Center for Mental Health in Schools
Continuing Education

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 also repression.
character disorder (character neurosis)
A personality disorder manifested 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 of associations, 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."
cluster suicides
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-behavioral psychotherapy
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 alcohol dependence 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; individual psychology; overcompensation.
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.
concrete thinking
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 or schizophrenia.
conduct disorder
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).
conversion disorder
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.
coping mechanisms
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."
cyclothymic disorder
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.

defense mechanism

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 undoing.
deja vu
A paramnesia consisting of the sensation or illusion that one is seeing what one has seen before.
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).
delusional jealousy
The false belief that one's sexual partner is unfaithful; also called the Othello delusion.
grandiose delusion
An exaggerated belief of one's importance, power, knowledge, or identity.
nihilisitic delusion
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.
persecutory delusion
The conviction that one (or a group or institution close to one) is being harassed, attacked, persecuted, or conspired against.
somatic delusion
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.
systematized delusion
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.
oppositional defiant
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 household.
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 dissociative disorder; the separation of an idea from its emotional significance and affect as seen in the inappropriate affect of schizophrenic patients.
Unpleasant mood.
dysthymic disorder
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 about past 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.