Center for Mental Health in Schools
Addressing Barriers to Learning:
New Directions for
Mental Health in Schools
Key Terms Related to Mental Health and Psychosocial Problems
C - D
Immobility with muscular rigidity or inflexibility and at times excitability. See also schizophrenia.
The healthful (therapeutic) release of ideas through "talking out" conscious
material accompanied by an appropriate emotional reaction. Also, the release into
awareness of repressed ("forgotten") material from the unconscious. See
character disorder (character neurosis)
A personality disordermanifested by a chronic, habitual, maladaptive
pattern of reaction that is relatively inflexible, limits the optimal use of
potentialities, and often provokes the responses from the environment that the person
wants to avoid. In contrast to symptoms of neurosis, character traits are typically
ego-syntonic. See also personality.
Pattern of speech that is indirect and delayed in reaching its goal because of excessive
or irrelevant detail or parenthetical remarks. The speaker does not lose the point, as is
characteristic of loosening ofassociations, and clauses remain logically
connected, but to the listener it seems that the end will never be reached. Compare with tangentiality.
A type of thinking in which the sound of a word, rather than its meaning, gives the
direction to subsequent associations. Punning and rhyming may substitute for logic, and
language may become increasingly a senseless compulsion to associate and
decreasingly a vehicle for communication. For example, in response to the statement
"That will probably remain a mystery," a patient said, "History is one of
my strong points."
Multiple suicides, usually among adolescents, in a circumscribed period of time
and area. Thought to have an element of contagion.
cocaine use disorders
In DSM-IV, this group includes cocaine dependence, cocaine abuse, cocaine intoxication,
cocaine withdrawal, cocaine delirium, cocaine psychotic disorder with delusions or
hallucinations, cocaine mood disorder, cocaine anxiety disorder, cocaine sexual
dysfunction, and cocaine sleep disorder.
A popular term referring to all the effects that people who are dependent on alcohol or
other substances have on those around them, including the attempts of those people to
affect the dependent person. The term implies that codependence is a psychiatric disorder
and hypothesizes that the family's actions tend to perpetuate (enable) the person's
dependence. Empirical studies, however, support a stress and coping model for explanation
of the family behavior.
Refers to the mental process of comprehension, judgment, memory, and reasoning, in
contrast to emotional and volitional processes. Contrast with conative.
Cognitive therapy; a short-term psychotherapy directed at specific target conditions or symptoms.
(Depression has been the most intensively investigated to date.) The symptoms
themselves are clues to the patient's verbal thoughts, images, and assumptions that
account for both the symptomatic state and the psychological vulnerability to that state.
Initial treatment is aimed at symptom reduction. The patient is taught to recognize the
negative cognitions that contribute significantly to the development or maintenance of
symptoms and to evaluate and modify such thinking patterns. The second phase of treatment
concerns the underlying problem.
The simultaneous appearance of two or more illnesses, such as the co-occurrence of schizophrenia
and substance abuse or of alcoholdependence and depression. The
association may reflect a causal relationship between one disorder and another or an
underlying vulnerability to both disorders. Also, the appearance of the illnesses may be
unrelated to any common etiology or vulnerability.
A defense mechanism, operating unconsciously (see unconscious), by which
one attempts to make up for real or fancied deficiencies. Also a conscious process
in which one tries to make up for real or imagined defects of physique, performance
skills, or psychological attributes. The two types frequently merge. See also Adler;
A group of associated ideas having a common, strong emotional tone. These ideas are
largely unconscious and significantly influence attitudes and associations. See
also Oedipus complex.
Repetitive ritualistic behavior such as hand washing or ordering or a mental act such as
praying or repeating words silently that aims to prevent or reduce distress or prevent
some dreaded event or situation. The person feels driven to perform such actions in
response to an obsession or according to rules that must be applied rigidly, even
though the behaviors are recognized to be excessive or unreasonable.
Thinking characterized by immediate experience, rather than abstractions. It may occur
as a primary, developmental defect, or it may develop secondary to organic brain disease
A disruptive behavior disorder of childhood characterized by repetitive and
persistent violation of the rights of others or of age-appropriate social norms or rules. Symptoms
may include bullying others, truancy or work absences, staying out at night despite
parental prohibition before the age of 13, using alcohol or other substances before the
age of 13, breaking into another's house or car, firesetting with the intent of causing
serious damage, physical cruelty to people or animals, stealing, or use more than once of
a weapon that could cause harm to others (e.g., brick, broken bottle, or gun).
One of the somatoform disorders (but in some classifications called a dissociative
disorder), characterized by a symptom suggestive of a neurologic disorder that
affects sensation or voluntary motor function. The symptom is not consciously or
intentionally produced, it cannot be explained fully by any known general medical
condition, and it is severe enough to impair functioning or require medical attention.
Commonly seen symptoms are blindness, double vision, deafness, impaired coordination,
paralysis, and seizures.
Ways of adjusting to environmental stress without altering one's goals or purposes;
includes both conscious and unconscious mechanisms.
Eating of filth or feces.
Deliberately seeking out and exposing oneself to, rather than avoiding, the object or
situation that is consciously or unconsciously feared.
The therapist's emotional reactions to the patient that are based on the therapist's unconscious
needs and conflicts, as distinguished from his or her conscious responses to
the patient's behavior. Countertransference may interfere with the therapist's ability to
understand the patient and may adversely affect the therapeutic technique. Currently,
there is emphasis on the positive aspects of countertransference and its use as a guide to
a more empathic understanding of the patient.
Freebase or alkaloidal cocaine that is named for the cracking sound it makes when
heated. Also known as "rock" for its crystallized appearance. It is ingested by
inhalation of vapors produced by heating the "rock."
In DSM-IV, one of the bipolar disorders characterized by numerous hypomanic
episodes and frequent periods of depressed mood or loss of interest or pleasure. These
episodes do not meet the criteria for a full manic episode or major depressive disorder,
The deterioration of existing defenses (see defense mechanism), leading to an
exacerbation of pathological behavior.
Unconscious intrapsychic processes serving to provide relief from emotional
conflict and anxiety. Conscious efforts are frequently made for the same reasons, but
true defense mechanisms are unconscious. Some of the common defense mechanisms defined in
this glossary are compensation, conversion, denial, displacement, dissociation,
idealization, identification, incorporation, introjection, projection,rationalization,
reaction formation, regression, sublimation, substitution,symbolization, and
A paramnesia consisting of the sensation or illusion that one is seeing what one has
A false belief based on an incorrect inference about external reality and firmly
sustained despite clear evidence to the contrary. The belief is not part of a cultural
tradition such as an article of religious faith. Among the more frequently reported
delusions are the following:
delusion of control
The belief that one's feelings, impulses, thoughts, or actions are not one's own but
have been imposed by some external force.
delusion of poverty
The conviction that one is, or will be, bereft of all material possessions.
delusion of reference
The conviction that events, objects, or other people in the immediate environment have a
particular and unusual significance (usually negative).
The false belief that one's sexual partner is unfaithful; also called the Othello
An exaggerated belief of one's importance, power, knowledge, or identity.
A conviction of nonexistence of the self, part of the self, or others, or of the world.
"I no longer have a brain" is an example.
The conviction that one (or a group or institution close to one) is being harassed,
attacked, persecuted, or conspired against.
A false belief involving the functioning of one's body, such as the conviction of a
postmenopausal woman that she is pregnant, or a person's conviction that his nose is
misshapen and ugly when there is nothing wrong with it.
A single false belief with multiple elaborations or a group of false beliefs that the
person relates to a single event or theme. This event is believed to have caused every
problem in life that the person experiences.
A defense mechanism, operating unconsciously, used to resolve emotional conflict
and allay anxiety by disavowing thoughts, feelings, wishes, needs, or external
reality factors that are consciously intolerable.
Feelings of unreality or strangeness concerning either the environment, the self, or
both. This is characteristic of depersonalization disorder and may also occur in schizotypal
personality disorder,schizophrenia, and in those persons experiencing
overwhelming anxiety, stress, or fatigue.
When used to describe a mood, depression refers to feelings of sadness, despair, and
discouragement. As such, depression may be a normal feeling state. The overt
manifestations are highly variable and may be culture specific. Depression may be a
symptom seen in a variety of mental or physical disorders, a syndrome of
associated symptoms secondary to an underlying disorder, or a specific mental disorder.
Slowed thinking, decreased pleasure, decreased purposeful physical activity, guilt and
hopelessness, and disorders of eating and sleeping may be seen in the depressive syndrome.
DSM-IV classifies depression by severity, recurrence, and association with hypomania or
mania. Other categorizations divide depression into reactive and endogenous
depressions on the basis of precipitants or symptom clusters. Depression in children may
be indicated by refusal to go to school, anxiety, excessive reaction to separation
from parental figures, antisocial behavior, and somatic complaints.
disruptive behavior disorder
A disturbance of conduct severe enough to produce significant impairment in social,
occupational, or academic functioning because of symptoms that range from
oppositional defiant to moderate and severe conduct disturbances.
symptoms may include losing temper; arguing with adults and actively refusing their
requests; deliberately annoying others; blaming others for one's mistakes; being easily
annoyed, resentful, or spiteful; and physically fighting with other members of the
conduct disturbance (moderate)
symptoms may include truancy or work absences, alcohol or other substance use before the
age of 13, stealing with confrontation, destruction of others' property, firesetting with
intent of causing serious damage, initiating fights outside of home, and being physically
cruel to animals.
conduct disturbance (severe)
symptoms may include running away from home overnight at least twice, breaking into
another's property, being physically cruel to people, stealing with confrontation,
repeatedly using a dangerous weapon, and forcing someone into sexual activity.
The splitting off of clusters of mental contents from conscious awareness, a
mechanism central to hysterical conversion and dissociativedisorder; the
separation of an idea from its emotional significance and affect as seen in the
inappropriate affect of schizophrenic patients.
One of the depressive disorders, characterized by a chronic course (i.e.,. seldom
without symptoms) with lowered mood tone and a range of other symptoms that may include
feelings of inadequacy, loss of self-esteem, or self-deprecation: feelings of hopelessness
or despair; feelings of guilt, brooding aboutpast events, or self-pity; low
energy and chronic tiredness; being less active or talkative than usual; poor
concentration and indecisiveness; and inability to enjoy pleasurable activities.