia- on the Bhagavadgita and other ancient Hindu
trist Benjamin Rush (1745–1813)] writings, it was introduced in the United States
transaction n. 1. any interaction between the in 1959 by Indian-born guru Maharishi Mahesh
individual and the social or physical environ- Yogi. The modern version of the original disci-
ment, especially during encounters between two pline consists of six steps that culminate in sit-
or more people. 2. in some psychotherapies, the ting with one’s eyes closed, while repeating a
interplay between the therapist and the patient mantra, for two 20-minute periods a day. Repe-
594
transference resistance
tition of the mantra serves to block distracting that is designed to release a drug at a steady rate
thoughts and to induce a state of relaxation in through absorption through the skin into the
which images and ideas can arise from deeper bloodstream. Transdermal patches are used, for
levels of the mind and from the cosmic source example, to administer nicotine in progressively
of all thought and being. The result is said to smaller doses to people who are trying to give up
be not only a greater sense of well-being but also smoking.
more harmonious interpersonal relations and Transderm-Scop n. a trade name for scopol-
the achievement of a state of ultimate self- amine.
awareness and restful alertness. See also mystic
transfer 1. vb. to shift or change from one loca-
union.
tion to another, one form to another, or one sit-
transcendental state a level of consciousness uation or condition to another. 2. n. the shift
believed to reach beyond waking, sleeping, and or change thus produced. 3. n. in gestalt psy-
hypnotic states. It is characterized physically by chology, the use of the solution to one prob-
lowered metabolism and reduced adrenergic lem in solving a second problem that has
functions and psychologically by alleviation of elements in common with the first.
tension, anxiety, and frustration and a high level transference n. in psychoanalysis, the dis-
of tranquillity. See also transcendental medi- placement or projection onto the analyst of
tation. unconscious feelings and wishes originally di-
transcendent counseling a form of counsel- rected toward important individuals, such as
ing that is based on the notion that behavior is parents, in the patient’s childhood. This process,
a product of an individual’s lifestyle and that which is at the core of the psychoanalytic
behavior change can only be achieved through method, brings repressed material to the surface
lifestyle change. Various directive and action- where it can be reexperienced, studied, and
oriented techniques and activities are employed, worked through. In the course of this process, it
such as interpersonal counseling, the use of re- is posited that the sources of neurotic difficulties
laxation and meditation, and adoption of exer- are frequently discovered and their harmful ef-
cise and nutrition programs. [developed by U.S. fects alleviated. Although quite specific to psy-
psychologist Frederick D. Harper (1943– )] choanalysis, the term’s meaning has had an
transcranial magnetic stimulation (TMS) impact far beyond its narrow confines, and
localized electrical stimulation of the brain transference—as unconscious repetition of ear-
through the skull caused by changes in the mag- lier behaviors and projection onto new sub-
netic field in coils of wire placed around the jects—is acknowledged as ubiquitous in human
head. Depending on the parameters, TMS may interactions. The role of transference in counsel-
elicit a response or disrupt functioning in the re- ing and short-term dynamic psychotherapy is
gion for a brief time. The technique was well recognized, and ongoing attempts to study
originally devised and is primarily used as an in- its role in a range of therapeutic encounters
vestigatory tool to assess the effects of electrical promise to expand and elucidate its meanings.
stimulation of the motor cortex. It is also being See also analysis of the transference; coun-
investigated as a possible therapy for some types tertransference; negative transference;
of movement disorders and psychological condi- positive transference; transference resis-
tions, such as depression, obsessive-compulsive tance.
disorder, and Tourette’s disorder. Repetitive transference analysis see analysis of the
transcranial magnetic stimulation (rTMS) con- transference.
sists of a series of TMS pulses. transference cure see flight into health.
transcription n. in genetics, the process transference neurosis in psychoanalysis,
whereby the genetic information contained in neurotic reactions released by the transfer-
dna is transferred to a molecule of messenger ence process that result from the revival and T
rna (mRNA), which subsequently directs pro- reliving of the patient’s early conflicts and trau-
tein synthesis. The base sequence of the mRNA mas. These reactions are posited to replace the
is complementary to that of the coding DNA original neurosis and help the patient become
strand and faithfully represents the instructions aware that his or her attitudes and behavior are
for assembling the component amino acids of actually repetitions of infantile drives. It is be-
the protein encoded by the gene (see genetic lieved that the transference neurosis must be re-
code). solved if the patient is to free himself or herself
transcultural psychotherapy any form of from the harmful effects of past experiences and
psychodynamic psychotherapy that empha- adopt more appropriate attitudes and responses.
sizes cultural sensitivity and awareness, includ- transference remission see flight into
ing culturally defined concepts of emotion, health.
psychodynamics, and behavior. In the psychiat- transference resistance in psychoanalysis, a
ric community the term is used somewhat more form of resistance to the disclosure of uncon-
often in a sense similar to multicultural scious material, in which the patient maintains
therapy in clinical psychology. silence or attempts to act out feelings of love
transdermal patch an adhesive application or hate transferred from past relationships to
595
transformation
the analyst. See also analysis of the transfer- are classified in DSM–IV–TR as adjustment dis-
ence. orders. See also adjustment reaction.
transformation n. 1. any change in appear- transient tic disorder a tic disorder involv-
ance, form, function, or structure. See also ing the presence of single or multiple tics occur-
metamorphosis. 2. the conversion of data to a ring many times a day for a period of between 4
different form through a rule-based, usually weeks and 1 year. The tics may be simple (e.g.,
mathematical process. 3. in psychoanalytic the- eye blinking, facial grimacing, throat clearing, or
ory, the process by which unconscious wishes or sniffing) or more complex (e.g., hand gestures,
impulses are disguised in order that they can stomping, echolalia, or meaningless change in
gain admittance to consciousness. —trans- vocal pitch or volume).
form vb. —transformational adj. transitional employment a vocational re-
transgender adj. having or relating to gender habilitation program that places individuals
identities that differ from culturally determined with disabilities or those who are economically,
gender roles and biological sex. Transgender socially, or otherwise disadvantaged (e.g., those
states include transsexualism, some forms of who are homeless or dependent on long-term
transvestism, and intersexuality. These states welfare) in paid entry-level positions in a com-
should not be confused with same-sex orienta- petitive working environment to gain the skills
tion. Also called transgendered. See also gen- and experience needed to eventually obtain a
der identity disorder. —transgenderism n. permanent job in the community workforce. Po-
transgenerational patterns patterns of be- sitions are often provided by participating com-
havior or personality characteristics that appear panies, and each placement typically lasts 6–9
in successive generations, often referring to neg- months. Program participants may hold several
ative or maladaptive behaviors (e.g., drug abuse, transitional employment positions before ob-
adolescent pregnancy, child abuse). taining permanent employment. See also sup-
ported employment.
transience n. impermanence that implies end-
ing and may invoke anticipation of loss. In transitional living a supervised living situa-
classical psychoanalytic theory, the idea that ev- tion that allows psychiatric or neurological
erything is transient may interfere with enjoy- patients to make the transition from the depend-
ment and preclude the establishment of deep or ence of a hospital setting to greater independ-
lasting relationships. —transient adj. ence before returning to fully independent
living.
transient global amnesia (TGA) a sudden
global amnesia—a form of transient amnestic transitional object 1. a thing (e.g., a doll or a
disorder—that typically resolves within 24 blanket) used by a child to ease the anxiety of
hours and occurs in the absence of any other separation from his or her first external object,
neurological abnormalities. Individuals with the mother, until the child has established a se-
TGA appear confused and disoriented and ask cure internal object, or mental representation of
frequent repetitive questions to try and make her, that provides a sense of security and com-
sense of their experience. They are unable to ac- fort. [first described by British psychoanalyst
quire new memories (anterograde amnesia); Donald W. Winnicott (1896–1971)] 2. by exten-
they also exhibit amnesiafor recently experi- sion, any person or thing that provides comfort,
enced events (retrograde amnesia). As the epi- security, and emotional well-being.
sode of TGA clears, new learning gradually transitional phenomenon an internal repre-
returns to normal and retrograde amnesia sentation of the relationship between an indi-
shrinks; individuals are left with a dense mem- vidual’s inner subjective representation of the
ory gap for the period of TGA. TGA may be trig- world and the objective reality of that world. See
gered by precipitating events, such as physical also transitional object. [first described by
exertion. The mechanism responsible for its oc- British psychoanalyst Donald W. Winnicott
T currence is poorly understood. (1896–1971)]
transient ischemic attack (TIA) an episode transitivism n. the illusory assumption of one’s
during which an area of the brain is suddenly de- symptoms or other characteristics by other peo-
prived of oxygen because its blood supply is temple. For example, individuals with schizophrenia
porarily interrupted, for example by thrombosis, might believe that others are also experiencing
embolism, or vascular spasm. Symptoms are the their hallucinations (e.g., hearing voices) or de-
same as those of stroke but disappear com- lusions (e.g., of being persecuted).
pletely, typically within 24 hours. transitory problem 1. a passing or short-lived
transient situational disturbance a DSM– symptom, sequela, or other sign of an illness or
II category for disturbances that in DSM–IV–TR disorder. 2. a problem or cause of concern that is
are classified as adjustment disorders. See also short-lived and of brief duration.
adjustment reaction. translation and back-translation as used
transient situational personality disor- primarily in cross-cultural research, a method of
der a DSM–I designation for posttraumatic ensuring that the translation of an assessment
stress disorder, replacing the older term trau- instrument into another language is adequate. A
matic neurosis. This category also included what bilingual person translates items from the source
596
trauma management therapy
language to the target language, and a different cable only if the condition is not due to another
bilingual person then independently translates mental disorder, such as schizophrenia, and is
the items back into the source language. The re- not associated with intersexuality or genetic
searcher can then compare the original with the abnormality. Many transsexuals feel that they
back-translated version to see if anything impor- belong to the opposite sex and are somehow
tant was changed in the translation. trapped in the wrong body. They therefore seek
transorbital lobotomy see lobotomy. to change their sex through surgical and hor-
monal means (see sex reassignment). —trans-
transparency n. 1. genuineness in relating to sexual adj., n.
other people, with minimal attempts to make a
good impression. 2. the state of being “invisi- transtheoretical model (TTM) a five-stage
ble,” that is, trying not to be noticed in certain theory to explain changes in people’s health be-
social situations (e.g., when volunteers are havior (see stages of change). It suggests that
sought for a task), for example, by avoiding eye change takes time, that different interventions
contact, remaining still, or hiding behind an- are effective at different stages, and that there are
other person. multiple outcomes occurring across the stages
(e.g., belief structure, self-efficacy). [developed in
transpersonal psychology an area in hu- the 1970s by U.S. clinical psychologist James O.
manistic psychology concerned with the ex- Prochaska (1942– )]
ploration of the nature, varieties, causes, and
effects of “higher” states of consciousness and transvestic fetishism in DSM–IV–TR, a para-
transcendental experiences. “Transpersonal” re- philia consisting of the persistent wearing by a
fers to the concern with ends that transcend heterosexual male of female clothes with the
personal identity and individual, immediate de- purpose of achieving sexual excitement and
sires. See also being cognition; peak experi- arousal. It typically begins in childhood or ado-
ence. lescence and should not be confused with trans-
vestism, the nonpathological cross-dressing
transplantation n. 1. the surgical implanta- by men or women of any sexual preference.
tion of a tissue or organ from one part of the
body to another or from one person (the donor) transvestism n. the process or habit of wearing
to another (the recipient). Such procedures often the clothes of the opposite sex. Transvestism,
induce pre- and postoperative anxieties, resis- or cross-dressing, is distinct from trans-
tance, and other behavioral manifestations that vestic fetishism. Also called transvestitism.
may have ramifications for psychological health —transvestic adj. —transvestite n.
and intervention. 2. the removal of a person Tranxene n. a trade name for clorazepate.
from a permanent home to a temporary resi- tranylcypromine n. see monoamine oxidase
dence or nursing home, which may result in inhibitor.
anxiety, depression, and other disturbances.
trauma n. 1. any disturbing experience that re-
transporter n. a protein complex that spans a sults in significant fear, helplessness, dissocia-
cell membrane and conveys neurotransmitters, tion, confusion, or other disruptive feelings
ions, or other substances between the exterior intense enough to have a long-lasting negative
and interior of the cell. For example, at synapses impact on a person’s attitudes, behavior, and
between neurons, transporters in the pre- other aspects of functioning. Traumatic events
synaptic membrane recognize and bind to neu- include those caused by human behavior (e.g.,
rotransmitter molecules and return them to the rape, toxic accidents) as well as by nature (e.g.,
presynaptic neuron for reuse (see reuptake). earthquakes) and often challenge an individual’s
Transporters may use passive transport, in which view of the world as a just, safe, and predictable
a substance is transported into or out of a cell ac- place. 2. any serious physical injury, such as a
cording to its concentration gradient across the widespread burn or a blow to the head. —trau-
cell membrane; or active transport, which is an matic adj. T
energy-dependent process often relying on the
hydrolysis of atp to provide energy to facilitate trauma management therapy a treatment
movement of a substance from one side of the program intended to alleviate the anxiety and
cell membrane to the other. fear, manage the anger, and enhance the inter-
personal functioning of combat veterans with
transposition of affect the transfer of the af- posttraumatic stress disorder. It is a sequential
fective component associated with a particular approach that combines (a) education, in which
idea or object to an unrelated idea or object, the client is informed about the symptom
as frequently occurs in obsessive-compulsive chronicity, skill deficits, and extreme social mal-
disorder. Also called displacement; displace- adjustment associated with posttraumatic stress
ment of affect. disorder; (b) exposure therapy, in which the
transsexualism n. a gender identity disor- client reexperiences—in imagination or through
der consisting of a persistent sense of discom- virtual reality—his or her specific traumatic
fort and inappropriateness relating to one’s events during individually administered weekly
anatomical sex, with a persistent wish to be rid sessions; (c) programmed practice, in which the
of one’s genitals and to live as a member of the client performs exposure-related homework as-
other sex. In DSM–IV–TR, the diagnosis is appli- signed by the therapist; and (d) socioemotional
597
traumatic brain injury
rehabilitation, in which the client participates treatment audit a procedure that measures
in structured, group-administered social and quality assurance in health care. Audit activities
emotional skills training sessions. [developed in include assessment of the structure, process, and
1996 by clinical psychologists B. Christopher outcome of the services provided. Audits occur
Frueh (1963– ), Samuel M. Turner (1944–2005), in a cyclical process, thus enabling the results of
Deborah C. Beidel, and Robert F. Mirabella and the assessment to be fed back to improve or
health administrator and political scientist Wal- maintain the services assessed.
ter J. Jones] treatment bias 1. a tendency for the type of
traumatic brain injury (TBI) damage to treatment given to a patient to be determined
brain tissue caused by external mechanical or influenced by the social class or cultural back-
forces, as evidenced by objective neurological ground of that patient. 2. a practitioner’s or
findings, posttraumatic amnesia, skull fracture, researcher’s unrealistically positive or negative
or loss of consciousness because of brain trauma. bias toward a particular type of intervention
traumatic disorder any disorder that results stategy.
from physical or psychological trauma. treatment effect the magnitude of the effect
traumatic grief a severe form of separation of a treatment (i.e., the independent variable)
distress that usually occurs following the sudden upon the response variable (i.e., the dependent
and unexpected death of a loved one. Numbness variable) in a study. It is usually measured as
and shock are frequently accompanied by a the difference between the level of response
sense of futility and purposelessness. A defining under a control condition and the level of re-
characteristic of traumatic grief is a sense of the sponse under the treatment condition in stan-
meaninglessness of life, although the total syn- dardized units.
drome includes many other painful and dys- treatment integrity see program integrity.
functional responses. treatment level a specific condition to which a
traumatic neurosis see transient situa- group or participant is exposed in a study or ex-
tional personality disorder. periment. For example, in a design employing
traumatic psychosis see situational psy- four groups, each of which is exposed to a differ-
chosis. ent dosage of a particular drug, each dosage
amount represents a level of the treatment fac-
trazodone n. a chemically unique antidepres-
tor.
sant that was introduced as a safer alternative
to the tricyclic agents. However, it was of limited treatment plan the recommended steps for in-
use as an antidepressant due to its pronounced tervening that the therapist or counselor devises
sedative effects and its association with prolonged, after an assessment of the client has been com-
painful, and unwanted erections (priapism) in a pleted. Many managed care plans require sub-
very small number of men who took the drug. Its mission of formal, written treatment plans prior
mechanism of antidepressant action is unclear; to approving mental health treatment. Compare
it is not a potent inhibitor of either serotonin or treatment protocol.
norepinephrine reuptake and it is an antagonist treatment protocol the formal procedures
at the 5-HT2 serotonin receptor. Although of lit- used in a system of psychotherapy. In some sys-
tle use as an antidepressant, trazodone is com- tems, such as experiential psychotherapy,
monly used in low doses for bedtime sedation or few explicit “rules” apply, whereas in others,
in controlling agitation and hostility in geriatric such as behavior therapy, strict adherence to
patients. A related agent, nefazodone, which is a treatment protocol is often used to guide the
less sedating and less associated with priapism, is therapist’s work. Compare treatment plan.
now available. U.S. trade name: Desyrel. treatment resistance 1. refusal or reluctance
Treacher Collins syndrome a principally on the part of an individual to accept psycholog-
T autosomal dominant hereditary disorder charac- ical or medical treatment or unwillingness to
terized by facial anomalies, including a small re- comply with the therapist’s or physician’s in-
tracted chin, small eyes with defects of the iris, structions or prescribed regimens. In psycho-
and deformed external ears. It is caused by sev- therapy it is the lack of a positive response by
eral genetic variations, including one that is a client to the techniques being used or to what
autosomal recessive. Many affected individuals the client feels is a rupture in the therapeutic
have conductive hearing loss; some have mental alliance, which requires the use of other stra-
retardation. Also called Berry syndrome; Fran- tegies or efforts to repair the alliance by the
ceschetti–Zwahlen–Klein syndrome; man- therapist. Examples of treatment resistance are
dibulofacial dysostosis. [Edward Treacher noncompliance with assignments, extended
Collins (1862–1919), British ophthalmologist] silences, talking about tangential issues, and
treatment n. 1. the administration of appropri- seemingly pointless debates about the therapist’s
ate measures (e.g., drugs, surgery, therapy) that approach, suggestions, and interpretations. See
are designed to relieve a pathological condition. also nonadherence. 2. failure of a disease or
2. the level of an independent variable in an disorder to respond positively or significantly to
experiment, or the independent variable itself. a particular treatment method.
See treatment level. treatment-seeking behavior the active pur-
598
triarchic theory of intelligence
suit of treatment by a person who is mentally or attorneys with various aspects of a trial in which
physically ill, uneasy, or disturbed. See help- his or her expertise is relevant. Trial consultation
seeking behavior. typically includes helping to prepare individuals
treatment validity see program integrity. for testimony, developing surveys to help in jury
selection and trial strategy development, and
treatment withholding discontinuing medi-
conducting change of venue surveys. Also called
cal treatment that has no benefit to the patient
jury consultant.
in terms of an eventual cure or short-term allevi-
ation of symptoms. trial design an outline or plan of the conditions
tremor n. any involuntary trembling of the body of a clinical trial that must be satisfied in
or a part of the body (e.g., the hands) due to neu- order to optimally evaluate the efficacy of a new
rological or psychological causes. Psychological treatment.
(or psychogenic) tremor may be mild, due to trial marriage an arrangement by which a cou-
tension, or violent and uncontrolled in severe ple attempts to determine their compatibility
disturbances. Toxic effects of drugs or heavy and suitability for formal marriage by living to-
metals may produce a transient tremor. A coarse gether for a period of time.
tremor involves a large muscle group in slow
movements, whereas a fine tremor is caused by a trial therapy a planned process of temporary
small bundle of muscle fibers that move rapidly. treatment, either in the early sessions of therapy
Some tremors occur only during voluntary or as a set of sessions prior to the initiation of
movements (action tremor); others occur in the long-term therapy, to test whether the client is
absence of any voluntary movements (resting suitable or ready for a commitment to the thera-
tremor). A senile tremor is one that is associated peutic process. Trial therapy is also used to assess
with aging. whether the therapist believes that his or her
treatment approach is compatible with the cli-
triad n. a set of three people involved in a dy-
ent and is able to resolve the problem.
namic relationship, for example, a therapist and
a couple receiving marital therapy. The three triangular theory of love the proposition
people are presumed to form a triangle that has that the various kinds of love can be character-
peculiar group characteristics and internal alli- ized in terms of the degree to which they possess
ances. the three basic components of love relation-
triad training model an approach to training ships: passion, intimacy, and commitment.
therapists and counselors that fosters an under- See companionate love; erotic love; pas-
standing of clients of other cultures and devel- sionate love; romantic love. [advanced in
ops multicultural counseling competencies. The 1988 by U.S. psychologist Robert J. Sternberg
didactic simulation matches a trainee therapist (1949– )]
or counselor from a particular culture with a triangulation n. 1. the process of confirming a
three-person team: (a) a “procounselor,” repre- hypothesis by collecting evidence from multiple
senting the trainee therapist’s or counselor’s source or experiments or using multiple proce-
own culture; (b) a coached “client,” who is hos- dures. The data from each source, experiment,
tile or resistant to the trainee, the therapy, or the or procedure support the hypothesis from
trainee’s culture; and (c) a catalyst “anti- a somewhat different perspective. 2. in family
counselor,” who represents the client’s ethnic therapy, a situation in which two members
group, religion, or other affiliation. The catalyst of a family in conflict each attempt to draw
serves as a bridge of communication and support another member onto their side. Triangulation
for the client, and the dynamic among all parties can occur, for example, when two parents are in
reveals issues, content, and effective approaches conflict and their child is caught in the middle.
to the trainee. See also multicultural the- —triangulate vb.
rapy. [developed by U.S. psychologist Paul
Bodholdt Pedersen (1936– )] triarchic theory of intelligence a theory T
of intelligence proposing three key abilities—
triage n. 1. a method of enhancing the effects of
analytical, creative, and practical—which are
treatment that involves the selection and sorting
viewed as largely although not entirely distinct.
of patients in an orderly and systematic fashion.
According to the theory, intelligence comprises
The patients are then routed to the most appro-
information-processing components, which are
priate treatment services available. 2. in evalua-
applied to experience (especially novel experi-
tion research, a method of allocating scarce
ences) in order to adapt to, shape, and select
resources among social programs in which only
environments. The theory is triarchic because
programs that need and are most likely to bene-
it contains three subtheories: one specifying
fit from the resources are considered.
the components of intelligence (componential
trial n. 1. in testing, conditioning, or other ex- subtheory), another specifying the kinds of ex-
perimentation, one performance of a given task perience to which the components are applied
(e.g., one run through a maze) or one presenta- (experiential subtheory), and a third specifying
tion of a stimulus (e.g., an ordered list of three- how the components are applied to experience
letter words). 2. see clinical trial. to be used in various kinds of environmental
trial consultant a social scientist who assists contexts (contextual subtheory). [proposed in
599
Triavil
1985 by Robert J. Sternberg (1949– ), U.S. psy- name: Surmontil). Side effects of TCAs include
chologist] significant anticholinergic effects (e.g., dry
Triavil n. a trade name for a combination of the mouth, blurred vision, constipation, urinary re-
tricyclic antidepressant amitriptyline and the tention), drowsiness or insomnia, confusion,
antipsychotic perphenazine, used for the treat- anxiety, nausea, weight gain, and impotence.
ment of concurrent anxiety and depression. They can also cause cardiovascular comp-
lications (particularly disturbances in heart
triazolam n. a short-acting benzodiazepine
rhythm). The tricyclics represented the mainstay
used primarily as a hypnotic and also to man-
of antidepressant treatment from the introduc-
age anxiety associated with dental procedures.
tion of imipramine in 1957 until fluoxetine
Following reports of severe psychological distur-
(Prozac)—the first ssri—was introduced in 1987.
bances associated with its use, including behav-
Although they are effective as antidepressants,
ioral disinhibition, aggression, agitation, and
their adverse side effects and—more signifi-
short-term memory impairment (anterograde
cantly—their lethality in overdose have led to a
amnesia), its sale was prohibited in the United
profound decline in their use. They remain,
Kingdom in 1991. U.S. trade name: Halcion.
however, the standard against which other anti-
tribade n. a woman who achieves sexual plea- depressants are compared; no other class of anti-
sure by rubbing her genitals against those of depressants has demonstrated more clinical
another woman. This activity is known as efficacy.
tribadism, which is also occasionally used as a
synonym for lesbianism. —tribadic adj. tridimensional theory of feeling the the-
ory that feelings can vary along three dimen-
trichomegaly-retinal degeneration syn- sions: pleasantness–unpleasantness (hedoric
drome a rare disorder marked by abnormally quality), excitement–calmness, and arousal–re-
short stature, long eyebrows and eyelashes, and laxation. The tridimensional theory is used to
poor vision due to retinal pigment degeneration. define different combinations and successions of
Some affected individuals exhibit slow psycho- feelings and describe the course of change of the
motor development and may have IQs of less feelings along each of the three dimensions. [in-
than 70; in others, average-range intelligence troduced by Wilhelm wundt]
has been reported.
trifluoperazine n. a high-potency antipsy-
trichophagy n. the act of persistently biting chotic of the piperazine phenothiazine class.
and eating one’s hair. Like other agents of this class, it acts primarily by
trichorrhexis nodosa with mental retar- blocking postsynaptic dopamine D2 receptors.
dation a congenital disorder marked by stubby, Trifluoperazine is appropriate for the treatment
brittle hair, thin tooth enamel, defective nails, of schizophrenia in both adults and children and
and severe mental retardation. Affected indi- severe, nonpsychotic anxiety in adults only. It
viduals who have been studied have shown may also be used to control behavioral symp-
microcephaly; X-rays have revealed a small toms associated with dementia. Because of its
cranial vault. Also called Pollitt syndrome. potentially severe side effects (e.g., tardive
trichotillomania n. an impulse-control disor- dyskinesia, neuroleptic malignant syn-
der characterized by persistent hair pulling at drome)—and the availability of other, relatively
any part of one’s body on which hair grows, nontoxic anxiolytics (e.g., the benzodiaze-
often with conspicuous hair loss. Feelings of in- pines)—it is not recommended for routine use in
creasing tension before the act and feelings of re- anxiety. U.S. trade name: Stelazine.
lease or satisfaction on completion are common. trigger 1. n. a stimulus that elicits a reaction. For
In DSM–IV–TR trichotillomania is included in example, an event could be a trigger for a mem-
the category impulse-control disorders not ory of a past experience and an accompanying
elsewhere classified. state of emotional arousal. 2. vb. to act as a trig-
T tricyclic antidepressant (TCA) any of a ger.
group of drugs, developed in the 1950s, that triggering cause a stimulus or phenomenon
were the original first-line medications for that initiates the immediate onset of a behavior
treatment of depression. They are presumed to problem. See also precipitating cause. Com-
act by blocking the reuptake of monoamine pare predisposing cause.
neurotransmitters (serotonin, dopamine, and nor-
epinephrine) into the presynaptic neuron, trihexyphenidyl n. an anticholinergic
thereby increasing the amount of neurotrans- drug used in the treatment of drug-induced
mitter available for binding to postsynaptic parkinsonian symptoms, such as those produced
receptors. Tricyclic antidepressants have a char- with use of conventional antipsychotics, and as
acteristic three-ring molecular core. They may be an adjunctive treatment for parkinson’s dis-
tertiary amines (e.g., imipramine, amitrip- ease. It acts by exerting a direct inhibitory effect
tyline) or their metabolites, which are second- on the parasympathetic nervous system and a re-
ary amines (e.g., desipramine, nortriptyline). laxing effect on smooth musculature. U.S. trade
Other members of the group include clomi- name: Artane.
pramine, protriptyline (U.S. trade name: Vi- triiodothyronine (T3) n. an iodine-containing
vactil), doxepin, and trimipramine (U.S. trade hormone that, together with thyroxine,
600
tryptophan hydroxylase
regulates metabolic activity. See thyroid hor- of a measurement or score that reflects the actual
mones. amount of the attribute possessed by the indi-
Trilafon n. a trade name for perphenazine. vidual being measured.
trimethoxyamphetamine (TMA) n. a syn- true self in psychoanalytic theory, the total of
thetic amphetamine derivative that is a cns an individual’s potentialities that could be de-
stimulant with purported hallucinogenic prop- veloped under ideal social and cultural condi-
erties similar to lsd and the naturally occurring tions. The term is used in the context of Erich
hallucinogen mescaline. Side effects and toxic- fromm’s approach to neurosis as a reaction to
ity of TMA and other “designer psychedelics” are cultural pressures and repressed potentialities.
similar to those of mdma. The concept is also used in the client-centered
therapy of Carl rogers. The realization of the
tripa ida see susto.
true self is a major goal of therapy.
triple-X condition see xxx syndrome.
true variance naturally occurring variability
triptans pl. n. a class of vasoconstrictor within or among research participants. This vari-
drugs used in the treatment of migraine head- ance is inherent in the nature of the participant
ache, the prototype of which is sumatriptan. and is not due to measurement error, impreci-
Triptans exert their therapeutic effect by acting sion of the model used to describe the variable of
as serotonin-receptor agonists at 5-HT1B interest in the research (e.g., a particular behav-
and 5-HT1D receptors, causing the constriction of ior), or other extrinsic factors.
cerebral blood vessels. Triptans should not be ad-
ministered concurrently with monoamine trust 1. n. reliance on or confidence in the worth,
oxidase inhibitors and should be used cau- truth, or value of someone or something. Trust is
tiously with ssris to avoid the risk of precipitat- considered by most psychological researchers to
ing a serotonin syndrome. be a primary component in mature relationships
with others, whether intimate, social, or thera-
21 trisomy see trisomy 21. peutic. See basic trust versus mistrust; in-
trisomy n. see autosome. —trisomic adj. terpersonal trust; security. 2. vb. to have
trisomy 13–15 see chromosome-13 trisomy. trust in someone or something.
trisomy 17–18 a congenital disorder character- trust exercise a common procedure in group
ized by low birth weight with various facial therapy and growth groups intended to help
anomalies, a prominent occiput, overlapping of members of the group learn to trust other peo-
the index finger over the third finger, and visual ple. The trust exercise may involve putting a
abnormalities. Severe mental retardation accom- member in a vulnerable position so that he or
panies the defect, which is due to non- she depends on the other group members for
disjunction of one of the chromosomes in the support. See also blind walk.
17–18 group. Also called Edwards syndrome; trust versus mistrust see basic trust versus
E trisomy. mistrust.
trisomy 21 a condition associated with 85% of truth serum a colloquial name for drugs, espe-
instances of down syndrome, characterized by cially the barbiturates amobarbital, pentobarbi-
the presence of three number 21 chromosomes tal, or thiopental, that are injected intrave-
in the body cells rather than the normal pair. nously in mild doses to help elicit information
The extra chromosome may be contributed by by inducing a relaxed, semihypnotic state in
either the father or the mother. Also called 21 which an individual is less inhibited and more
trisomy. communicative. The term is derived from the re-
troilism n. sexual activity involving three peo- ported use of such drugs by police to extract con-
ple. A troilist is a person who, in such a relation- fessions from suspects.
ship, enjoys engaging in heterosexual activities tryptamine derivatives a group of drugs that
with a partner as well as observing the partner in are chemically related to serotonin (5-
T
sexual activities with a third person. The third hydroxytryptamine). They include a number of
person may be of the same sex as the partner or agents with hallucinogenic effects similar to
the troilist. If the third person is of the same sex those of lsd, including dmt (dimethyltrypta-
as the troilist, only observation occurs. If the mine), det (diethyltryptamine), bufotenin, and
third person is of the same sex as the troilist’s psilocin. Tryptamine derivatives may also be
partner, the troilist may engage in sexual activity classified as substituted indolealkylamines.
with both of them.
tryptophan n. one of the essential amino acids
truancy n. absence from school without permis- of the human diet. It is a precursor of the neuro-
sion. Persistent truancy before the age of 13 is an transmitter serotonin and plays a role in gen-
example of a serious violation of major rules, one eral physiological processes. In plants and many
of the symptoms of conduct disorder. Also animals it is also a precursor of the B vitamin
called school truancy. —truant adj. nicotinic acid. Tryptophan depletion—loss of
true schizophrenia see nuclear schizo- tryptophan in the brain—may be induced for re-
phrenia. search purposes.
true score in classical test theory, that part tryptophan hydroxylase an enzyme that
601
T score
catalyzes the first step in the biosynthesis of psychotherapy in which a patient is supervised
serotonin. It uses tetrahydrobiopterin as a 24 hours a day by the therapist, who has legal,
coenzyme to transform the dietary amino acid L- medical, and financial control over the patient,
tryptophan to 5-hydroxytryptophan (5-HTP). or by the therapist’s assistants, who maintain
This reaction is the rate-limiting step in seroto- control over the patient under the direction of
nin synthesis, limited by levels of tryptophan in the therapist. Sometimes mobile telephones or
the brain as well as by levels of activity of neu- other communication devices are used by the as-
rons that use serotonin as a neurotransmitter. sistants to receive and obtain direction and in-
T score any of a set of scores scaled so that they formation from the therapist. Often a parent or
have a mean equal to 50 and standard devia- partner of the patient initiates this process when
tion equal to 10. the situation is so desperate that no other
method seems possible. [developed by U.S. psy-
TSCS abbreviation for tennessee self-concept
chologist Eugene E. Landy (1934–2006)]
scale.
t test any of a class of statistical tests based on the twilight state a state of clouded consciousness
fact that the test statistic follows the t distribu- in which the individual is temporarily unaware
tion when the null hypothesis is true. Most t of his or her surroundings, experiences fleeting
tests deal with hypotheses about the mean of a auditory or visual hallucinations, and responds
population or about differences between means to them by performing irrational acts, such as
of different populations. undressing in public, running away, or commit-
ting violence. The disturbance occurs primarily
tuberoinfundibular tract one of three
in temporal lobe epilepsy, dissociative reactions,
major neural pathways in the brain that use do-
and alcoholic intoxication. On regaining normal
pamine as their principal neurotransmitter (see
consciousness, individuals usually report that
dopaminergic). The cell bodies of this tract,
they felt they were dreaming and have little or
which is a local circuit in the hypothalamus, pro-
no recollection of their behavior. See also dream
ject short axons to the pituitary gland. The
state.
tuberoinfundibular tract is associated with regu-
lation of hypothalamic function and specific twin control in a twin study, a method in
hormones (e.g., prolactin). Alterations in hor- which the target twin—that is, the one who has
mone function involving this tract are often had certain experiences or training or has been
seen in patients taking phenothiazine anti- exposed to the experimental conditions—is
psychotics. compared against the twin who has not had the
tumor n. 1. see neoplasm. 2. swelling, one of experiences, training, or treatment and therefore
the cardinal signs of inflammation. serves as a control. Also called cotwin con-
trol.
Turner’s syndrome a chromosomal disorder,
specific to women, marked by the absence of all twins pl. n. see dizygotic twins; monozygotic
or a part of one of the two X (female) chromo- twins.
somes. The effects include underdevelopment
twin study research using twins. The purpose of
or absence of primary and secondary sex char-
such research is usually to assess the relative con-
acteristics, infertility, and various physical
tributions of heredity and environment to some
abnormalities (e.g., short stature, lack of men-
attribute. Specifically, twin studies often involve
struation). See also noonan’s syndrome. [re-
comparing the characteristics of identical and
ported in 1938 by Henry H. Turner (1892–1970),
fraternal twins and comparing twins of both
U.S. endocrinologist]
types who have been reared together or reared
twelve-step program a distinctive approach apart. For example, two types of study have been
to overcoming addictive, compulsive, or behav- used to investigate intelligence in twins: (1)
ioral problems that was developed initially in al- Identical twins reared apart. Here the genotypes
T coholics anonymous (AA) to guide recovery (genetic makeups) are identical but as there is no
from alcoholism and is now used, often in an shared environment disparity in intelligence
adapted form, by a number of other self-help must result from the different environments. (2)
groups. In the context of alcoholism, for in- Comparisons between identical twins reared
stance, the twelve-step program in AA asks each together and fraternal twins reared together.
member to (a) admit that he or she cannot con- Here one can assume that each pair of twins
trol his or her drinking; (b) recognize a supreme shares the same environment, but while the
spiritual power, which can give the member identical twins have 100% of their genes in com-
strength; (c) examine past errors, a process that is mon, the fraternal twins share only 50% of their
carried out with another member who serves as genes. The assumptions made in these studies
sponsor; (d) make amends for these errors; (e) de- are, however, never completely fulfilled. For ex-
velop a new code and style of life; and (f) help ample, the identical twins reared apart have had
other alcoholics who are in need of support. some common environment, if only their
Variations of this model also exist for drug abuse intrauterine experiences. Moreover, identical
and addiction, gambling addiction, and other twins reared together usually have more similar
problems. environments than fraternal twins raised to-
twenty-four-hour therapy a procedure in gether. These differences can make the estima-
602
typology
tions of heritability of intelligence open to some of aggression and hostility, marked by an ab-
doubts. sence of time urgency and lack of a need to
twisted symbols see strephosymbolia. display or discuss one’s accomplishments and
achievements. Compare type a behavior.
twitching n. a series of small muscular contrac-
tions. Type B personality a personality pattern char-
acterized by low levels of competitiveness and
two-by-two factorial design an experimen- frustration and a relaxed, easy-going approach.
tal design in which there are two independent
Type B individuals typically do not feel the need
variables each having two levels. When this de-
to prove their superiority or abilities. Compare
sign is depicted as a matrix, two rows represent
type a personality. [outlined in the 1970s by
one of the independent variables and two col-
U.S. physicians Meyer Friedman (1910–2001)
umns represent the other independent variable.
and Ray H. Rosenman]
See factorial design.
Type III error an error in direction (posi-
two-chair technique see empty-chair tech-
tive/negative, higher/lower) when two groups
nique.
are shown empirically to be different. Re-
two-factor design a factorial design in searchers frequently investigate the direction
which two independent variables are manipu- rather than the size of a relationship (e.g., inves-
lated. Also called two-way factorial design. tigating “Which is more?” or “Which is
two-factor theory of emotion see better?”), and they make a Type III error when
schachter–singer theory. they use a nondirectional two-tailed test to
two-spirit n. in some Native American cultures, make a directional decision: After conducting
a person, typically male, who takes on the gen- the test and finding statistical significance,
der identity of the opposite sex with the ap- the researcher inspects data visually to decide
proval of the society. The culture often views (incorrectly) upon the direction of the observed
such individuals as having a special spiritual or relationship.
guidance role in the community. In the Navajo Type D personality a “distressed” personality
culture such a person is termed a nadle, in the pattern, characterized by a high degree of nega-
Lakota culture the term winkte is used, and in tive affectivity (i.e., a tendency to experience
other cultures a literal translation of “man- negative emotions) in combination with a con-
woman” might be used. The traditional schol- scious tendency to suppress self-expression in
arly term berdache is now used less frequently social interaction. Accumulating evidence sug-
because of its negative implications of male pros- gests that Type D individuals are at increased risk
titution or of a “kept” status. of developing coronary heart disease and
two-tailed test a statistical test of an experi- other chronic medical conditions.
mental hypothesis that does not specify the ex- Type I error the error of rejecting the null hy-
pected direction of an effect or a relationship. pothesis when it is in fact true. Investigators
Also called nondirectional test. Compare make this error when they believe they have
one-tailed test. detected an effect or a relationship that does not
two-way analysis of variance a statistical actually exist. Also called alpha error.
test analyzing the joint and separate influences Type II error the error of failing to reject the
of two independent variables on a depend- null hypothesis when it is in fact not true.
ent variable. Investigators make this error if they conclude
two-way factorial design see two-factor that a particular effect or relationship does not
design. exist when in fact it does. Also called beta
error.
Tylenol n. a trade name for acetaminophen.
type theory any hypothetical proposition or
Type A behavior a behavior pattern that may principle for the grouping of people by kind of T
be associated with increased risk of coronary personality or by personality characteristics. An
heart disease. It is marked by competitiveness, example of such a theoretical system of person-
achievement motivation, aggression and hostil- ality classification is that of Swiss psychoanalyst
ity, impatience and a distorted sense of time ur- Carl Jung (1875–1961), who divided individuals
gency, and polyphasic activity (e.g., shaving or into types according to (a) attitudes of intro-
eating while reading a newspaper). Compare version and extraversion and (b) the domi-
type b behavior. nant functions of the psyche.
Type A personality a personality pattern char- typhomania n. delirium occurring in individ-
acterized by chronic competitiveness, high lev- uals with typhoid fever and typhus.
els of achievement motivation, and hostility.
The lifestyles of Type A individuals are said to typical antipsychotic see antipsychotic.
predispose them to coronary heart disease. Com- typical schizophrenia see nuclear schizo-
pare type b personality. [outlined in the 1970s phrenia.
by U.S. physicians Meyer Friedman (1910–2001) typology n. any analysis of a particular category
and Ray H. Rosenman] of phenomena (e.g., individuals, things) into
Type B behavior a behavior pattern that is free classes based on common characteristics, for
603
tyramine
example, a typology of personality. —typologi- preventing normal metabolism of the tyramine

cal adj. and resulting in a greatly aggravated effect on
blood pressure. As a consequence, the patient
tyramine n. a biogenic amine found in high
may suffer a hypertensive crisis.
concentrations in a variety of sources, including
ripe cheese, broad beans, ergot, mistletoe, some tyrosine hydroxylase an enzyme that cata-
wines, and many foodstuffs that are produced lyzes the first, and rate-limiting, step in the
via enzymatic action. Tyramine is derived from biosynthesis of the catecholamine neurotrans-
the amino acid tyrosine and is sympatho- mitters dopamine, norepinephrine, and epi-
mimetic, causing an increase in blood pressure nephrine. It transforms dietary tyrosine, using
and heart action. Foods containing tyramine the coenzyme tetrahydrobiopterin and molec-
react with monoamine oxidase inhibitors, ular oxygen, to L-dopa.
604
Uu
UCR fees abbreviation for usual, customary, and the long run with the true values in the popula-
reasonable fees (see customary, prevailing, tion.
and reasonable fees). uncertainty avoidance 1. a cognitive style
Ucs abbreviation for unconscious. characterized by a tendency to adhere to what is
already known, thought, or believed. It contrasts
ulcer n. an erosion of a tissue surface, such as the
with uncertainty orientation, which is the ten-
mucosal lining of the digestive tract. Peptic ul-
dency to seek out new information and ideas
cers, which affect the stomach and duodenum,
and to enjoy exploring and mastering uncer-
are associated with increased secretion of hydro-
tainty. 2. an intolerance of ambiguity or uncer-
chloric acid and pepsin, a digestive enzyme, or
tainty and a psychological need for formal rules.
increased susceptibility of the lining of the stom-
See also need for closure. [defined by Dutch
ach and duodenum to the effects of these sub-
cultural psychologist Geert Hofstede (1928– )]
stances. See also dyspepsia.
uncertainty orientation see uncertainty
Ullrich–Noonan syndrome see noonan’s
avoidance.
syndrome. [Otto Ullrich (1894–1957), German
pediatrician; Jacqueline Noonan (1921– ), U.S. unconditional love see unconditional posi-
pediatrician] tive regard.
ultimate opinion testimony opinion testi- unconditional positive regard an attitude
mony by an expert witness that directly informs of caring, acceptance, and prizing expressed by
the court about the issue in dispute. For exam- others irrespective of an individual’s behavior
ple, an expert witness who testifies that the de- and without regard to the other’s personal stan-
fendant is insane is giving ultimate opinion dards, which is considered conducive to self-
testimony. awareness, self-worth, and personality growth.
Posited by Carl rogers to be a universal human
Ultiva n. a trade name for remifentanil. See need essential to healthy development, uncon-
fentanyl.
ditional positive regard is the centerpiece of his
ultrasonic irradiation a form of psycho- client-centered therapy and is also empha-
surgery in which sound waves of a frequency of sized in many other therapeutic approaches.
1000 kHz are directed through trephine open- Compare conditional positive regard.
ings in the skull for up to 14 min. It is an alterna- unconditioned reinforcement see primary
tive to prefrontal lobotomy (see lobotomy) and reinforcement.
is rarely used now.
unconditioned response (UCR; UR) the un-
ultrasound n. sound whose frequency exceeds learned response to a stimulus: any original re-
the human audibility range, often used in order sponse that occurs naturally and in the absence
to measure and record structures and structural of conditioning (e.g., salivation in response to
change within the body in the imaging tech- the presentation of food). The unconditioned re-
nique called ultrasonography (or sonography). sponse is a reflex that serves as the basis for es-
Echoes from ultrasound waves reflected from tis- tablishment of the conditioned response in
sue surfaces are recorded to form structural im- pavlovian conditioning.
ages for diagnostic purposes, for example, to
examine a growing fetus during pregnancy or to unconditioned stimulus (UCS; US) a stimu-
examine internal organs, such as the heart, liver, lus that elicits an unconditioned response, as
kidneys, and gallbladder, for signs of health or in withdrawal from a hot radiator, contraction of
disease. the pupil on exposure to light, or salivation
when food is in the mouth. Also called uncon-
ululation n. 1. a shrill lament or wailing associ- ditional stimulus. Compare conditioned
ated with emotional expression and ritual be- stimulus.
havior in various cultures. 2. a rare name for the
incoherent wailing of some individuals with unconscious 1. (Ucs) n. in psychoanalytic the-
psychosis. ory, the region of the psyche that contains mem-
ories, emotional conflicts, wishes, and repressed
unbiased adj. impartial or without net error. In impulses that are not directly accessible to
unbiased procedures, studies, and the like any er- awareness but that have dynamic effects on
rors that do occur are random error and there- thought and behavior. Sigmund freud some-
fore self-cancelling in the long run. times used the term dynamic unconscious to
unbiased sampling a survey design in which distinguish this concept from that which is
the values produced by the samples coincide in merely descriptively unconscious but “static”
605
unconscious cognition
and with little psychological significance. Com- unconventional therapy treatment that may
pare conscious; preconscious. See also be unique, controversial, or both, in that it is not
cognitive unconscious; collective uncon- traditionally accepted by the health care profes-
scious; personal unconscious. 2. adj. relat- sions. See complementary and alternative
ing to or marked by absence of awareness or lack medicine.
of consciousness. uncovering n. in psychotherapy, the process of
unconscious cognition cognitive processes, peeling away an individual’s defenses and pass-
such as thinking, memory processing, and lining beyond a focus on symptoms to get to the
guistic processing, that occur in the absence of underlying roots of a problem. Uncovering tech-
awareness. See cognitive unconscious. niques may include psychoanalysis and other
unconscious homosexuality see latent ho- psychodynamic or depth therapies, deep explo-
mosexuality. ration of issues, and the use of trust to encourage
truthfulness on the part of the client.
unconscious inference theory the hypothe-
sis that perception is indirectly influenced by in- uncriticalness n. a nonjudgmental attitude on
ferences about current sensory input that make the part of the therapist, which is considered es-
use of the perceiver’s knowledge of the world sential in Carl rogers’s nondirective approach
and prior experience with similar input. For ex- (see client-centered therapy) as well as in
ample, consider two trees of the same height but other forms of psychotherapy. Criticism is held
different distances from the perceiver. The im- to inhibit clients’ efforts to recognize and revise
ages of the trees that appear on the retina are of their self-defeating patterns of thought and be-
different sizes, but the knowledge that one tree is havior.
farther away than the other leads the perceiver uncued panic attack a panic attack that oc-
to infer, without conscious effort, that in actual- curs unexpectedly rather than being brought on
ity the two trees are the same size. [proposed by by a specific situation or trigger. It is therefore
German physiologist Hermann von Helmholtz perceived to have occurred spontaneously. Also
(1821–1894)] called unexpected panic attack. Compare
cued panic attack; situationally predis-
unconscious motivation in psychoanalytic
posed panic attack.
theory, wishes, impulses, aims, and drives of
which the self is not aware. Examples of behav- underdog n. the rationalizations and self-
ior produced by unconscious motivation are justifications employed by an individual to allay
purposive accidents, slips of the tongue, and the sense of guilt or shame arising from an in-
dreams that express unfulfilled wishes. See also ability to meet the demands of internal moral
parapraxis. standards or other rules of conduct (the
topdog). [first described by German-born U.S.
unconscious perception a phenomenon, the
psychiatrist Frederick (Fritz) R. Perls (1893–
existence of which is controversial, in which a
1970)]
stimulus that is not consciously perceived none-
theless influences behavior. See preattentive understanding n. 1. the process of gaining in-
processing. sight about oneself or others or of comprehend-
ing the meaning or significance of something,
unconscious process 1. in psychoanalytic the- such as a word, concept, argument, or event.
ory, a psychical process that takes place in the
See also apprehension; comprehension. 2. in
unconscious, for example, repression. 2. in
counseling and psychotherapy, the process of
cognitive psychology, a mental process that oc-
discerning the network of relationships between
curs without a person’s awareness and subserves
a client’s behavior and his or her environment,
cognitive activity. Also called preattentive
history, aptitudes, motivation, ideas, feelings, re-
process; subliminal process. Compare con-
lationships, and modes of expression. —under-
scious process.
stand vb.
unconscious resistance in psychoanalytic undifferentiated schizophrenia in DSM–
theory, resistance proper, as opposed to con- IV–TR, a subtype of schizophrenia in which
U scious resistance. the individual exhibits prominent psychotic fea-
uncontrolled adj. not regulated or measured, tures, such as delusions, hallucinations, disorga-
particularly by an investigator in the course of nized thinking, or grossly disorganized behavior,
research. but does not meet the criteria for any of the
uncontrolled variable a characteristic factor other subtypes of the disorder. The DSM–III des-
that is not regulated or measured by the investi- ignation was undifferentiated type schizo-
gator during an experiment or study, such that it phrenic disorder.
is not the same for all participants in the re- undifferentiated somatoform disorder
search. For example, if the investigator collects in DSM–IV–TR, a somatoform disorder in
data on participants having varying levels of ed- which one or more physical complaints persist
ucation, then education is an uncontrolled vari- for 6 months or longer and cannot be explained
able. If the investigator, however, were to collect by a known medical condition. Unlike facti-
data only on participants with college degrees tious disorder or malingering, these symp-
then education would be a controlled variable. toms are not intentionally feigned or produced.
606
universality
It should not be confused with somatoform sode, a hypomanic episode, or a mixed

disorder not otherwise specified. episode. As such, it contrasts with bipolar dis-
unfinished business in therapy and counsel- order. The term is sometimes used synony-
ing, the personal experiences that have been mously with major depressive disorder.
blocked or tasks that have been avoided because unipolar mania a bipolar disorder in which
of feared emotional or interpersonal effects. only manic episodes have occurred. Except in
Many therapists believe that people have an urge rare cases, manic episodes tend eventually to be
to complete unfinished business in order to followed by one or more major depressive epi-
achieve satisfaction and peace. Those working sodes.
with the dying and their families believe that
unipolar rating scale a type of survey that
dealing with unfinished business is an impor-
prompts a respondent to evaluate the degree
tant aspect of the dying and grieving processes.
to which a single quality or attribute is present.
unfinished story projective technique in For example, consider a five-point scale with the
which participants are required to complete a following anchors: (1) not at all satisfied, (2)
story by role play, discussion, or writing. It is in- slightly satisfied, (3) moderately satisfied, (4) very
tended to reveal information about the partici- satisfied, and (5) completely satisfied. Since there
pants’ concerns. is no anchor that represents the opposing qual-
unfitness n. 1. the state or condition of lacking ity of dissatisfaction, the scale has one pole. Also
fitness or health. 2. in biology, the inability of an called unipolar scale. Compare bipolar rat-
organism to produce viable offspring in a given ing scale.
environment. Compare fitness. unique trait see idiographic trait.
unfreezing n. a therapeutic goal to rid an indi-
United Nations Declaration on the Rights
vidual of rigid beliefs and stereotypes of self, oth-
of Mentally Retarded Persons a 1971 dec-
ers, and the world.
laration by the United Nations affirming the
unidimensional adj. having a single dimen- human rights of people with mental retardation.
sion or composed of a single or a pure factor. These issues were largely subsumed under the
Compare multidimensional. 1993 Standard Rules on the Equalization of Op-
unidimensional concept see bipolar con- portunities for Persons with Disabilities. See
cept. rights of people with mental retardation.
Unified Tri-Service Cognitive Perfor- unity of consciousness the concept that the
mance Assessment Battery (UTCPAB) a contents of awareness are coherent, internally
battery of tests compiled in 1984 by a group of consistent, or shaped by a common goal. From
experimental research psychologists. It presents this it follows that mutually inconsistent events
computerized, clinically relevant psychomotor cannot simultaneously appear in awareness.
and neuropsychological tests for the rapid as-
univariate adj. characterized by a single vari-
sessment of the integrity of the nervous system.
able. Compare multivariate. See also bivari-
unilateral couple counseling the counsel- ate.
ing of one partner on his or her relationship to
the other. Even when only one partner partici- universal design a quality of a product or built
pates in counseling, the focus is on the partners’ environment so conceived as to make it opti-
relationship. See also couples counseling. mally usable and comfortable for people of all
ages and abilities. Universal design as a concept
unilateral neglect a disorder resulting from goes beyond mere accessibility and removal of
damage to the parietal lobe of the brain and barriers, in accordance with the mandates of
characterized by a loss of conscious perception such laws as the Americans With Disabilities Act
of objects in the half of the visual field (usually (ADA), by emphasizing the inclusiveness of de-
the left half) that is opposite the location of sign to accommodate a wide range of physical
the lesion, alien limb syndrome, and other and cognitive abilities. Also called transgener-
striking neuropsychological features. Also called ational design. See also barrier-free envi-
hemineglect. ronment. U
unimodal distribution a set of scores with a
universality n. 1. the tendency to assume that
single peak, or mode, around which values tend
one’s personal qualities and characteristics, in-
to fluctuate, such that the frequencies at first
cluding attitudes and values, are common in the
increase and then decrease. Compare bimodal
general social group or culture. 2. in mob and
distribution; multimodal distributions.
crowd settings, the tendency for individuals to
unipolar depression any depressive disor- assume that atypical, unusual behaviors are al-
der, that is, any mood disorder marked by one lowable because many others in the situation are
or more major depressive episodes or a pro- performing such actions (“everybody’s doing
longed period of depressive symptoms with no it”). See contagion. 3. in self-help and psycho-
history of manic or hypomanic symptoms or therapy groups, a curative factor fostered by
mixed episodes. members’ recognition that their problems and
unipolar disorder persistent or pervasive de- difficulties are not unique to them, but instead
pression that does not involve a manic epi- are experienced by many of the group members.
607
universality of emotions
Also called impression of universality. See tion or position; it will also require an experi-
also curative factors model. enced and confident interviewer.
universality of emotions the finding that uppers pl. n. slang for various drugs that stimu-
certain emotional expressions, appraisals, and late the central nervous system, such as amphet
manifestations are the same or highly similar amine and methamphetamine. See cns stimu-
across cultures and societies. Compare cul- lant.
tural specificity of emotions. See also pri- UR 1. abbreviation for unconditioned re-
mary emotion. sponse. 2. abbreviation for utilization review.
unlearning n. see deconditioning. Urecholine n. a trade name for bethanechol.
unobtrusive measure a measure obtained urethral eroticism in psychoanalytic theory,
without disturbing the participant or alerting sexual pleasure derived from urination. Also
him or her that a measurement is being made. called urethral erotism. See urolagnia.
The behavior or responses of such participants
are thus assumed to be unaffected by the investi- urethritis n. inflammation of the urethra, with
gative process or the surrounding environment. symptoms of painful urination (dysuria) and
Compare obtrusive measure. urethral discharge. The infection may be trans-
mitted by sexual contact, as in the case of gon-
unpleasantness n. an emotional state that is orrhea.
experienced when an event is incongruent with
one’s goals or is associated with pain. See also di- urinary incontinence loss of conscious con-
mensional theory of emotion. —unpleas- trol of urination due to an organic condition,
ant adj. such as a neurological disorder or age-related
changes in the bladder or kidneys. Compare
unpleasure n. in psychoanalytic theory, the
enuresis.
psychic pain, tension, and ego suffering that is
consciously felt when instinctual needs and urolagnia n. sexual interest focused on urine
wishes, such as hunger and sex, are blocked by and urination. This may involve watching oth-
the ego and denied gratification. [translation of ers urinate, being urinated on during sexual ac-
German Unlust, “reluctance” or “listlessness”] tivity, urinating on the partner during sexual
activity, or drinking one’s own urine. See also
unresolved adj. 1. in psychotherapy, denoting
urethral eroticism.
emotional or psychic conflicts not yet suffi-
ciently dealt with and assimilated or understood. urophilia n. a paraphilia involving urine and
See also unfinished business. 2. describing any urination as a major source of arousal during
stimulus whose characteristics cannot be deter- sexual activity.
mined by the perceiver. U.S. Department of Veterans Affairs (VA)
unshared environment see nonshared en- an agency of the U.S. government established in
vironment. 1930 to administer the laws providing benefits
and other services to veterans, their dependents,
unsociable adj. lacking sociability because of a
and their beneficiaries. Its mission is to serve U.S.
disinclination to interact and form relationships
veterans and their families with compassion; to
with others.
be their principal advocate in ensuring that they
unspecified mental retardation the diag- receive medical care, benefits, social support,
nosis made when an individual is presumed to and lasting memorials; and to promote the
have mental retardation but is too severely im- health, welfare, and dignity of all veterans in rec-
paired or uncooperative to be evaluated through ognition of their service to the nation.
the use of standard intelligence tests and
adaptive behavior measures. The DSM–IV–TR Usher syndrome a genetic disorder, inherited
designation is mental retardation, severity un- as an autosomal recessive trait (see recessive al-
specified. lele), causing sensorineural deafness, deteriora-
tion of vision due to retinitis pigmentosa, and,
unstable personality disorder see border- in some cases, loss of balance. [Charles Howard
line personality disorder. Usher (1865–1942), British ophthalmologist]
U unstructured autobiography see autobi- usual, customary and reasonable fees
ography. (UCR fees) see customary, prevailing, and
unstructured interview an interview that reasonable fees.
imposes minimal structure by asking open- UTCPAB abbreviation for unified tri-service
ended (rather than set) questions and allowing cognitive performance assessment battery.
the interviewee to steer the discussion into areas
of his or her choosing. Unstructured interviews uterine orgasm see vulval orgasm.
are used in a variety of contexts but are particu- utility standards the information require-
larly popular in personnel selection, the idea is ments of those for whom an evaluation research
that such an approach will reveal more of the ap- study is carried out. These standards include
plicant’s traits, interests, priorities, and interper- identifying all stakeholders, selecting evaluation
sonal and verbal skills than a structured objectives appropriate to the intended recipients
interview. The appropriateness of the tech- of the findings, providing clear and timely re-
nique will depend on the nature of the occupa- porting of information, and following proce-
608
uxoricide
dures that maximize the study’s utilization. See a utilization review often addresses whether the
also accuracy standards; feasibility stan- level of service provided is the most appropriate
dards; propriety standards. to the severity of the presenting problem. See
utilization review (UR) a formal review of the also continued-stay review; extended-stay
necessity and quality of services provided in a review.
hospital or clinic or by an individual provider. uxoricide n. the murder of a wife by her hus-
Conducted by a specially appointed committee, band.
609
Vv
VA abbreviation for u.s. department of veter- valence n. 1. in the field theory of Kurt lewin,
ans affairs. the subjective value of an event, object, person,
VABS abbreviation for vineland adaptive be- or other entity in the life space of the individ-
havior scales. ual. An entity that attracts the individual has
positive valence, while one that repels has nega-
vagabond neurosis see dromomania. tive valence. 2. in certain theories of motivation,
vagina dentata in psychoanalytic theory, the the anticipated satisfaction of attaining a partic-
unconscious fantasy that the vagina is a mouth ular goal or outcome.
with teeth that can castrate the male partner. In validating marriage a long-lasting marriage
women, the fantasy is believed to stem from in- in which the partners express mutual respect
tense penis envy and a desire to castrate the even when they disagree.
partner as an act of revenge; in men, it is believed
to stem from castration anxiety. validation n. the process of establishing the
truth or logical cogency of something, for exam-
vaginal administration see administra- ple determining the accuracy of a research in-
tion. strument in measuring what it is designed to
vaginal envy a psychological characteristic of measure. In some forms of psychotherapy, vali-
men who desire the ability to become pregnant dation may take the form of mirroring of the
and bear children. See also femininity com- client’s judgment or experience by the therapist.
plex; womb envy. —validate vb.
vaginal orgasm 1. female orgasm achieved validity n. 1. the characteristic of being founded
through vaginal stimulation. 2. in early psycho- on truth, accuracy, fact, or law. 2. the degree to
analytic theory, the “mature, feminine” orgasm, which a test or measurement accurately mea-
as opposed to “immature, masculine” orgasms sures or reflects what it purports to measure.
produced from clitoral stimulation. This view There are various types of validity, for example
has long since been refuted. Indeed, researchers concurrent validity and construct valid-
have demonstrated that the clitoris is the focus ity. —valid adj.
of female sexual response and that vaginal or- validity criterion an external criterion that
gasms are primarily related to indirect stimula- is used to define the attribute that an instrument
tion of the clitoris and labia during intercourse. is purported to measure and that is used to esti-
See coital anorgasmia. mate the validity of the measurement instru-
vaginal sex sexual intercourse by means of vagi- ment.
nal penetration. See coitus. Valium n. a trade name for diazepam.
vaginismus n. a sexual dysfunction in which valor n. see courage.
spasmic contractions of the muscles around the
vagina occur during or immediately preceding
valproic acid a carboxylic acid (also formulated
as valproate sodium; U.S. trade name: Depacon)
sexual intercourse, causing the latter to be pain-
used as an anticonvulsant and mood stabi-
ful or impossible. Vaginismus is not diagnosed if
lizer. Although exact mechanisms of action re-
the dysfunction is due solely to the effects of a
main unclear, valproic acid may exert its effects
medical condition, although medical conditions
by reducing membrane sodium-channel activity
may be involved as a factor in the problem. See
(see ion channel), thereby slowing neuronal
also functional vaginismus.
activity. It may also stimulate the synthesis of
vagotomy n. surgical cutting or interruption of the inhibitory neurotransmitter gamma-amino-
the vagus nerve, which has motor, sensory, butyric acid (GABA). Valproic acid and valproate
and physiological functions. sodium are officially approved by the U.S. Food
vagus nerve the tenth cranial nerve, a mixed and Drug Administration for the management of
nerve with both sensory and motor fibers that seizures and of manic episodes associated with
serves many functions. The sensory fibers bipolar disorders. Although in general less toxic
innervate the external ear, vocal organs, and than lithium, these drugs have been associated
thoracic and abdominal viscera. The motor with fatalities due to liver failure, particularly in
nerves innervate the tongue, vocal organs, and— children under 2 years of age, as well as pancre-
through many ganglia of the parasympathetic atitis; serum monitoring of drug levels and liver
nervous system—the thoracic and abdominal function is therefore required, particularly on
viscera. Also called cranial nerve X; pneumo- starting treatment. Valproic acid and valproate
gastric nerve. sodium should not be taken during pregnancy
610
vasopressin
due to risks of neural tube defects in the fetus. trials, information is gradually withdrawn until
U.S. trade name: Depakene. the patient can respond correctly in the absence
value-drive care a federally backed movement of any cues.
to improve quality and reduce costs in U.S. variability n. 1. the quality of being subject to
health care by increasing system transparency change or variation in behavior or emotion. 2. in
and encouraging consumer choice. Such an em- statistics and experimental design, the degree to
phasis on quality contrasts with the current vol- which members of a group or population differ
ume-driven model of care in which consumers from each other.
are passive recipients of treatments and provid- variable n. a quantity in an experiment or test
ers are reimbursed for the number of cases they that varies, that is, takes on different values
handle, regardless of patient outcome or the (such as test scores, ratings assigned by judges,
standard of services rendered. The central prem- and other personal, social, or physiological indi-
ise underlying value-driven care is that informed cators) that can be quantified (measured). Also
consumers are active and discriminating deci- called variate.
sion makers who will examine their available
variance (symbol: σ2) n. a measure of the spread,
service options and choose those that will be the
or dispersion, of scores within a sample,
most beneficial and cost effective, which in turn
whereby a small variance indicates highly simi-
will foster competition among providers to pro-
lar scores, all close to the sample mean, and a
vide better services at reduced costs (e.g., by
large variance indicates more scores at a greater
eliminating waste, improving cooperation and
distance from the mean and possibly spread over
coordination among providers, preventing fore-
a larger range. Also called index of variabil-
seeable patient complications, etc.). For exam-
ity.
ple, if a person needing an operation could
review readily available statistics on outcome, variate n. a specific value of a particular vari-
price, and so forth, he or she likely will avoid able.
choosing hospitals, procedures, or medical pro- vascular dementia severe loss of cognitive
fessionals having poor success rates or costing functioning as a result of cerebrovascular dis-
too much. According to the U.S. government, ease. It is often due to repeated strokes. Also
however, the success of value-driven care recalled multi-infarct dementia.
quires not only the consistent measurement and vascular depression a major depressive epi-
public reporting of provider quality and cost in- sode that occurs shortly after the onset or treat-
formation, but also the nationwide adoption of ment of cardiovascular disease or that is assumed
standardized, interoperable health information to be caused by cardiovascular disease. Often,
technology and the use of incentives that moti- this episode is characterized by anhedonia
vate all parties within the system—payors, pa- rather than depressed mood.
tients, providers, and health care facilities—to
achieve better care for less money. vascular insufficiency failure of the cardio-
vascular system to deliver an adequate supply of
values clarification any process intended to blood to the body tissues. This may involve large
promote an individual’s awareness and under- regions of the body or a particular organ or area
standing of his or her moral principles and ethi- of an organ. atherosclerosis, for example, can
cal priorities and their relationships to behavior reduce the blood supply to the leg muscles, caus-
and place in daily life. Individuals may be asked ing cramplike pains and limping; the heart, re-
to carry out a series of exercises to this effect in sulting in angina pectoris; or the brain, causing
some forms of psychotherapy. symptoms of stroke.
vampirism n. a belief in the existence of vam- vasoconstrictor n. any drug or other agent
pires. In the portrayal of vampirism in literature, (e.g., the hormone vasopressin) that causes con-
sexual pleasure is often associated with sucking striction of blood vessels so that the diameter of
blood from another person, a representation of the vessels is reduced. The vasomotor nerves of
the “love bite.” Vampirism is variously inter- the sympathetic nervous system also serve as
preted by some psychoanalytic thinkers as oral vasoconstrictors. Vasoconstrictor drugs are used
sadism, oedipal strivings, fear of castration, or to increase blood pressure that has fallen to dan-
aggressive hostile feelings. gerously low levels. Also called vasopressor. V
vandalism n. willful defacement or destruction vasodilator n. any drug or other agent that
of property. A persistent pattern of vandalism is serves to increase the diameter of blood vessels,
one symptom of conduct disorder. generally by relaxing smooth muscle in arterial
vanishing cues methodology a computer- walls. Vasodilators are commonly used in the
assisted training technique designed to teach treatment of hypertension and angina pectoris.
new, complex knowledge to individuals with vasopressin n. a peptide hormone produced in
memory impairment. The technique takes ad- the paraventricular nucleus and supraoptic nu-
vantage of the patient’s preserved ability to cleus of the hypothalamus and released by the
respond to partial cues. Initially, as much in- posterior pituitary gland into the blood as
formation is provided as is needed for the pa- controlled by osmoreceptors. It has two forms
tient to make a correct response. Across learning that differ by a single amino acid—lysine vaso-
611
VD
pressin (LVP) in pigs and arginine vasopressin venereal disease see sexually transmitted
(AVP) in humans and all other mammals—and disease.
that bind to one of three distinct receptors, venlafaxine n. an antidepressant that works by
called V1a, V1b, and V2. Both forms increase inhibiting the reuptake of both serotonin and
fluid retention in the body by signaling the kid- norepinephrine; it belongs to a class called the
neys to reabsorb water instead of excreting it in SNRIs (serotonin and norepinephrine reuptake
urine, and also raise blood pressure by signaling inhibitors). Its mechanism of action therefore
specific smooth muscle cells to contract and nar- differs from that of the ssris, which—some be-
row small blood vessels. In addition to these and lieve—makes it a more effective treatment for
various other physiological functions, vaso- depression than SSRIs. It is also appropriate for
pressin modulates complex cognitive func- treatment of generalized anxiety disorder and
tions—such as attention, learning, and the social anxiety disorder. Like other antidepres-
formation and recall of memories—and may also sants, it should not be administered concur-
modulate emotion. Additionally, vasopressin rently with monoamine oxidase inhibitors.
and the chemically related peptide hormone U.S. trade name: Effexor.
oxytocin have been implicated in a range of
mammalian social behaviors including aggres- ventilation n. in psychotherapy and counsel-
sion, territoriality, maternal and paternal care, ing, a client’s full and free expression of feelings
pair-bond formation and mating, social recog- or emotions, especially in session.
nition, attachment, affiliation, vocalization, and ventral stream a series of specialized visual re-
spacing behavior, as well as components of gions in the cerebral cortex of the brain that orig-
human social behaviors and the etiology of au- inate in the striate cortex (primary visual cortex)
tism. AVP secretion also appears to play a critical of the occipital lobe and project forward and
role in the stress response through activation downward into the lower temporal lobe. It is
of the hypothalamic–pituitary–adrenocor- known informally as the “what” pathway of per-
tical system (HPA system): In times of stress ception. Compare dorsal stream.
the HPA axis secretes corticotropin-re- ventricle n. 1. an anatomical cavity in the body,
leasing factor and AVP to synergistically stim- such as any of the ventricles of the heart. 2. any
ulate the release of corticotropin from the of the four interconnected cavities inside the
anterior pituitary gland, culminating in a rise brain, which serve as reservoirs of cerebrospinal
in circulating glucocorticoids. Vasopression fluid. Each of the two lateral ventricles com-
may also be involved in the modulation of anxi- municates with the third ventricle via the in-
ety and in the pathophysiology of anxiety tervventricular foramen; the third and fourth
disorders, including posttraumatic stress dis- ventricles communicate with each other, via the
order, and has been implicated in the cerebral aqueduct, and with the central canal of
pathophysiology of depression as well. The hor- the spinal cord and the subarachnoid space. Also
mone is produced synthetically (U.S. trade called cerebral ventricle. —ventricular adj.
names DDAVP, Minirin, or Stimate) as well for
ventricular puncture a surgical procedure in
such therapeutic purposes as helping the body
which an opening from the outside is made to
conserve fluids (e.g., in the treatment of diabe-
the lateral ventricle areas of the brain. The pro-
tes insipidus), restoring blood pressure (e.g.,
cedure may be performed in order to reduce
in the treatment of hypotension), and facilitat-
intracranial pressure, to inject medications
ing blood clotting (e.g., in the treatment of he-
(e.g., antibiotics) directly into the brain, or to ob-
mophilia). Also called antidiuretic hormone
tain cerebrospinal fluid. See also ventriculo-
(ADH).
atrial shunt.
VD abbreviation for venereal disease. See sexu- ventriculoatrial shunt a surgically created
ally transmitted disease. passage for draining cerebrospinal fluid from the
vegetative adj. 1. pertaining to basic physio- ventricles of the brain to the external jugular
logical functions, such as those involved in vein, as in the treatment of hydrocephalus.
growth, respiration, sleep, digestion, excretion, The shunt carries the fluid through a catheter to
and homeostasis, which are governed primarily the venous system that empties into the right
by the autonomic nervous system. 2. living atrium of the heart.
V without apparent cognitive neurological func- verapamil n. see calcium-channel blocker.
tion or responsiveness, as in persistent vegeta- veratrine n. see hellebore.
tive state.
verbal automatism see automatism.
vegetative state a condition in which an in-
verbal behavior therapy a form of behavior
dividual is immobile and noncommunicative,
therapy, developed in the 1960s, that is based
unaware of self or the environment, and unre-
upon the principles of observational learn-
sponsive to stimuli. The condition occurs pri-
ing and conditioning and incorporates the
marily in individuals with serious brain injury
notion of reciprocal determinism. The pro-
and is characterized by a nonfunctioning cere-
cess involves a thorough inventory of symptoms
bral cortex. See persistent vegetative state.
and behavioral problems, the identification of
vegetotherapy n. see orgone therapy. those problems that will be the focus of the
612
vicarious function
therapy, a careful functional analysis of these the truth of a statement, conclusion, or hypothe-
target problems, development of specific reason- sis.
able goals for behavior change for each target Versed n. a trade name for midazolam.
problem, and the selection of appropriate thera-
peutic techniques to achieve the specific goal vertigo n. an unpleasant, illusory sensation of
for each target problem. [developed by Albert movement or spinning of oneself or one’s sur-
bandura] roundings due to neurological disorders, psy-
chological stress (e.g., anxiety), or activities that
Verbal Comprehension Index on the disturb the labyrinth (which contains the organs
wechsler adult intelligence scale and other of balance) in the inner ear (as in a roller-coaster
Wechsler tests, a subset of verbal tests thought to ride).
measure verbal knowledge and comprehension
more purely than the other tests included in the vestibular system a system in the body that
verbal iq. is responsible for maintaining balance, posture,
and the body’s orientation in space and plays
verbal fluency test any of a group of tests in an important role in regulating locomotion and
which participants are required, within a limited other movements. It consists of the vestibular
period, to generate words that fit a specific cate- apparatus in the inner ear, the vestibular nerve,
gory or have specific characteristics (e.g., they and the various cortical regions associated with
may all start with the same letter). Compare de- the processing of vestibular (balance) informa-
sign fluency test. tion.
verbal intelligence the ability to use words vestigial body image the subjective or inter-
and combinations of words effectively in com-
nal image of one’s appearance that is not neces-
munication and problem solving.
sarily modified by changes to one’s external
verbal IQ a broad measure of verbal ability as features. For example, individuals who have lost
obtained on standardized intelligence tests and large amounts of weight may continue to have a
affected by native verbal skills, experience, edu- vestigial body image of an overweight individ-
cation, test tasking skills, and test motivation. ual.
See iq.
vestured genital apposition sexual activity
verbalization n. 1. the expression of thoughts, in which clothed participants place their genital
feelings, and fantasies in words. Verbalization is regions together and thrust or rub against each
a common feature of most forms of psychother- other, simulating coitus. The activity may or
apy, which has led to the use of the terms sign may not be carried to the point of orgasm for one
system and talking cure to refer to the disci- or both partners.
pline and practice. Apart from the general com-
vibrator n. an appliance containing a small elec-
munication that occurs between therapist and
tric motor that produces a vibrating action, used
client as part of the psychotherapeutic pro-
to stimulate the genitals and other sensitive
cess, a particularly striking form of verbalization
areas during masturbation or sexual activity
occurs in the use of free association. 2. in psy-
with a partner. The device may be powered by
chiatry, a symptom involving excessive or un-
batteries or by household electric current. Some
controlled speech, as in circumstantiality or
vibrators strap on the hand, making the fingers
pressured speech. —verbalize vb.
vibrate during sexual stimulation. Another type
verbal leakage slips of the tongue, verbal has a vibrating mechanism on which a number
ambiguities, or other aspects of speech thought of attachments of different size, shape, and tex-
to reveal information about an individual’s mo- ture can be placed, and these stimulate the body
tives and behavior that he or she has attempted directly. Other vibrators are cylinders that can be
to conceal. Body language that is similarly re- used externally or inserted into the vagina or
vealing is described by some psychologists as anus.
nonverbal leakage. See also freudian slip; para-
praxis; symptomatic act.
Vicodin n. a trade name for a combination of
hydrocodone and acetaminophen.
verbal masochism a sexual disorder in which
an individual enjoys hearing words that are hu-
vicarious adj. 1. substitutive or second-hand:
applied, for example, to the satisfaction ob-
miliating and insulting and derives sexual ex-
citement from the abuse. According to Austrian-
tained by viewing the experiences of others in V
television programs. It is widely believed that
born U.S. psychologist Theodore Reik (1888–
human conditioning of fear responses can occur
1969), the sexual excitement may depend on the
through vicarious means, and that gratification
choice and emphasis of words or sentences used.
of needs can be partially accomplished through
verbigeration n. apparently meaningless repe- watching the actions of others. 2. occurring
tition of specific words or phrases. Also called when one organ performs part of the functions
catalogia; cataphasia. normally performed by another.
verbomania n. see logorrhea. vicarious function a theory to explain the
verification n. the process of establishing the ability to recover from the effects of brain dam-
truth or accuracy of something, especially the age. It is based on evidence that many functions
use of objective, empirical data to test or support are not strictly localized in the brain, and that
613
vicarious learning
many brain areas can assume a function previ- vigor n. physical and mental robustness and en-
ously performed by a brain area that has been ergy. —vigorous adj.
damaged. Vineland Adaptive Behavior Scales
vicarious learning see observational (VABS) an assessment of an individual’s per-
learning. sonal and social functioning in four domains:
vicarious traumatization (VT) the impact communication, daily living skills, socialization,
on a therapist of repeated emotionally intimate and motor skills. The VABS, which is a modifica-
contact with trauma survivors. More than tion and replacement of the 1935 Vineland So-
countertransference, VT affects the therapist cial Maturity Scale, currently contains items
across clients and situations. It results in a covering the age range from birth to 90 years.
change in the therapist’s own worldview and Data are gathered through a rating form or
sense of the justness and safety of the world. semistructured interview with the person’s par-
Therapist isolation and overinvolvement in ents or caregivers. The scales are used not only to
trauma work can increase the risk of vicarious diagnose and evaluate individuals with various
traumatization. disabilities—dementia, brain injuries, mental re-
tardation, autism, or other developmental prob-
vicious circle a situation or behavioral pattern lems—but also to formulate educational and
in which an individual’s or group’s problems be- treatment (habilitative or rehabilitative) pro-
come increasingly difficult because of a ten- grams. The VABS was originally published in
dency to “address” or ignore them repetitively 1984; the most recent version is the VABS–II,
through unhealthy defensive reactions that, in published in 2005. [originally developed by psy-
fact, compound them. chologists Sara S. Sparrow (1933–2010), David A.
victim n. 1. an individual who is the target of an- Balla, and Domenic V. Cicchetti (1937– )]
other person’s violent, discriminatory, harass- violence n. 1. the expression of hostility and
ing, or assaultive behaviors. 2. an individual rage with the intent to injure or damage people
who has experienced an accident or natural di- or property through physical force. See also
saster. —victimization n. domestic violence. 2. passion or intensity of
victim blaming see blaming the victim. emotions or declarations. —violent adj.
videotape methods in clinical psychology and viral hypothesis of schizophrenia the the-
psychiatry, the use of videotape recordings of ory, first suggested in the early 20th century,
therapy sessions for therapeutic, research, or that psychoses resembling schizophrenia are as-
teaching purposes. Videotaped sessions are typi- sociated with influenza epidemics. It was later
cally reviewed as a part of clinical supervision observed that several types of viral encephalitis
and are useful in providing trainees with feed- may include schizophrenia-like symptoms, and
back. Occasionally patients are invited to view many studies have investigated the effect of ex-
the videotape with the therapist and recall their posure to viral agents, especially in utero, on
thoughts and emotions. subsequent development of schizophrenia. In
particular, U.S. psychiatrist E. Fuller Torrey
Vienna Psychoanalytic Society see wed-
(1938– ) has noted that the viral hypothesis ac-
nesday evening society.
counts for the greater number of people with
Viennese School a group of early 20th-century schizophrenia who are born from January to
practitioners of psychoanalysis, based in Vienna, April (see seasonality effect), a period during
who followed the theories of Sigmund freud. which there is a high incidence of viral infec-
Also called Vienna School; Wiener Schule. tions. More recently, however, it has been sug-
See also wednesday evening society. gested that virus exposure is a risk factor for—
vigilance n. a state of extreme awareness and rather than a key causative event in—the devel-
watchfulness directed by one or more members opment of schizophrenia.
of a group toward the environment, often to- Virchow–Seckel syndrome see seckel’s
ward potential threats (e.g., predators, intruders, bird-headed dwarfism.
enemy forces in combat). In animal behavior,
virginity n. the state of a person who has not
vigilance increases in females after the birth of
participated in sexual intercourse. Traditionally,
their young and in response to alarm calls. In
V a woman was assumed to be a virgin if her
large groups there can be a division of labor,
hymen was not ruptured, but a ruptured hymen
with individuals taking turns in vigilance. In
is no longer regarded as prima facie evidence of
a millitary context, vigilance tasks (e.g., sentry
loss of virginity, as other events can cause this.
duty, ship and air traffic control, antiaircraft
and missile defense tracking) demand maximum virility n. the state of possessing the qualities of
physiological and psychological attention and an adult male, especially capacity for coitus. See
readiness to react, characterized by an ability also maleness; masculinity. —virile adj.
to attend and respond to stimulus changes for virtual reality therapy a form of in vivo
uninterrupted periods of time. This level of vigi- exposure therapy in which clients are active
lance can produce significant cognitive stress participants immersed in a three-dimensional
and occasional physiological stress reactions. computer-generated interactive environment
—vigilant adj. that allows them a sense of actual presence in
614
visual impairment
scenarios related to their presenting problems. tially the ability to perform perceptual opera-
This treatment is currently used primarily for tions. Subtypes of each form exist, based on the
anxiety-related disorders, such as fear of flying. type of visual stimulus the person has difficulty
visceral brain the area of the brain that is recognizing, such as objects (visual object
involved in the neurophysiological control of agnosia or visual form agnosia), multiple objects
emotional behavior and experience (including or pictures (simultanagnosia), faces (prosopag-
motivated behavior). Its major structures are nosia), or colors (color agnosia).
the amygdala, hippocampal formation, and visual apperception test a projective tech-
septal area. These structures are considered to nique in which participants (most often chil-
regulate responses organized, in principle, by the dren and adolescents) are presented with a
hypothalamus and basal ganglia and to provide visually oriented task, for example, to draw a
them with much of the necessary information. It person, object, or situation; to finish an incom-
integrates cognitive aspects with commands for plete drawing; or to create a narrative from a sin-
action. gle or multiple visual stimuli.
visceral drive a drive that is derived from a visual attention disorder any disturbance of
physiological need. Also called viscerogenic a person’s ability to detect and attend to visual
drive. stimuli. Examples include bálint’s syndrome
viscerogenic need in the personology of U.S. and visual neglect.
psychologist Henry Alexander Murray (1893– visual dyslexia a form of acquired dyslexia (see
1988), one of the primary, physiological needs alexia) characterized by multiple reading errors
that arise from organic processes and lead to involving the substitution or transposition of
physical gratification. They include the needs for letters within words (see paralexia). The result-
air, water, food, sex, urination, and defecation. ing misread words are often very similar to the
Compare psychogenic need. actual words (e.g., reading wife as life, or bug
as dug). [proposed in 1973 by British neuro-
viscerotonia n. the personality type that, ac-
psychologists John C. Marshall and Freda
cording to sheldon’s constitutional theory
Newcombe (1925–2001)]
of personality, is associated with an endo-
morphic physique (see endomorph) and is visual hallucination visual perception in the
characterized by a tendency toward love of com- absence of any external stimulus. Visual halluci-
fort, love of food, relaxation, and sociability. nations may be unformed (e.g., shapes, colors)
—viscerotonic adj. or complex (e.g., figures, faces, scenes). In hallu-
cination associated with psychoses (e.g., para-
vision n. 1. the sense of sight, in which the eye is noid schizophrenia, alcohol- or hallucinogen-
the receptor and the stimulus is radiant energy
induced psychotic disorder), the individual is
in the visible spectrum. 2. a visual hallucination
unaware of the unreality of the perception,
often involving a religious or mystical experi-
whereas insight is retained in other conditions
ence. 3. a mental image of something or some-
(e.g., pathological states of the visual system).
one, produced by the imagination. —visual adj.
Visual hallucinations may arise in association
vision rehabilitation the rehabilitation of with lesions of the peripheral or central visual
individuals with visual impairment ranging pathway or visual cortical areas; they are often
from blindness to low vision. Services provided present in temporal-lobe epilepsy and may ap-
include functional assessments of a person’s vi- pear during prolonged isolation. See also pedun-
sual abilities, if any; orientation and mobility cular hallucinosis.
training; rehabilitation teaching (e.g., adaptive visual illusion a misperception of external vi-
skills training in managing one’s activities of sual stimuli that occurs as a result of a misinter-
daily living); instruction in the use of optical pretation of the stimuli, such as a geometric
devices and assistive technology; career ser- illusion. Visual illusions are among the most
vices and training; and psychological counsel- common type of illusion.
ing.
visual imagery mental imagery that involves
visiting nurse a registered nurse who pro- the sense of having “pictures” in the mind. Such
vides nursing services to patients in their homes. images may be memories of earlier visual experi-
Visiting nurses are usually employed by a local ences or syntheses produced by the imagination V
visiting nurse association. (as, for example, in visualizing a pink kangaroo).
Vistaril n. a trade name for hydroxyzine. Visual imagery can be used for such purposes as
visual agnosia loss or impairment of the ability dealing with traumatic events, establishing de-
to recognize and understand the nature of vis- sensitization hierarchies, or improving physi-
ual stimuli. Classically, a distinction between cal performance. See visualization.
apperceptive and associative forms of visual visual impairment partial or total inability to
agnosia has been made. Individuals with the for- see, or to see normally, due to partial or complete
mer are said to have deficits in the early stages of loss or absence of vision or to visual dysfunction.
perceptual processing, whereas those with the Visual impairment encompasses the continuum
latter either do not display such problems or do from blindness to low vision. It can result
so to a degree not sufficient to impair substan- from disease or degenerative disorder (e.g., cata-
615
visualization
ract, glaucoma, diabetic retinopathy, or macular and effectiveness is still a matter of debate and
degeneration), injury, or congenital defects (e.g., research. See also megavitamin therapy.
refractive errors, astigmatism). The degree of vi- vitamin A toxicity a condition caused by ex-
sual impairment is assessed in terms of disability cessive intake of vitamin A (retinol). A large
in everyday life. Also called vision impair- overdose of vitamin A—500,000 IU or more—
ment. can cause headache, vomiting, bone pain, weak-
visualization n. 1. the process of creating a vi- ness, blurred vision, irritability, and flaking of
sual image in one’s mind (see visual imagery) the skin. Long-term intake of 100,000 IU or more
or mentally rehearsing a planned movement in per day can also lead to toxicity. Symptoms in-
order to learn skills or enhance performance. 2. clude hair loss, headache, bone thickening, an
in psychotherapy, the intentional formation by enlarged liver and spleen, anemia, menstrual
a client of mental visual images of a scene or his- problems, stiffness, joint pain, weakness, and
torical incident that may be inhibited or the dry skin. On the other hand, high doses of beta-
source of anxiety. The purpose is to bring the vi- carotene (which can be converted to vitamin A
sualized scene into the present therapeutic situa- in the body) have no toxic effects.
tion where it can be discussed and worked out to vitamin deficiency lack of a vitamin needed
reduce its negative implications. See also guided for normal bodily functions. For example, defi-
affective imagery. 3. a hypnotic method used ciency of thiamine (vitamin B1) is often associ-
to induce or increase relaxation in which the in- ated with severe and chronic alcoholism (see
dividual is asked to imagine, for example, sitting wernicke’s encephalopathy; wernicke–kor-
comfortably at home and then to use all senses sakoff syndrome).
in perceiving the scene (e.g., the curtains blow- vitamin D toxicity a condition caused by ex-
ing in the windows, the texture of the armchair). cessive intake of vitamin D. Long-term overdose
The more fully the individual concentrates on of vitamin D can cause irreversible damage to
these features, the more deeply relaxed he or she the kidneys and cardiovascular system and can
becomes. —visualize vb. retard growth in children. Excessive amounts of
visual neglect a form of sensory neglect in the vitamin may lead to high blood pressure and
which the individual is unaware of half the vi- premature hardening of the arteries. Nausea, ab-
sual field. This occurs most often in the left dominal pain, loss of appetite, weight loss, sei-
visual field following right parietal damage or zures, and an irregular heartbeat may be signs of
dysfunction. See neglect. overdose.
visuoconstructive test any of a wide range of vitex agnus castus see agnus castus.
tests that require a combination of visual and VMI abbreviation for developmental test of
motor skills in the construction of an end prod- visual–motor integration.
uct as an evaluation of these nonverbal skills.
vocational counseling 1. a counseling service
The most common examples of these tests are
provided to employees who seek guidance on
drawing tests, block-design tests, and jigsaw-
such matters as adjusting to new jobs or roles,
puzzle tests. Also called visual-construction
developing their careers within organizations,
test.
or any personal or other problems affecting job
vitality n. physical or intellectual vigor or en- satisfaction or job performance. See also out-
ergy: the state of being full of zest and enthusias- placement counseling. 2. see vocational
tic about ongoing activities. See also fitness. guidance.
vitamin n. an organic substance that in minute vocational guidance the process of helping
quantities is essential for normal growth and an individual to choose an appropriate vocation
health. Many vitamins function as coenzymes, through such means as (a) in-depth interviews;
aiding in the metabolism of carbohydrates, fats, (b) administration of aptitude, interest, and per-
and proteins. A few vitamins can be synthesized sonality tests; and (c) discussion of the nature
in the human body, but most must be supplied and requirements of specific types of work in
in the diet. The most important are vitamin A, which the individual expresses an interest. Also
the vitamin B complex (including thiamine, called vocational counseling.
riboflavin, pyridoxine, cyanocobalamin [B12], vocational rehabilitation the rehabilita-
V folic acid, nicotinic acid, and pantothenic acid), tion of individuals with mental or physical dis-
vitamin C (ascorbic acid), vitamin E, and vita- abilities or those who have been injured or ill in
min K. Vitamins were so named in 1913 by Pol- order to develop or restore productivity. A voca-
ish-born U.S. biochemist Casimir Funk (1884– tional rehabilitation program includes assess-
1967), based on his belief that all vitamins were ment, vocational guidance, and training and
amines. involves helping the individual to develop skills
vitamin and mineral therapy the treat- that have been lost or neglected and to find or re-
ment of mental or physical conditions through a turn to employment in the competitive job
daily intake of diagnostic-specific vitamins or market or another setting (see sheltered work-
mineral supplements (or both) in specific dos- shop; transitional employment). Also called
ages. These are typically prescribed in conjunc- occupational rehabilitation. See also work
tion with some psychopharmacological agent, rehabilitation center.
616
vulval orgasm
vocational services vocational guidance, cates or properties. [developed by Eilhard von

testing, and training, together with practical as- Domarus, German psychiatrist]
sistance in finding employment, as provided by von Recklinghausen’s disease an auto-
a school, college, hospital, clinic, or rehabilita- somal dominant hereditary disorder in which
tion center. the common anomalies are pigmented (pale
voice disorder any disorder that affects the brown) patches on the skin and tumors of the
pitch, loudness, tone, or resonance of the voice. peripheral nervous system (neurofibromas);
See also communication disorder not oth- the latter may be firm subcutaneous nodules or
erwise specified. soft cutaneous lumps that invaginate (form
voice–stress analyzer an instrument that de- a pocket) when pressed. Visual, hearing, and
tects minute alterations in the voice, undetect- other neurological anomalies may occur, and
able to the human ear, that presumably occur about a quarter of affected individuals show
when a person is under stress. It is sometimes mental retardation. It is popularly called Ele-
used as a lie detector, although its reliability and phant Man’s disease (so named after a 19th-
validity are controversial, and the results are not century patient, John Merrick, who was known
accepted as evidence in many U.S. courts of law. as “the Elephant Man”). Also called neuro-
voice therapy the diagnosis and remediation of fibromatosis. [described in 1882 by Friedrich
voice disorders by a specialist in the physiology D. von Recklinghausen (1833–1910), German
and pathology of voice production. See also pathologist]
speech and language therapy. voodoo death a culture-bound syndrome
volatile marriage a long-lasting marriage observed in Haiti, Africa, Australia, and islands
marked by both passionate arguments and ex- of the Pacific and the Caribbean. An individual
pressions of affection, but with more positive who has disobeyed a ritual or taboo is hexed or
than negative interactions. cursed by a medicine man or sorcerer (often by
pointing a bone at the culprit) and dies within a
volubility n. excessive, uncontrollable talkative- few days. U.S. physiologist Walter B. Cannon
ness: a common symptom of a manic episode. (1871–1945), one of the first researchers of voo-
volume of distribution (symbol: Vd) the doo death, suggested that the individual’s strong
amount of a drug in the body in relation to its belief in the curse caused physiological reactions
concentration in various body fluids (e.g., blood, in the body resulting in death. Also called bone
plasma, extracellular fluid). It is expressed by the pointing; thanatomania. See also psychic
equation Vd = dose (amount of drug in body)/con- suicide.
centration in body fluid.
voyeurism n. a paraphilia in which preferred
voluntary admission admission of a patient or exclusive sexual interest and arousal is fo-
to a mental hospital or other inpatient unit at his cused on observing unsuspecting people who are
or her own request, without coercion. Such hos- naked or in the act of undressing or engaging
pitalization can end whenever the patient sees in sexual activity. Although the voyeur seeks
fit, unlike involuntary hospitalization, the no sexual activity with the person observed, or-
length of which is determined by a court or the gasm is usually produced through masturbation
hospital. Also called voluntary commit- during the act of “peeping” or later, while vis-
ment; voluntary hospitalization. ualizing and remembering the event. Also called
voluntary behavior behavior that is inten- inspectionalism. —voyeuristic adj.
tional in nature (e.g., walking, tapping at a key to VT abbreviation for vicarious traumatization.
receive food), as opposed to reflexive behav-
ior. See also operant behavior. vulnerability n. susceptibility to developing a
condition, disorder, or disease when exposed to
voluntary commitment see voluntary ad- specific agents or conditions. —vulnerable adj.
mission.
vulnerability factor a variable that, if experi-
voluntary hospitalization see voluntary enced or triggered, affects the probability that an
admission. individual will develop a condition, disorder, or
volunteerism n. the act or practice of donating disease.
(i.e., without pay) one’s time and energy to activ-
vulval orgasm orgasm produced from stimula-
ities that contribute to the common good.
tion of the vulva (including the clitoris and V
vomiting n. ejecting the contents of the stom- labia). Some researchers have proposed that
ach through the mouth. Normally occurring as there are two types of orgasm, vulval and uter-
an autonomic physiological reaction to the in- ine, the latter involving deep vaginal penetra-
gestion of toxic substances, vomiting may also tion that results in contractions of the uterus
be self-induced, as in bulimia nervosa, as an in- during orgasm. Uterine contractions are said not
appropriate means of managing body weight to occur with vulval orgasms. This theory sug-
(see purging). gests that a more complete or satisfying orgasm
von Domarus principle an explanation of results from intercourse than from stimulation
schizophrenic thinking based on the concept of the vulva alone. However, many women have
that the individual perceives two things as iden- reported that whether or not uterine contrac-
tical merely because they have identical predi- tions accompany orgasm does not depend on
617
Vygotsky, Lev Semenovich
the type of stimulation or sexual activity but oral language) available in his or her culture. In
rather on how intense the orgasm is, and that contrast to Jean piaget, who held that cogni-
the most intense orgasms occur in such activities tive stages unfold naturally and inevitably and
as cunnilingus or during vibrator stimulation of that education should follow these stages,
the clitoris. See also vaginal orgasm. Vygotsky held that the stages are in part driven
Vygotsky, Lev Semenovich (or Vigotsky; by education and that therefore education
1896–1934) Russian psychologist. Vygotsky should take place within a “zone of proximal
earned his doctorate in 1925 from the Psycho- development,” aiming to stretch the child’s ca-
logical Institute in Moscow, where he re- pabilities beyond the current stage. Vygotsky’s
mained on the research staff for the remainder views were banned in the Soviet Union for po-
of his career, although he also lectured and su- litical reasons from the 1930s to mid-1950s;
pervised research in Leningrad and Kharkov. they reached the West only after considerable
Vygotsky is best known for his sociocultural delay, but are now quite influential. Among his
theory of cognitive development, stressing the most important writings are Thought and Lan-
interaction of the child’s natural capabilities guage (1934) and the posthumously published
with the symbolic mediators (e.g., written and Mind in Society (1978).
618
Ww
WAB abbreviation for western aphasia bat- awareness and there being no reference to sleep
tery. or trance are common to most.
Wada test a presurgical and diagnostic tech- walk-in clinic a clinic in which diagnostic or
nique for determining hemispheric functions, therapeutic service is available without an ap-
typically memory and language, by injecting a pointment. See also drop-in center.
small dose of a barbiturate into an internal ca- wandering behavior a disturbance of motor
rotid artery. While each hemisphere is separately activity that involves directionless, disoriented
anesthetized, various cognitive tasks are admin- movement. This behavior typically occurs in in-
istered; impairments on these tasks suggest that dividuals with neurological impairment, demen-
these functions are represented in the anesthe- tia, alcohol dependence, or extreme stress.
tized hemisphere. The Wada test is typically used
prior to temporal lobectomy in severe epi- wanderlust n. (German: desire for wandering) a
lepsy. Also called intracarotid amobarbital tendency or compulsion to travel or roam. See
procedure; intracarotid sodium amytal also dromomania.
test (ISA); Wada dominance test; Wada warehousing n. the practice of confining pa-
technique. [Juhn Atsushi Wada (1924– ), Jap- tients with mental disorders to large institutions
anese-born Canadian neurosurgeon] for long-term, often lifetime, custodial care. This
WAIS abbreviation for wechsler adult intelli- colloquial term implies lack of treatment beyond
gence scale. housing and feeding.
waiting-list control group a group of re- Watson, John Broadus (1878–1958) U.S. psy-
search participants that will receive the same in- chologist. Watson earned his PhD in 1903 from
tervention given to the experimental groups the University of Chicago, where he studied biol-
but at a later time, thus functioning as a con- ogy and neurophysiology with Jacques Loeb
trol group in the interim. (1859–1924) and Henry H. Donaldson (1857–
1938), as well as philosophy and psychology
waiting-list phenomenon in psychotherapy
with James Rowland angell and John dewey.
and counseling, the unusual occurrence of a
He then became an instructor and head of the
“cure” in a person who is on a waiting list for
university’s psychological laboratory. From 1908
treatment. Such occurrences suggest that the an-
to 1920 he headed the program in experimental
ticipation of treatment, in and of itself, has pro-
psychology at Johns Hopkins University but was
found psychological effects, which are similar to
forced to resign because of a divorce scandal.
the placebo effect.
Thereafter, he worked for the J. Walter Thomp-
wakefulness n. a condition of awareness of son advertising company in New York City
one’s surroundings, generally coupled with while continuing to write popular psychological
an ability to communicate with others or to sig- works. Watson, an important figure in the early
nal understanding of what is being communi- history of comparative psychology, is best
cated by others. It is characterized by low- known as the founder of behaviorism, which
amplitude, random, fast-wave electrical activity eschewed the then-current emphasis on the
in the brain, as recorded on an electroencephalo- study of consciousness through the method of
gram. introspection and favored instead an objec-
waking dream 1. a metaphor for a vision. 2. a tive study of observable, measurable behavior,
dream process in the psychoanalytic theory of molded on the methods of natural science. In
British psychiatrist Wilfred Ruprecht Bion applying this approach, major emphasis was
(1897–1979). placed on learned behavior, stimulus–response
waking hypnosis a technique—or the state connections, and pavlovian conditioning,
produced by such a technique—in which hyp- which Watson introduced to American psychol-
notic effects (see hypnotic susceptibility) are ogy. Watson served as president of the American
achieved in a participant’s normal state of con- Psychological Association in 1915. Among his
sciousness without reference to sleep or a relaxed most influential works were his 1913 Psychologi-
state. It is induced through an apparently natu- cal Review article, “Psychology as the Behaviorist
ral, but carefully considered, choice of simple Views It,” and Psychology From the Standpoint of a
words, gestures, and directives upon which to Behaviorist (1919).
focus. There are almost as many definitional Watson–Glaser critical thinking ap-
variations as there are practitioners, but the cri- praisal a measure of critical thinking in
teria of participants being in a normal state of which participants are asked to read and evalu-
619
waxy flexibility
ate various statements, such as arguments, the- and a Working Memory index score; a Verbal IQ,
ses, problems, and interpretations. [Goodwin B. a Performance IQ, and a Full Scale IQ with a
Watson (1899–1976) and Edward Maynard mean of 100 and a standard deviation of 15; or
Glaser (1911–1993), U.S. psychologists] both index scores and IQs. The current version,
waxy flexibility see catalepsy. WAIS-IV (2008), retains most of the subtests of
WAIS-III but has modified some of them and
Ways of Coping Questionnaire (WAYS) a added three new ones (Visual Puzzles, Figure
66-item questionnaire administered to identify Weights, and Cancellation). The core battery of
thoughts and behaviors that adults use to cope 10 subtests yields a Full Scale IQ and index scores
with stressful encounters in everyday life. It con- on the same four domains of cognitive ability
sists of statements (e.g., “I talked to someone to (verbal comprehension, perceptual organiza-
find out more”) to which participants must re- tion, processing speed, and working memory).
spond using a 4-point likert scale, ranging [David wechsler]
from “does not apply and/or not used” to “used
a great deal.” The WAYS measures coping pro- Wechsler Intelligence Scale for Children
cesses, not coping styles. [developed by U.S. psy- (WISC) an intelligence test developed initially
chologists Susan Folkman (1938– ) and Richard in 1949 and standardized for children aged from
S. Lazarus (1922–2002)] 6 years to 16 years 11 months. It currently in-
cludes 10 core subtests (Similarities, Vocabulary,
WCST abbreviation for wisconsin card sort- Comprehension, Block Design, Picture Con-
ing test. cepts, Matrix Reasoning, Digit Span, Letter–
weak ego see ego weakness. Number Sequencing, Coding, Symbol Search)
and 5 supplemental subtests (Word Reasoning,
Wechsler, David (1896–1981) German-born
Information, Picture Completion, Arithmetic,
U.S. psychologist. Wechsler earned his doctorate
Cancellation) that measure verbal comprehen-
at Columbia University in 1925 under Robert S.
sion, perceptual reasoning, processing speed,
Woodworth (1869–1962). During World War I
and working memory capabilities, yielding
he worked under Edwin G. Boring (1886–1968),
index scores for each as well as a Full Scale IQ
scoring the Army’s Alpha tests of intelligence
with a mean of 100 and a standard deviation of
and administering and scoring the Beta tests.
15. The most recent version of the test is the
After the war Wechsler studied with Charles
WISC–IV, published in 2003. [David wechsler]
Spearman (1863–1945) and Karl Pearson (1857–
1936) in London, then went into private practice Wechsler Memory Scale (WMS) a collection
until becoming chief psychologist at Bellevue of tests that assesses different memory functions
Psychiatric Hospital in New York City in 1932. in individuals aged 16 to 90 years old. It has un-
It was there that Wechsler first developed the dergone several revisions since its original publi-
Wechsler–Bellevue Intelligence Scale, which pro- cation in 1945, including in the Wechsler
vided subtest scores for different components Memory Scale–Revised (WMS–R, 1987), the
of intelligence, such as verbal and quantitative WMS-III (1997), and the most current version,
ability, in contrast to the single-score tests of the the WMS-IV (2009). The latter’s standard battery
stanford–binet intelligence scale. Wechs- measures an individual’s memory performance
ler’s test was ultimately standardized as the on seven subtests and yields scores in five in-
wechsler adult intelligence scale (WAIS). dexes: Immediate Memory, Delayed Memory,
It and the wechsler intelligence scale for Visual Memory, Visual Working Memory, and
children (WISC) are still the dominant tests Auditory Memory. [David wechsler]
worldwide for measuring cognitive abilities. See Wechsler Preschool and Primary Scale
also wechsler preschool and primary scale of Intelligence (WPPSI) an intelligence test
of intelligence. for children aged 2 years 6 months to 7 years 3
Wechsler Adult Intelligence Scale (WAIS) months that currently includes seven verbal
an intelligence test, for individuals aged 16 years subtests (Information, Vocabulary, Receptive
to 90 years. The WAIS was originally published Vocabulary, Word Reasoning, Similarities, Com-
in 1955 (revised in 1981) as a modification and prehension, Picture Naming) and seven perfor-
replacement of the Wechsler–Bellevue Intelli- mance subtests (Picture Completion, Picture
gence Scale (1939) , which consisted of subtests Concepts, Block Design, Object Assembly, Ma-
that yielded separate verbal and performance trix Reasoning, Symbol Search, Coding). These
IQs as well as an overall IQ. The third edition subtests yield Verbal, Performance, and Full
W (WAIS-III, 1997) included seven verbal subtests Scale IQs with a mean of 100 and a standard de-
(Information, Comprehension, Arithmetic, Sim- viation of 15 as well as General Language and
ilarities, Digit Span, Vocabulary, Letter–Number Processing Speed index scores. The WPPSI was
Sequencing) and seven performance subtests originally published in 1967; the most recent
(Digit Symbol, Picture Completion, Block De- version is the WPPSI–III, published in 2002. A
sign, Picture Arrangement, Object Assembly, new edition, WPPSI-IV, is expected in 2012.
Matrix Reasoning, Symbol Search). Depending [David wechsler]
on the specific combination of subtests adminis- Wednesday Evening Society an informal
tered, the test yielded a Verbal Comprehension, group of Sigmund freud’s disciples who met
a Perceptual Organization, a Processing Speed, with him for instruction in psychoanalysis, be-
620
Wertheimer, Max
ginning in 1902. The Society evolved into the premature aging that may appear before the age
larger Vienna Psychoanalytic Society in 1910. of 20. The patients are usually of short stature.
See also viennese school. The symptoms include graying and loss of hair,
weekend hospitalization a form of partial skin atrophy, underactivity of the endocrine
hospitalization in which psychiatric patients glands, accumulation of calcium deposits in the
function in the community during the week but tissues, and a form of arthritis. Also called
spend the weekend in the hospital. progeria adultorum; Werner’s syndrome.
[Carl Otto Werner (1879–1936), German physi-
weight n. 1. heaviness: the extent of downward
cian]
gravitational force exerted on an object or body.
2. a coefficient or multiplier used in an equation Wernicke–Korsakoff syndrome a syn-
or statistical investigation and applied to a par- drome resulting from chronic alcoholism or
ticular variable to reflect the contribution to the nutritional insufficiency, associated with de-
data. ficiency of vitamin B1 (thiamine). The syndrome
is characterized by an acute confusional stage,
weighted item an item on a test or scale that is
ataxia, and oculomotor problems (see
multiplied by a weight other than 1.0 before
wernicke’s encephalopathy), followed by
scores on items are combined.
chronic changes in mental status and memory
weighted test a test in a test battery that has (see korsakoff’s syndrome). Lesions are cen-
been multiplied by a weight other than 1.0 be- tered in the midbrain, cerebellum, and dien-
fore scores on tests are combined. cephalon. [Karl Wernicke (1848–1904), German
Weight Watchers a widely available weight neurologist; Sergei S. Korsakoff (1854–1900),
loss and control program that includes aspects of Russian psychiatrist]
both support groups and self-help groups. Wernicke’s aphasia a loss of the ability to
well-being n. a state of happiness, contentment, comprehend sounds or speech (auditory amne-
low levels of distress, overall good physical and sia), and in particular to understand or repeat
mental health and outlook, or good quality of spoken language (see aphasia) and to name ob-
life. jects or qualities (see anomia). The condition is a
Wellbutrin n. a trade name for bupropion. result of brain damage and may be associated
well-defined problem a problem with clear with other disorders of communication, includ-
initial conditions and goals and standard ing alexia, acalculia, or agraphia. Also called
methods for proceeding from the former to the auditory aphasia; cortical sensory apha-
latter. sia. [Karl Wernicke]
well-integrated personality see integra- Wernicke’s encephalopathy a neurological
ted personality. disorder caused by a deficiency of vitamin B1
(thiamine). The principal symptoms are confu-
wellness n. a dynamic state of physical, mental, sion, oculomotor abnormalities (gaze palsy and
and social well-being. Some researchers and cli-
nystagmus), and ataxia. The disorder is most
nicians have viewed wellness as the result of four
frequently associated with chronic alcoholism
key factors over which an individual has some
but is also found in cases of pernicious anemia,
control: biology (i.e., body condition and fit-
gastric cancer, and malnutrition. These symp-
ness), environment, lifestyle, and health care
toms are likely to resolve with thiamine treat-
management. The wellness concept is the no-
ment, although most individuals then develop
tion that individual health care and health care
severe retrograde and anterograde amnesia as
programs should actively involve the promotion
well as impairment in other areas of cognitive
of good mental and physical health rather than
functioning, including executive functions (see
merely being concerned with the prevention
korsakoff’s syndrome). Also called cerebral
and treatment of illness and disease.
beriberi; Wernicke’s disease. [first described
wellness program a health care program em- in 1881 by Karl Wernicke]
phasizing the wellness concept.
Wertheimer, Max (1880–1943) German-born
Welsh Figure Preference Test (WFPT) a U.S. psychologist. Wertheimer earned his doc-
nonverbal personality assessment in which par- torate at the University of Würzburg in 1904,
ticipants indicate “like” or “dislike” for each of studying with Karl Marbe (1869–1953) and
400 black-and-white figures varying in complex- Oswald Külpe (1862–1915). After a number of
ity from simple line drawings of geometric fig- years lecturing at the University of Frankfurt, he
ures to detailed, multiline abstractions. Initially moved to the University of Berlin, where he was W
designed to diagnose psychiatric disorders, the appointed professor in 1922. He returned to
WFPT currently includes several scales intended Frankfurt as chair in 1929, but with the Nazi rise
to measure a variety of constructs, both patho- to power he emigrated to the United States in
logical (e.g., anxiety, repression) and nonpatho- 1933 and taught at the New School for Social Re-
logical (e.g., creativity, originality). [originally search in New York City. Wertheimer is widely
developed in 1949 by George S. Welsh (1918– regarded as the founder of gestalt psychol-
1990), U.S. psychologist] ogy, along with Wolfgang köhler and Kurt
Werner’s disease a rare hereditary disorder af- koffka. His most important contributions in-
fecting both sexes and characterized by signs of cluded his early experiments on the phi phe-
621
Westermarck effect
nomenon, which is the perception of apparent wife swapping a form of group sex in which
movement when two separate stationary lines two or more married couples exchange spouses
are presented in rapid succession. Unable to by mutual agreement for the purpose of sexual
account for this phenomenon on the basis of ex- intercourse. The practice of wife swapping may
isting theories of perception, Wertheimer sug- also include watching the husband or wife
gested in a 1912 paper that certain perceptions, participate in sexual intercourse with another
such as the phi phenomenon, were based not on person’s spouse. Also called mate swapping;
the isolated elements contained in the thing per- partner swapping. See also swinging.
ceived but in the percept taken as a whole (ges- wihtigo (wihtiko) n. see windigo.
talt). Wertheimer is also famous for his work on
the gestalt principles of organization and Wildervanck’s syndrome a hereditary disor-
productive thinking. The latter research was der associated with klippel–feil syndrome and
published posthumously as the book Productive characterized by deafness and paralysis of the
Thinking (1945), which has been influential in abducens nerve. Cranial asymmetry and mental
the field of cognitive psychology. retardation may also occur. [reported in 1952 by
L. S. Wildervanck, Dutch geneticist]
Westermarck effect the proposal that people
who grow up in close proximity in the same will disturbance a deficiency or lack of will-
household do not find one another sexually power identified by Swiss psychiatrist Eugen
attractive later in life. It is based on the observa- Bleuler (1857–1939) as a basic symptom of
tion that people who had extensive contact with schizophrenia. The person may appear apathetic
one another as children rarely ever married, and lacking in objectives and motivation. An-
despite being available as mates. [Edward Wes- other form of will disturbance is characterized by
ermarck (1862–1939), Finnish anthropologist] a high degree of activity that is trivial, inappro-
priate, or purposeless.
Western Aphasia Battery (WAB) a test bat-
tery that evaluates numerous aspects of lan- Wille zur Macht see will to power.
guage—spontaneous speech, comprehension, Williams syndrome (Williams–Barratt
repetition, naming, etc.—and is used to deter- syndrome; Williams–Beuren syndrome) a
mine the severity and type of a language distur- rare disorder caused by deletion of a segment of
bance as well as to assess such skills as writing, chromosome 7. In addition to mental retarda-
reading, and calculation. The current version, tion, it is characterized by failure to thrive,
Western Aphasia Battery–Revised (WAB-R), was high concentrations of calcium in the blood,
published in 2006. [developed by Canadian psy- narrowing of blood vessels (particularly the
chologist Andrew Kertesz (1935– )] aorta, which restricts blood flow from the heart),
wet dream see nocturnal emission. and unusual facial features (e.g., short nose with
a broad tip, wide mouth, small chin). Addi-
wet pack see hydrotherapy.
tionally, individuals with Williams syndrome
WFPT abbreviation for welsh figure prefer- are highly sociable and have superior verbal
ence test. (compared to nonverbal) skills. [described in the
whipping n. striking a person with a rod, lash, 1960s by J. C. P. Williams, 20th-century New Zea-
or similar instrument. See flagellation. land cardiologist; Brian Gerald Barratt–Boyes
white matter parts of the nervous system com- (1924–2006), New Zealand cardiologist; and
posed of nerve fibers that are enclosed in a my- Alois J. Beuren (1919–1984), German cardiolo-
elin sheath, which gives a white coloration to gist]
otherwise grayish neural structures. The sheaths Willie M. class action a class action lawsuit in
cover only the fibers, so regions containing North Carolina, settled out of court in 1979, that
mainly cell bodies are gray. Compare gray established a special class of children aged 18
matter. years and younger. Class members have emo-
whiteout syndrome a psychosis occurring in tional, mental, or neurological disabilities, are
individuals (e.g., arctic explorers and mountain- violent or assaultive, have been placed in resi-
eers) who are exposed to the same white, impov- dential programs, and have not received appro-
erished environment for long periods of time. priate treatment or educational services. Related
whitiko n. see windigo. service entitlements are specified in the agree-
ment between the defendants and plaintiffs. The
WHO abbreviation for world health organi- class persists to the present day.
zation.
W WHO (10) Well-Being Index a 10-item ques-
Willowbrook Consent Judgment a land-
mark agreement in 1975 between agencies, par-
tionnaire, commissioned by the World Health
ents, and friends of the court (the plaintiffs) and
Organization, that includes negative and posi-
New York State (the defendant), detailing the
tive aspects of well-being in a single uni-
rights of people with mental retardation who
dimensional scale. The index has been used to
lived at the Willowbrook State School in Staten
examine well-being in patients experiencing
Island, NY, for several years. It set out standards
chronic diseases.
for the residents’ living environment, evaluation
Wiener Schule see viennese school. of services, personnel, education, recreation,
wife beating see battered women. food and nutrition services, dental services, psy-
622
Wittmaack–Ekbom syndrome
chological services, physical therapy services, considered a test of executive functions.

speech and audiology services, medical and [originally developed in 1948 by U.S. psy-
nursing services, safety procedures, treatment chologists David A. Grant (1916– ) and Esta A.
and medication, building maintenance, emer- Berg]
gencies, records, and movement to community wish n. 1. in psychoanalytic theory, the psycho-
settings. Willowbrook State School was later re- logical manifestation of a biological instinct
named Staten Island Developmental Center; it that operates on a conscious or unconscious
closed during the 1980s. Also called Willow- level. 2. in general language, any desire or long-
brook Consent Decree. ing.
willpower n. the ability to carry out one’s inten- wish-fulfillment n. in psychoanalytic theory,
tions. See self-control.
the gratification, in fantasy or in a dream, of a
will psychology see action theory. wish associated with a biological instinct.
will therapy a form of psychotherapy based on wishful thinking a thought process in which
the theory that neuroses can be avoided or over- one interprets a fact or reality according to what
come by asserting the will (or “counterwill”) and one wishes or desires it to be.
by achieving independence. According to this
theory, will is central to personality formation withdrawal n. see substance withdrawal.
and life is a long struggle to separate oneself from withdrawal-destructiveness n. in the psy-
the mother psychologically, just as one is physi- choanalysis of Erich fromm, a style of relating
cally separated from the mother during birth. based on withdrawal and isolation from others,
Also called Rankian therapy. See also birth destructive behavior directed toward others, or a
trauma. [developed by Austrian psychoanalyst combination of the two. Fromm held that this
Otto Rank (1884–1939)] style of relating was motivated by a need to es-
will to meaning the need to find a suitable tablish emotional distance arising from a fear of
meaning and purpose for one’s life. Will to dependency.
meaning is the basis and fundamental motiva- withdrawal reaction 1. an extreme form of
tion of logotherapy, a technique for address- social withdrawal that sometimes occurs in
ing problems related to the experience of severe cases of major depressive episode. 2. a
meaninglessness. reemergence or exacerbation of symptoms as a
will to power 1. in the individual psychology result of cessation of treatment with medication,
of Alfred adler, the determination to strive for such as anxiolytics.
superiority and domination, which he believed withdrawal reflex a reflex that may be elic-
to be particularly strong in men who feel a need ited by any painful stimulus or unexpected
to escape the feelings of insecurity and inferior- threat to the well-being of the individual. It is
ity that they associate with femininity. 2. in the characterized by sudden movement away from
thought of German philosopher Friedrich Nietz- the potentially damaging stimulus, which re-
sche (1844–1900), the determination to affirm quires rapid coordination of neuromuscular
oneself through courage, strength, and pride, units.
which necessitates casting off the “slave moral-
ity” of Christianity, democracy, and false com- withdrawing response in behavioral psy-
passion. Also called Wille zur Macht. chology, any behavior designed to sever contact
with a noxious stimulus. See also escape behav-
windigo n. a severe culture-bound syndrome ior.
occurring among northern Algonquin Indians
living in Canada and the northeastern United within-cell variance see pooled variance.
States. The syndrome is characterized by delu- within-group variance variation in experi-
sions of becoming possessed by a flesh-eating mental scores among identically treated individ-
monster (the windigo) and is manifested in uals within the same group who experienced the
symptoms including depression, violence, a same experimental conditions. It is determined
compulsive desire for human flesh, and some- through an analysis of variance and com-
times actual cannibalism. Also called whitiko; pared with between-groups variance to ob-
wihtigo; wihtiko; witigo; witiko; wittigo. tain an f ratio.
WISC abbreviation for wechsler intelligence within-subjects design an experimental de-
scale for children. sign in which the effects of treatments are seen
Wisconsin Card Sorting Test (WCST) a test through the comparison of scores of the same W
that requires participants to deduce from feed- participant observed under all the treatment
back (right vs. wrong) how to sort a series conditions. Also called repeated measures de-
of cards depicting different geometric shapes in sign; within-group design. Compare be-
various colors and quantities. Once the partici- tween-subjects design.
pant has identified the underlying sorting prin- witigo (witiko) n. see windigo.
ciple (e.g., by color) and correctly sorts 10
consecutive cards, the principle is changed with- wittigo n. see windigo.
out notification. Although the task involves Wittmaack–Ekbom syndrome see ekbom’s
many aspects of brain function, it is primarily syndrome. [Theodor Wittmaack, German phy-
623
Witzelsucht
sician; Karl-Axel Ekbom (1907–1977), Swedish bered, but in studies of recognition memory,
physician] lower frequency words are better remembered.
Witzelsucht n. a type of joking mania (from word-recognition threshold in tests involv-
German, literally, “compulsive wisecracking”), ing word recognition, the minimum amount of
characterized by a morbid desire to tell poor time that a word must be exposed for a person to
jokes and meaningless stories, that can be a identify it correctly.
symptom of damage to the frontal lobe of the word salad severely disorganized and virtually
brain. See also moria. incomprehensible speech or writing, marked by
WMS abbreviation for wechsler memory scale. severe loosening of associations strongly sug-
Wolf Man in the annals of psychoanalysis, a gestive of schizophrenia. The person’s associa-
landmark case reported by Sigmund freud in tions appear to have little or no logical connec-
1918. It involved a conversion symptom (consti- tion. Also called jargon aphasia; paraphrasia;
pation), a phobia (for wolves and other animals), word hash. See also neologistic jargon;
a religious obsession (piety alternating with blas- schizophrenic thinking.
phemous thoughts), and an appetite disturbance workaholic n. a colloquial name for an individ-
(anorexia), all of which proved to be reactions to ual who has a compulsive need to work, works to
early experiences. Freud saw this case as confir- an excessive degree, and has trouble refraining
mation for his theory of infantile sexuality. from work. This type of driven overinvolvement
woman-centered psychology an approach in work is often a source of significant stress, in-
to psychology that emphasizes the physical, terpersonal difficulties, and health problems. See
psychological, and social experiences that are also ergomania.
particularly characteristic of women. See engen- work-for-pay unit an inpatient or aftercare
dering psychology; feminist psychology. work facility constituting a component of a com-
womb envy 1. in psychoanalytic theory, the prehensive rehabilitation program for patients
envy felt by some men for the reproductive ca- with mental disorders. Such units offer pre-
pacity of women, regarded as an unconscious vocational screening and evaluation, vocational
motive that leads them to denigrate women. See training, ego-strength assessment, and simple to
also vaginal envy. [proposed by German-born complex work-related tasks, performed under su-
U.S. psychoanalyst Karen D. Horney (1885– pervision, for which patients receive payment.
1952)] 2. the desire of a transsexual, or of a trans- See sheltered workshop.
vestite male whose gender identity is female, to working hypothesis a provisional hypothe-
wear female clothing or have sex-change sur- sis readily subject to revision upon further ex-
gery. perimentation.
womb fantasy in psychoanalytic theory, the working memory as originally described in
fantasy of returning to the womb or existing in 1960 by U.S. cognitive psychologist George
the womb, usually expressed in symbolic form, Armitage Miller (1920– ), U.S. experimental
for example, living under water or being alone in psychologist Eugene Galanter (1924– ), and
a cavern. Austrian-born U.S. neuropsychologist Karl H.
word approximation a speech disturbance in Pribram (1919– ), any of various hypothetical
which conventional words are used in uncon- systems involved in the brief retention of infor-
ventional or inappropriate ways (as in meto- mation in a highly accessible state. The term has
nymy), or new but understandable words are evolved, however, to refer primarily to the 1974
constructed out of ordinary words (e.g., easify for model of British cognitive psychologists Alan D.
simplify). Baddeley (1934– ) and Graham J. Hitch for the
word-association test a projective test in short-term maintenance and manipulation of
which the participant responds to a stimulus information necessary for performing complex
word with the first word that comes to mind. cognitive tasks such as learning, reasoning, and
The technique was invented by British scientist comprehension. According to their multicom-
Sir Francis Galton (1822–1911) in 1879 for use in ponent conceptualization, working memory
exploring individual differences, and German comprises a phonological loop for temporarily
psychiatrist Emil Kraepelin (1856–1926) was the manipulating and storing speech-based informa-
first to apply it to the study of abnormality. tion and a visuospatial sketchpad that performs
a similar function for visual and spatial informa-
word-form dyslexia a type of acquired dys-
W lexia characterized by the inability to recognize
tion. Both are supervised by a limited capacity
central executive, a control system responsible
and read whole words, which can be read only for the distribution of attention and general co-
by spelling them out letter by letter. Also called ordination of ongoing processes. A fourth com-
spelling dyslexia. ponent, the episodic buffer, was added to the
word-frequency study a study in which the model in 2000; it binds together information
frequency of to-be-remembered words is manip- about the same stimulus or event from the differ-
ulated to investigate the effect of this variable on ent subsidiary systems to form an integrated rep-
later memory. Typically, in studies of free re- resentation that is essential to long-term
call, higher frequency words are better remem- memory storage. The Baddeley and Hitch work-
624
Wundt, Wilhelm Max
ing memory model, which introduced an el- of mental health worldwide. The federation or-
ement of assessment and planning into the ganizes World Mental Health Day.
memory mechanism, has replaced the idea of World Health Organization (WHO) a spe-
a unitary short-term memory system and cialized agency of the United Nations that pro-
become one of the most influential and well- motes technical medical cooperation among
known concepts within memory psychology, nations, carries out programs to control and
continuing to stimulate research and debate eradicate disease, and strives to improve the
more than 35 years after its introduction. In- quality of human life. Founded in 1948, the
deed, the model has proved valuable in account- WHO has four main functions: (a) to give world-
ing for experimental data from a wide range of wide guidance in the field of health; (b) to set
participants under a rich array of task condi- global standards for health; (c) to cooperate with
tions. Current interest focuses most strongly on governments in strengthening national health
the link between working memory and long- programs; and (d) to develop and transfer appro-
term memory and on the processes allowing the priate health technology, information, and stan-
integration of information from the component dards. The WHO defines health as “a state of
subsystems. complete physical, mental and social well-being
Working Memory Index an index used in and not merely the absence of disease or infir-
the wechsler memory scale as well as the mity.” Its headquarters are in Geneva, Switzer-
Wechsler intelligence tests that evaluates the land.
ability to manipulate and process visual and au- worry n. a state of mental distress or agitation
ditory stimuli in short-term or working memory. due to concern about an impending or antici-
working self-concept see phenomenal self. pated event, threat, or danger.
WPPSI abbreviation for wechsler preschool
working through 1. in psychotherapy, the and primary scale of intelligence.
process by which clients identify, explore, and
deal with psychological issues, on both an intel- wraparound services a philosophy of care
lectual and emotional level, through the presen- and related services that includes a planning
tation of such material to, and in discussion process involving a focal person, concerned fam-
with, the therapist. 2. in psychoanalysis, the ily members, and providers of services. It results
process by which patients gradually overcome in a highly individualized set of closely coordi-
their resistance to the disclosure of uncon- nated community services and natural supports
scious material and are repeatedly brought face for the person and his or her family, which
to face with the repressed feelings, threatening achieves a variety of intervention outcomes.
impulses, and internal conflicts at the root of Wraparound services have been developed in
their difficulties. several service sectors, including mental health,
child welfare, and developmental disabilities,
work rehabilitation center a facility in and have been proven effective as an alternative
which employees who have been injured recu- to residential services for multiproblem individ-
perate and prepare for returning to employment. uals and their families.
Rehabilitation efforts focus on an individual’s
writer’s block inhibited ability to start or con-
specific therapeutic needs, include participation
tinue working on a piece of writing. Such diffi-
in simulated work activities, and incorporate
culty is attributed primarily to psychological
workplace education designed to prevent future
factors (e.g., fear of failure) but may also result
injury. See also vocational rehabilitation.
from fatigue or burnout. Suggested remedies
work therapy the use of compensated or un- often include writing spontaneously about an
compensated work activities as a therapeutic unrelated topic, doing more reading, and chang-
agent for individuals with mental or physical ing something about the physical environment.
disorders. For example, self-esteem or interper- writer’s cramp a painful spasm of the muscles
sonal or cognitive skills may be enhanced when involved in writing or typing, which may be a
these individuals function in a safe, controlled form of occupational cramp or a functional
environment, where they may either acquire disorder. See also repetitive strain injury.
fundamental training for new skills or receive re-
training in skills that have been lost or dimin- W-state n. the waking state (see wakefulness),
ished. as opposed to the D-state (see dream state) and
the S-state (sleeping state).
work-up n. in health care, a total patient evalua- Wundt, Wilhelm Max (1832–1920) German
tion, which may include laboratory assessments, W
psychologist and physiologist. Wundt received
radiologic series, medical history, and diagnostic
his medical degree in 1855 and his second doc-
procedures.
torate in 1857, studying under Johannes Müller
World Federation for Mental Health an (1801–1858). He then served as an assistant to
international, nongovernmental association of Hermann Von Helmholtz (1821–1894), who had
organizations and individuals formed in 1948 to a great influence on him. Wundt became the
advance the prevention of mental and emo- founder of experimental psychology when
tional disorders, the proper treatment and care he established the first official psychological lab-
of those with such disorders, and the promotion oratory in Leipzig in 1879. There he and his stu-
625
Wyatt v. Stickney decision
dents applied introspective and psychophysical include his Grundzüge der physiologischen
methods to a wide range of subjects, including Psychologie (1873–1874); Völkerpsychologie: Eine
reaction time, word associations, attention, Untersuchung der Entwicklungsgesetze von Sprache,
judgment, and emotions. A man of encyclopedic Mythus, und Sitte (1900–1920); and his many
knowledge, Wundt published monumental works papers published in the journal he founded
not only on the history and foundations of psy- in 1881, Philosophische Studien. See also folk psy-
chology, but also on logic, ethics, and the psychology; structuralism.
chological interpretation of history and
anthropology. Because his research laboratory Wyatt v. Stickney decision a 1972 Alabama
became the premier locus of study for the new District Court decision stipulating that the
science of psychology in the late 19th century, state could not hold people involuntarily in
Wundt’s influence extended around the globe, hospital facilities without proper standards.
with his students founding laboratories and uni- These standards include a humane environ-
versity departments when they returned to their ment, adequate staff, and appropriate treat-
countries of origin. His most important works ment.
626
Xx
Xanax n. a trade name for alprazolam. of the normal pair. Affected females are likely to
xanthines pl. n. see methylxanthines. have minor physical anomalies and mental re-
tardation; IQs of affected individuals have
X chromosome the sex chromosome that is ranged from 30 to 80 in studies.
responsible for determining femaleness in hu-
mans and other mammals. The body cells of nor- XXXXX syndrome a rare chromosomal disor-
mal females possess two X chromosomes (XX), der in which a female has five X chromosomes
whereas males have one X chromosome and one instead of the normal pair. All affected individu-
y chromosome (XY). In humans, various au- als studied had mental retardation, and some
thorities estimate that the X chromosome carries had ocular or other anomalies, such as patent
between 1,000 and about 2,000 genes, including ductus arteriosus (a heart defect), micro-
many responsible for hereditary diseases (see cephaly, or limb abnormalities.
sex-linked). Abnormal numbers of X chromo- XXXXY syndrome a rare chromosomal disor-
somes lead to genetic imbalance and a range of der in which a male inherits three extra X chro-
disorders and syndromes. See also fragile x mosomes resulting in a variety of anomalies,
syndrome. including abnormally small genitalia, a short,
broad neck, and hypotonia (flaccid muscles).
Xenazine n. a U.S. trade name for tetraben-
Most affected individuals have mental retarda-
azine.
tion, with IQs of less than 60.
xenoglossophilia n. a tendency to use strange
XXXY syndrome a relatively rare chromo-
or foreign words, particularly in a pretentious
somal disorder in which a child inherits the full
manner.
complement of both male and female sex chro-
xenophobia n. 1. a strong and irrational, some- mosomes. Affected individuals have a normal
times pathological, fear of strangers. 2. hostile penis but small testes and prostate, and about
attitudes or aggressive behavior toward people of half develop enlarged breasts. IQs of those tested
other nationalities, ethnic groups, or even differ- have ranged from 20 to 76. Most cases have been
ent regions or neighborhoods. —xenophobic found by screening projects in mental institu-
adj. tions and may not represent the spectrum of
xenorexia n. the pathological ingestion of inedi- cases in the general population.
ble objects. XXY syndrome see klinefelter’s syndrome.
xeroderma pigmentosum a syndrome ac- XXYY syndrome a chromosomal disorder in
quired as an autosomal recessive trait (see which a male is born with a double complement
recessive allele) and marked by extreme of the normal XY chromosome pair. Skeletal de-
photosensitivity. It is caused by a defect in the formities, genital anomalies, and mental retarda-
ability of the body to repair damage to DNA re- tion are common effects. More than half the
sulting from exposure to ultraviolet light, which affected individuals tested had IQs below 70, and
leads to cancerous changes in skin cells and in- some exhibited bizarre behavior. Enlarged
creased mortality. microcephaly, mental retar- breasts and eunuchoid abdominal and hip fat
dation, and dwarfism may also be present. are among the physical traits.
X-linked adj. see sex-linked. xylene n. a volatile solvent that, when chroni-
XO syndrome see turner’s syndrome. cally inhaled, can cause kidney failure and
death. See inhalant.
XXX syndrome a rare chromosomal disorder
characterized by the presence of three X (female) Xyrem n. a trade name for ghb.
chromosomes. The majority of affected females XYY syndrome a chromosomal anomaly dis-
are physically and mentally normal. Delays in covered in 1961 and associated with males who
mental development, when present, are usually were aggressive or violent in institutions for
mild. This disorder is sometimes associated with criminals. It was originally assumed that the
prader–willi syndrome. Also called triple-X extra Y chromosome predisposes males to such
condition. behavior, but the theory was modified when
XXXX syndrome a chromosomal disorder in XYY anomalies were later found among nor-
which a female has four X chromosomes instead mal males. Also called double-Y condition.
627
Yy
yagé n. see ayahuasca. finally deep contemplation. [Sanskrit, “union”
or “yoke”]
yakee n. see epena.
yohimbine n. a stimulant alkaloid derived from
yantra n. a visual pattern on which attention is the bark of the African tree Pausinystalia yohimbe
focused during concentrative meditation. and from Rauwolfia serpentina root. It acts as an
Compare mantra. antagonist at α2-adrenoreceptors (see alpha-
yaupon n. see cassina. adrenergic receptor); at high doses, it is a
monoamine oxidase inhibitor and can cause
yawning n. the act of drawing in through the serious adverse effects when taken together with
mouth a volume of air that is much larger than antidepressants, tyramine-containing foods (e.g.,
that inhaled in normal respiration, serving to liver, cheeses), or over-the-counter products
improve oxygen supplies to the brain. Some re- containing phenylpropanolamine, such as nasal
search indicates that yawning is mediated by the decongestants and diet aids. Yohimbine has
same neurotransmitters in the brain that af- achieved a reputation as a sexual enhancer in
fect emotions, mood, appetite, and so forth (i.e., men, but there is little clinical evidence suggest-
serotonin, dopamine, glutamic acid, and nitric ing its efficacy is greater than placebo. It has also
oxide). The more of these compounds that are been studied as a potential treatment for erectile
activated in the brain, the greater the frequency dysfunction, with contradictory results regard-
of yawns. Yawns can be a form of nonverbal ing its effectiveness. Chemically related to reser-
communication in that they are contagious pine (see rauwolfia derivatives), yohimbine
and can indicate boredom or disagreement as is a sympathomimetic drug and may increase
well as sleepiness. anxiety or produce panic attacks in susceptible
Y chromosome the sex chromosome that is individuals. Side effects may include nervous-
responsible for determining maleness in hu- ness, irritability, dizziness, skin flushing, or
mans and other mammals. The body cells of nor- headache. More serious effects, including renal
mal males possess one Y chromosome and one x failure, seizures, and death, have also been re-
chromosome (XY). The Y chromosome is much ported, calling into question the safety of
smaller than the X chromosome and is thought yohimbine-containing products. Yohimbine
to carry just a handful of functioning genes. should not be taken by people with hypotension
Hence, males are far more susceptible to sex- (low blood pressure), diabetes, or heart, liver, or
linked diseases than females, because the Y kidney disease. It is available as an herbal rem-
chromosome cannot counteract any defective edy and also in prescription form (U.S. trade
genes carried on the X chromosome. name: Yocon).
yea-saying n. answering questions positively re- Youngberg v. Romeo the initial lawsuit that
gardless of their content, which can distort the culminated in the pennhurst consent decree.
results of surveys, questionnaires, and similar In this action, the U.S. Supreme Court held that
instruments. Also called response acquies- people with mental retardation who were in-
cence. Compare nay-saying. voluntarily committed to state mental retarda-
tion institutions have a constitutional right to
Yerkes–Dodson law see inverted-u hypoth- reasonably safe conditions, freedom from unrea-
esis. [Robert M. Yerkes (1876–1956), U.S. psy- sonable restraints, and the services reasonably
chobiologist, and John Dillingham Dodson required to protect their liberty and interests.
(1879–1955), U.S. psychologist]
youpon n. see cassina.
yoga n. a school or tradition of Hindu philosophy you statement see i statement.
and practical teaching that ultimately seeks to
achieve mystic union of the self with the Su- youth counseling consultation that provides
preme Being, or of the human spirit with the advice, information, and support to young peo-
universal spirit, through a prescribed mental dis- ple, usually in adolescence or slightly younger.
cipline and physical exercises. Yoga exercises, Youth counseling may focus on any issue that
including regulation of breathing and the adap- raises concerns or conflicts related to studying,
tation of bodily postures (see asana), are used as family involvement, sexuality and gender
a means of releasing tension and redirecting en- identity, or peer relationships. It may be used
ergy (i.e., prana; see chi) and achieving a state of to counter low self-image and feelings of inade-
self-control, physical and mental relaxation, and quacy often experienced by young people.
628
Zz
zaar n. see zar. attack or are taking antiarrhythmic drugs. Com-
zaleplon n. a nonbenzodiazepine hypnotic mon side effects include orthostatic hypo-
used for short-term treatment of insomnia. It has tension and sedation. U.S. trade name: Geodon.
a rapid onset but short duration of action. Side ZOF abbreviation for zone of optimal func-
effects are less frequent compared with other tioning.
classes of hypnotics but commonly include Zofran n. a trade name for ondansetron.
headache, dizziness, abdominal pain, nausea, Zoloft n. a trade name for sertraline.
and amnesia. Although chemically unrelated to
the benzodiazepines, zaleplon acts at the same zolpidem n. a nonbenzodiazepine hypnotic for
gabaa receptor and carries a similar potential short-term management of insomnia. Although
for abuse. U.S. trade name: Sonata. structurally different from the benzodiazepines,
it acts similarly by binding to a specific site
zar (zaar) n. a culture-bound syndrome, oc- on the gabaa receptor. Though infrequent
curring in North African and Middle Eastern cul- compared with other agents, side effects typi-
tures, that is attributed to spirit possession. cally include dizziness, headache, nausea and
Occurring most frequently in women, zar often vomiting, and amnesia. U.S. trade name:
involves dissociative, somatic, and affective Ambien.
symptoms, such as shouting, laughing, apathy,
and refusal to perform daily tasks.
zone of optimal functioning (ZOF) the
range of physiological arousal within which
Zarontin n. a trade name for ethosuximide. See an individual can perform at the peak of
succinimide. physical, mental, and skillful ability. Also called
Zelmid n. a trade name for zimeldine. zone of individual optimal functioning
zelotypia n. extreme overzealousness in advo- (ZIOF).
cating a cause. zooerasty n. sexual excitement or gratification
Zen therapy psychotherapy that is informed by obtained through anal or genital intercourse
and incorporates the philosophy and practices or other sexual contact with an animal. In DSM–
of Zen Buddhism and that, like existentialism, IV–TR the corresponding term is zoophilia.
is concerned with the unique meaning of the cli- Also called zooerastia; bestiality. See also
ent’s life within the universal context, rather sodomy.
than with simple adjustment to or removal of zoolagnia n. sexual attraction to animals. See
symptoms. Contemplation, through meditation zooerasty; zoophilia.
and intuition, of human nature and human exis- zoomania n. an extremely intense or active form
tence are believed to lead to a therapeutic align- of zooerasty or zoophilia.
ment of the client with a sense of the oneness of zoophilia n. a paraphilia in which animals are
the universe and to spiritual (and, thus, cogni- repeatedly preferred or exclusively used to
tive, affective, and behavioral) transformation. achieve sexual excitement and gratification. The
See also mystic union. animal, which is usually a household pet or farm
zest n. see vitality. animal, is either used as the object of intercourse
zimeldine n. an antidepressant with ssri prop- or is trained to lick or rub the human partner,
erties that was removed from the worldwide referred to as a zoophile. The most commonly
market in 1983 due to its severe neurological used animals are pigs and sheep, in rural
side effects. Former European trade name: settings. Also called zoophilism. See also
Zelmid. zooerasty.
ZIOF abbreviation for zone of individual optimal zoosadism n. a paraphilia in which sexual
functioning (see zone of optimal function- arousal and satisfaction are obtained from tor-
ing). turing an animal. This may occur during direct
sexual contact with the animal, or the person
ziprasidone n. an atypical antipsychotic
may masturbate later, using memories of the
that is used for the treatment of schizophrenia
event as masturbatory fantasies.
and of acute manic or mixed episodes associated
with bipolar disorders. It may prolong the Q-T Z transformation see fisher’s r to z trans-
interval of the cardiac cycle (see electro- formation.
cardiographic effect) and should therefore zuclopenthixol n. a conventional (typical or
not be taken by patients with abnormal heart first-generation) antipsychotic of the thio-
rhythms or by those who have had a recent heart xanthene class. Side effects include sedation,
629
Zung Self-Rating Depression Scale
neuromuscular rigidity, and dystonia, and—like not feel hopeful”). [originally developed in 1965
similar agents—it is associated with long-term by William W. K. Zung, U.S. psychiatrist]
risk of tardive dyskinesia. Zuclopenthixol is Zurich School a group of psychoanalysts who
not available in the United States. Canadian trade were early followers of Carl jung in Zurich, as
name: Clopixol. opposed to the viennese school of Sigmund
Zung Self-Rating Depression Scale (SDS) freud’s followers.
a widely used adult self-report depression- Zyban n. a trade name for bupropion.
screening instrument designed to measure the
Zydis n. a trade name for olanzapine.
intensity of depressive or mood-related symp-
toms. It is also a tool for tracking a client’s re- zygote n. a fertilized egg, or ovum, with a dip-
sponse to depression treatment over time. The loid set of chromosomes, half contributed by
SDS consists of 20 statements to which partici- the mother and half by the father. The zygote di-
pants must respond using a 4-point likert vides to become an embryo, which continues to
scale, ranging from “none or little of the time” divide as it develops and differentiates—in hu-
to “most or all of the time.” Half of the questions mans eventually forming a fetus. —zygotic
are worded positively (e.g., “I have trouble sleep- adj.
ing”) and half are worded negatively (e.g., “I do Zyprexa n. a trade name for olanzapine.
630
Appendixes
Biographical Entries
Adler, Alfred (1870–1937), Austrian psychiatrist Lewin, Kurt (1890–1947), German-born U.S.
Allport, Gordon Willard (1897–1967), U.S. psychologist
psychologist Luria, Alexander R. (1902–1977), Russian
Angell, James Rowland (1869–1949), U.S. neuropsychologist
psychologist Maslow, Abraham Harold (1908–1970), U.S.
Asch, Solomon E. (1907–1996), Polish-born U.S. psychologist
psychologist May, Rollo (1909–1994), U.S. psychologist,
Bandura, Albert (1925– ), Canadian-born U.S. psychoanalyst, and existentialist
psychologist McClelland, David (1917–1998), U.S.
Binet, Alfred (1857–1911), French psychologist psychologist
Bowlby, Edward John Mostyn (1907–1990), Meehl, Paul Everett (1920–2003), U.S.
British psychiatrist psychologist
Brown, Roger (1925–1997), U.S. psychologist Miller, Neal Elgar (1909–2002), U.S.
Cronbach, Lee J. (1916–2001), U.S. psychologist psychologist
Dewey, John (1859–1952), U.S. philosopher, Osgood, Charles Egerton (1916–1991), U.S.
educator, and psychologist psychologist
Erikson, Erik H. (1902–1994), German-born U.S. Pavlov, Ivan Petrovich (1849–1936), Russian
psychologist physiologist
Eysenck, Hans Jurgen (1916–1997), German-born Piaget, Jean (1896–1980), Swiss child
British psychologist psychologist and epistemologist
Festinger, Leon (1919–1989), U.S. psychologist Rogers, Carl (1902–1987), U.S. psychologist
Freud, Anna (1895–1982), Austrian-born British Rorschach, Hermann (1884–1922), Swiss
psychoanalyst psychiatrist
Freud, Sigmund (1856–1939), Austrian Skinner, Burrhus Frederic (1904–1990), U.S.
neurologist and psychiatrist psychologist
Fromm, Erich (1900–1980), German-born U.S. Spence, Kenneth Wartinbee (1907–1967), U.S.
psychoanalyst psychologist
Guilford, Joy Paul (1897–1987), U.S. psychologist Sperry, Roger Wolcott (1913–1994), U.S.
Hall, Granville Stanley (1844–1924), U.S. psychologist
psychologist Terman, Lewis Madison (1877–1956), U.S.
Hilgard, Ernest R. (1904–2001), U.S. psychologist psychologist
Hull, Clark Leonard (1884–1952), U.S. Thurstone, Louis Leon (1887–1955), U.S.
psychologist psychologist
James, William (1842–1910), U.S. psychologist Titchener, Edward Bradford (1867–1927), British-
and philosopher born U.S. psychologist
Jung, Carl Gustav (1875–1961), Swiss psychiatrist Tolman, Edward Chace (1886–1959), U.S.
and psychoanalyst psychologist
Kinsey, Alfred (1894–1956), U.S. zoologist and Vygotsky, Lev Semenovich (or Vigotsky; 1896–
sex researcher 1934), Russian psychologist
Klein, Melanie (1882–1960), Austrian-born Watson, John Broadus (1878–1958), U.S.
British psychoanalyst psychologist
Koffka, Kurt (1886–1941), German experimental Wechsler, David (1896–1981), Romanian-born
psychologist U.S. psychologist
Köhler, Wolfgang (1887–1967), German Wertheimer, Max (1880–1943), German-born
experimental psychologist U.S. psychologist
Lashley, Karl Spencer (1890–1958), U.S. Wundt, Wilhelm Max (1832–1920), German
psychologist psychologist and physiologist
633
Psychotherapy and Psychotherapeutic
Approach Entries
acceptance and commitment therapy coma therapy

action-oriented therapy combination therapy
active analytic psychotherapy combined therapy
active therapy computerized therapy
activity-group therapy concurrent therapy
activity-interview group psychotherapy configurational analysis
adaptational approach conjoint therapy
adjunctive therapy constructivist psychotherapy
adjuvant therapy contact desensitization
affirmative therapy convulsive therapy
ahistoric therapy coping-skills training
analytical psychotherapy core conflictual relationship theme
analytic group psychotherapy correspondence training
anamnestic analysis cortical undercutting
anger control therapy cotherapy
animal-assisted therapy couples therapy
art therapy covert desensitization
assignment therapy covert sensitization
atropine-coma therapy (ACT) creative arts therapy
attitude therapy dance therapy
attribution therapy Dauerschlaf
aversion therapy depth-oriented brief therapy
Beck therapy depth therapy
behavioral couples therapy developmental therapy
behavioral family therapy dialectical behavior therapy
behavioral group therapy didactic group therapy
behavioral relaxation training directive group psychotherapy
behavioral sex therapy directive play therapy
behavioral weight control therapies directive therapy
behavior modification distance therapy
behavior therapy drama therapy
bereavement therapy dynamic psychotherapy
bibliotherapy eclectic psychotherapy
biological therapy ecosystemic approach
brain-wave therapy educational therapy
brief group therapy ego analysis
brief intensive group cognitive behavior therapy electroconvulsive therapy (ECT)
brief psychodynamic psychotherapy electronarcosis
brief stimulus therapy (BST) electrosleep therapy
carbon dioxide therapy electrotherapy
cerebral electrotherapy (CET) emergency psychotherapy
child analysis emetic therapy
child psychotherapy emotional reeducation
chronotherapy emotion-focused couples therapy
client-centered therapy emotion-focused therapy
cognitive-analytic therapy environmental therapy
cognitive behavioral couples therapy Ericksonian psychotherapy
cognitive behavioral group therapy e-therapy
cognitive behavior therapy (CBT) ethnotherapy
cognitive processing therapy (CPT) evocative therapy
cognitive therapy (CT) exercise therapy
collaborative therapy existential analysis
634
Psychotherapy and Psychotherapeutic Approach Entries
existential–humanistic therapy Milligan annihilation method

existential psychotherapy monotherapy
experiential psychotherapy moral therapy
exposure therapy Morita therapy
expressive therapy motivational enhancement therapy
extended-family therapy movement therapy
eye-movement desensitization and reprocessing multicultural therapy
(EMDR) multimodal therapy (MMT)
family group psychotherapy multiple family therapy
family therapy multiple-impact therapy
feminist family therapy multiple marital therapy
feminist therapy multiple monitored electroconvulsive treatment
focal psychotherapy (MMECT)
frontal lobotomy music therapy
functional family therapy naikan
geriatric psychotherapy narcotherapy
gestalt therapy narrative psychotherapy
group-analytic psychotherapy network therapy
group psychotherapy nondirective play therapy
half-show nondirective therapy
holistic education objective psychotherapy
horticultural therapy operant conditioning therapy
humanistic therapy organic therapies
hydrotherapy panic control treatment
hypnotherapy paraverbal therapy
imaginal exposure parent effectiveness training (PET)
imago therapy parent management training
implosive therapy pastoral counseling
indirect method of therapy personal construct therapy
individual therapy persuasion therapy
insight therapy phenomenological therapy
instigation therapy phototherapy
integrative behavioral couples therapy play-group psychotherapy
integrative psychotherapy play therapy
integrityy group psychotherapy poetry therapy
intensive psychotherapy polypharmacy
interpersonal group psychotherapy process experiential psychotherapy
interpersonal psychotherapy (IPT) projective play
interpersonal reconstructive psychotherapy projective psychotherapy
interpretive therapy psychedelic therapy
in vivo exposure psychoanalysis
Kleinian psychoanalytic group psychotherapy
leaderless group therapy psychoanalytic play technique
leukotomy psychoanalytic psychotherapy
light therapy psychodynamic group psychotherapy
lobectomy psychodynamic psychotherapy
lobotomy psychopharmacotherapy
logotherapy psychosocial therapy
long-term therapy psychosurgery
LSD psychotherapy psychotherapy by reciprocal inhibition
maintenance therapy puppetry therapy
manual arts therapy quadrangular therapy
manualized therapy radical therapy
marital therapy rational emotive behavior therapy (REBT)
medical family therapy reality therapy
medical psychotherapy reconditioning therapy
megadose pharmacotherapy reconstructive psychotherapy
megavitamin therapy recreational therapy
metaphor therapy reeducation
methadone maintenance therapy regressive electroshock therapy
Metrazol shock treatment reinforcement therapy
milieu therapy relationship therapy
635
Psychotherapy and Psychotherapeutic Approach Entries
release therapy structural therapy

reminiscence therapy structured interactional group psychotherapy
reparative therapy structured learning
response prevention suggestion therapy
restoration therapy supportive-expressive psychotherapy
role-divided psychotherapy supportive psychotherapy
role therapy suppressive therapy
scheduled awakening surface therapy
sector therapy systematic desensitization
self-control therapy systematic rational restructuring
self-instructional training tandem therapy
self-management time-extended therapy
semantic therapy time-limited day treatment
sensate focus time-limited psychotherapy (TLP)
sex therapy topectomy
shock therapy tractotomy
short-term psychodynamic psychotherapy transactional psychotherapy
single-session therapy (SST) transcendence therapy
social-network therapy transcultural psychotherapy
social skills training (SST) transorbital lobotomy
social therapy trial therapy
sociotherapy ultrasonic irradiation
solution-focused brief therapy verbal behavior therapy
somatic therapy virtual reality therapy
spontaneity training vitamin and mineral therapy
strategic family therapy will therapy
stress-inoculation training (SIT) work therapy
structural family therapy Zen therapy
636

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Copyright © 2013 by the American Psychological Association. All rights reserved.

AMERICAN PSYCHOLOGICAL ASSOCIATION STAFF

Typeset in Aylesbury, England, by Market House Books, Ltd.

Library of Congress Cataloging-in-Publication Data

APA dictionary of clinical psychology. — 1st ed.

British Library Cataloguing-in-Publication Data

The citation for this publication is American Psychological Association. (2013).

Printed in the United States of America

Quick Guide to Format xi

APA Dictionary of Clinical Psychology 1

Biographical Entries 633

Psychotherapy and Psychotherapeutic 634

This dictionary is the fourth in a family of lexicographical works published by the

Gary R. VandenBos, PhD

Senior Editors (American Psychological Association)

Senior Editors (Market House Books, Ltd.)

Mark Appelbaum, PhD

John G. Albinson, PhD Erica L. Fener, PhD

Katharine McGovern, PhD Tonya L. Smith-Jackson, PhD

Headword bariatrics n. a field of medicine that focuses on Part-of-speech label

Beck Anxiety Inventory (BAI) a self-report, Abbreviation

Plural form benny n. (pl. bennies) slang for an ampheta-

behavior hierarchy a ranking of possible re-

behaviorism n. an approach to psychology, for-

Sense number body narcissism 1. an exaggerated preoccupa-

accommodation n. 1. adjustment or modifica- patients with bleeding disorders). It is also sold

acroparesthesia, marked by peripheral-nerve ir- transmission of a nerve impulse or the contrac-

information or past events is called retrograde individual experiences a period of social

(nonsteroidal anti-inflammatory drugs)—most stage of psychosexual development, involving

animus n. in analytic psychology, (a) an ar- anomalous experience any of a variety of

anton’s syndrome is an example of ano- blocks the physiological effects of androgens,

characteristic of anticholinergic drugs and anticipatory guidance counseling and edu-

sponsive to these hormones. Examples include antimuscarinic drug see anticholinergic

lants (e.g., phentermine, diethylpropion), pare consistency motive; self-enhancement

neurological dysfunction and is believed to rep- arachnophobia n. see spider phobia.

Armed Services Vocational Aptitude thought to produce a pleasurable response.

toms. For example, hypertension is considered athymia n. 1. absence of feeling or emotion. 2.

automatization n. 1. the development of a depression characterized by agitation and self-

avoidance–avoidance conflict a situation avoidant paruresis inability to urinate in the

BBBG syndrome see telecanthus-hypospad- bed-wetting n. the involuntary discharge of

experimental investigator or participant or by a psychology a naturalistic science, Watson pro-

changes in an attempt to relieve chronic muscu- biographical data information gathered by a

caused or aggravated by a physician’s examina- panediols, a group originally developed as

of personality, is associated with an ecto- review of case records to determine whether

similar to this neurotransmitter. Cholinergic age intelligence. The trait is transmitted by an

relationships. The counselor’s responsibilities clinical judgment research empirical stud-

vated in tropical regions worldwide, including cognitive behavioral couples therapy

dream or symptom, so as to be unrecognizable. obsessive-compulsive personality disorder.

continuous rating scale a scale on which rat- contrasuggestibility n. a tendency to do or

core conflictual relationship theme a hemispheric commissures, it is known as the

behavioral or physiological response that, by it- deconditioning n. a technique in behavior

schizophrenia or of certain dissociative dis- origin, catharsis, or deconditioning tech-

vert desensitization; systematic desensiti- and attention-deficit/hyperactivity disorder.

(see empty-chair technique); or (c) with an dibenzodiazepine n. any member of a class of

dihydromorphine n. a semisynthetic opioid antihistamine at H1 receptors that are used

ception by using a photograph distorted to be simply an empirical description of that

dopamine-receptor antagonists substances in working memory and attentional control.

is rarely a problem (although frustration may be dysponesis n. in biofeedback, a state of habitual

enantiodromia n. in the approach of Carl murmur, and minute hemorrhages (particularly

mension of narcissism may be particularly useful vironmental assessment of employee job

erotic instinct 1. in psychoanalytic theory, the erotomania n. 1. a preoccupation with sexual

exocathection n. a concentration of psychic tions can produce a particular outcome (e.g.,

ered to be involved in fetishism. Fetishism the individual consistently relies more on