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
A - B

A

abnormality
In psychological terms, any mental, emotional, or behavioral activity that deviates from culturally or scientifically accepted norms.
abreaction
Emotional release or discharge after recalling a painful experience that has been repressed because it was not consciously tolerable (see conscious). A therapeutic effect sometimes occurs through partial or repeated discharge of the painful affect. See also systematic desensitization.
abstinence
Foregoing some kind of gratification; in the area of alcohol or drug dependence, being without the substance on which the subject had been dependent.
abuse, substance
Impairment in social and occupational functioning resulting from the pathological and "compulsive" use of a substance. The concept is closely related to the definition of substance dependence, which has similar symptoms of impairment but may include evidence of physiological tolerance or withdrawal. Typical symptoms of abuse include failure to fulfill major role obligations at work, school, or home; recurrent use of the substance in situations where such use is physically hazardous; substance-related legal problems; and continued use even though it causes or exaggerates interpersonal problems. See also dependence, substance.
abused child
A child or infant who has suffered repeated injuries, which may include bone fractures, neurologic and psychological damage, or sexual abuse at the hands of a parent, parents, or parent surrogate(s). The abuse takes place repeatedly and is often precipitated, in the case of physical abuse, by the child's minor and normally irritating behavior. Child abuse also includes child neglect.
academic problem
School difficulty that is not due to a mental disorder. Examples are failing grades or significant underachievement in a person with adequate intellectual capacity.
academic disorders
In DSM-IV, this is a major group of infancy, childhood, and adolescence disorders that includes reading disorder, mathematics disorder, and disorder of written expression.
accident-proneness
Susceptibility to accidents based on psychological causes or motivations, usually unconscious.
acculturation difficulty
A problem in adapting to or finding an appropriate way to adapt to a different culture or environment. The problem is not based on any coexisting mental disorder.
acting out
Expressions of unconscious emotional conflicts or feelings in actions rather than words. The person is not consciously aware of the meaning of such acts (see conscious). Acting out may be harmful or, in controlled situations, therapeutic (e.g., children's play therapy).
adaptation
Fitting one's behavior to meet the needs of one's environment, which often involves a modification of impulses, emotions, or attitudes.
addiction
Dependence on a chemical substance to the extent that a physiological and/or psychological need is established. This may be manifested by any combination of the following symptoms: tolerance, preoccupation with obtaining and using the substance, use of the substance despite anticipation of probable adverse consequences, repeated efforts to cut down or control substance use, and withdrawal symptoms when the substance is unavailable or not used.
ADHD
See attention-deficit/hyperactivity disorder.
adjustment
Often transitory functional alteration or accommodation by which one can better adapt oneself to the immediate environment and to one's inner self. See also adaptation.
adjustment disorder
An imprecise term referring to emotional or behavioral symptoms that develop in response to an identifiable stressor. The symptoms, which may include anxiety, depressed mood, and disturbance of conduct, are clinically significant in that the distress exceeds what would be expected under the circumstances, or significant impairment in social or occupational functioning is produced. Duration of symptoms tends to be self-limited, not persisting more than 6 months after termination of the stressor or its consequences. Sometimes the disorder is designated as "acute" if duration is 6 months or less, and as "persistent" or "chronic" if symptoms endure beyond 6 months.
affect
Behavior that expresses a subjectively experienced feeling state (emotion); affect is responsive to changing emotional states, whereas mood refers to a pervasive and sustained emotion. Common affects are euphoria, anger, and sadness. Some types of affect disturbance are:
blunted
Severe reduction in the intensity of affective expression.
flat
Absence or near absence of any signs of affective expression such as a monotonous voice and an immobile face.
inappropriate
Discordance of voice and movements with the content of the person's speech or ideation.
labile
Abnormal variability, with repeated, rapid, and abrupt shifts in affective expression.
restricted or constricted
Reduction in the expressive range and intensity of affects.
affective disorder
A disorder in which mood change or disturbance is the primary manifestation. Now referred to as mood disorder. See depression.
aggression
Forceful physical, verbal, or symbolic action. May be appropriate and self- protective, including healthy self-assertiveness, or inappropriate as in hostile or destructive behavior. May also be directed toward the environment, toward another person or personality, or toward the self, as in depression.
agitation
Excessive motor activity, usually nonpurposeful and associated with internal tension. Examples include inability to sit still, fidgeting, pacing, wringing of hands, and pulling of clothes. See psychomotor agitation.
agoraphobia
Anxiety about being in places or situations in which escape might be difficult or embarrassing or in which help may not be available should a panic attack occur. The fears typically relate to venturing into the open, of leaving the familiar setting of one's home, or of being in a crowd, standing in line, or traveling in a car or train. Although agoraphobia usually occurs as a part of panic disorder, agoraphobia without a history of panic disorder has been described.
alcohol dependence
Dependence on alcohol characterized by either tolerance to the agent or development of withdrawal phenomena on cessation of, or reduction in, intake. Other aspects of the syndrome are psychological dependence and impairment in social and/or vocational functioning. This is also called alcoholism.
Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA)
An agency in the U.S. Department of Health and Human Services that was replaced in 1992 by the Substance Abuse and Mental Health Services Administration (SAMHSA). In reorganizing ADAMHA into SAMHSA, the three ADAMHA research institutes, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH), were moved to the National Institutes of Health. What remain in SAMHSA are the substance abuse and mental health services programs.
alcohol hallucinosis
An organic mental disorder consisting of auditory hallucinations occurring in a clear sensorium, developing shortly after the reduction or cessation of drinking, usually within 48 hours. The disorder commonly follows prolonged and heavy alcohol use.
alcohol psychosis
A group of major mental disorders associated with organic brain dysfunction due to alcohol; in DSM-IV, categorized as alcohol-induced psychotic disorder. Includes delirium tremens and alcohol hallucinosis.
alcohol use disorders
In DSM-IV, this group includes alcohol dependence, alcohol abuse, alcohol intoxication, alcohol withdrawal, alcohol delirium, alcohol persisting dementia, alcohol persisting amnestic disorder, alcohol psychotic disorder, alcohol mood disorder, alcohol anxiety disorder, alcohol sleep disorder, and alcohol sexual dysfunction. See abuse, substance; dependence, substance; intoxication, alcohol; withdrawal symptoms, alcohol.
ambivalence
The coexistence of contradictory emotions, attitudes, ideas, or desires with respect to a particular person, object, or situation. Ordinarily, the ambivalence is not fully conscious and suggests psychopathology only when present in an extreme form.
amnesia
Pathologic loss of memory; a phenomenon in which an area of experience becomes inaccessible to conscious recall. The loss in memory may be organic, emotional, dissociative, or of mixed origin, and may be permanent or limited to a sharply circumscribed period of time. Two types are distinguished:

anterograde
Inability to form new memories of events following such as condition(s).
retrograde
Loss of memory for events preceding the amnesia proper and the condition(s) presumed to be responsible for it.
amphetamine use disorders
In DSM-IV, this group includes amphetamine (or related substance) dependence, amphetamine abuse, amphetamine intoxication, amphetamine withdrawal, amphetamine delirium, amphetamine psychotic disorder, amphetamine mood disorder, amphetamine anxiety disorder, amphetamine sexual dysfunction, and amphetamine sleep disorder.
amphetamines
A group of chemicals that stimulate dopamine release in the central nervous system; often misused by adults and adolescents to control normal fatigue and to induce euphoria. Used clinically to treat hyperkinetic disorder and narcolepsy.
androgyny
A combination of male and female characteristics in one person.
anhedonia
Inability to experience pleasure from activities that usually produce pleasurable feelings. Contrast with hedonism.
anniversary reaction
An emotional response to a previous event occurring at the same time of year. Often the event involved a loss and the reaction involves a depressed state. The reaction can range from mild to severe and may occur at any time after the event.
anomie
Apathy, alienation, and personal distress resulting from the loss of goals previously valued. Emile Durkheim popularized this term when he listed it as a principal reason for suicide.
anorexia nervosa
An eating disorder characterized by refusal or inability to maintain minimum normal weight for age and height combined with intense fear of gaining weight, denial of the seriousness of current low weight, undue influence of body weight or shape on self-evaluation, and, in females, amenorrhea or failure to menstruate. Weight is typically 15% or more below normal, and it may decrease to life-threatening extremes. In the restricting subtype, the person does not engage regularly in binge eating. In the binge eating/purging, or bulimic, subtype, the person engages in recurrent episodes of binge eating or purging during the episode of anorexia nervosa. See also bulimia nervosa.
Antabuse (disulfiram)
A drug used in treatment of alcohol dependence to create an aversive response to alcohol. It blocks the normal metabolism of alcohol and produces increased blood concentrations of acetaldehyde that induce distressing symptoms such as flushing of the skin, pounding of the heart, shortness of breath, nausea, and vomiting. With more severe reactions, hypertension, cardiovascular collapse, and, sometimes, convulsions may occur.
antisocial behavior
Conduct indicating indifference to another's person or property; criminal behavior, dishonesty, or abuse are examples. In DSM-IV, childhood or adolescent antisocial behavior and adult antisocial behavior (in contrast to antisocial personality disorder, etc.) are included as "other conditions that may be a focus of clinical attention."
anxiety
Apprehension, tension, or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognized. Primarily of intrapsychic origin, in distinction to fear, which is the emotional response to a consciously recognized and usually external threat or danger. May be regarded as pathologic when it interferes with effectiveness in living, achievement of desired goals or satisfaction, or reasonable emotional comfort.
anxiety disorders
In DSM-IV, this category includes panic disorder without agoraphobia, panic disorder with agoraphobia, agoraphobia without history of panic disorder, specific (simple) phobia, social phobia (social anxiety disorder), obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder (includes overanxious disorder of childhood), anxiety disorder due to a general medical condition, and substance-induced anxiety disorder. (The inclusion of mixed anxiety-depressive disorder into this category awaits further study.) See agoraphobia; generalized anxiety disorder; mixed anxiety-depressive disorder; obsessive-compulsive disorder; panic disorder; phobia; posttraumatic stress disorder.
apathy
Lack of feeling, emotion, interest, or concern.
apperception
Perception as modified and enhanced by one's own emotions, memories, and biases.
Asperger's disorder
A disorder of development characterized by gross and sustained impairment in social interaction and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities occurring in the context of preserved cognitive and language development.
Attachment disorder, reactive
A disorder of infancy or early childhood, beginning before the child is 5 years old, characterized by markedly disturbed and developmentally inappropriate social relatedness. In the inhibited type of reactive attachment disorder, failure to respond predominates, and responses are hypervigilant, avoidant, or highly ambivalent and contradictory. Frozen watchfulness maybe present. In the disinhibited type, indiscriminate sociability is characteristic, such as excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures. The majority of children who develop this disorder (either type) are from a setting in which care has been grossly pathogenic. Either the caregivers have continually disregarded the child's basic physical and emotional needs, or repeated changes of the primary caregiver have prevented the formation of stable attachments.
attention-deficit/hyperactivity disorder (ADHD)
A child whose inattention and hyperactivity-impulsivity cause problems may have this disorder. Symptoms appear before the age of 7 years and are inconsistent with the subject's developmental level and severe enough to impair social or academic functioning.

In the predominantly inattentive type, characteristic symptoms include distractibility, difficulty in sustaining attention or following through on instructions in the absence of close supervision, avoidance of tasks that require sustained mental effort, failure to pay close attention to details in schoolwork or other activities, difficulty in organizing activities, not listening to what is being said to him or her, loss of things that are necessary for assignments, and forgetfulness in daily activities.

In the predominantly hyperactive-impulsive type, characteristic symptoms are that the person inappropriately leaves his or her seat in classroom or runs about, fidgets or squirms, has difficulty in engaging in leisure activities quietly, has difficulty in awaiting turn in games, and blurts out answers to questions before they are completed.

The two types may be combined.

autistic disorder
A disorder of development consisting of gross and sustained impairment in social interaction and communication; restricted and stereotyped patterns of behavior, interest, and activities; and abnormal development prior to age 3 manifested by delays or abnormal functioning in social development, language communication, or play. Specific symptoms may include impaired awareness of others, lack of social or emotional reciprocity, failure to develop peer relationships appropriate to developmental level, delay or absence of spoken language and abnormal nonverbal communication, stereotyped and repetitive language, idiosyncratic language, impaired imaginative play, insistence on sameness (e.g., nonfunctional routines or rituals), and stereotyped and repetitive motor mannerisms.
aversion therapy
A behavior therapy procedure in which associated with undesirable behavior are paired with a painful or unpleasant stimulus, resulting in the suppression of the undesirable behavior.

B

biofeedback
The use of instrumentation to provide information (i.e. feedback) about variations in one or more of the subject's own physiological processes not ordinarily perceived (e.g., brain wave activity, muscle tension, blood pressure). Such feedback over a period of time can help the subject learn to control certain physiological processes even though he or she is unable to articulate how the learning was achieved.
bipolar disorders
In DSM-IV, a group of mood disorders that includes bipolar disorder, single episode; bipolar disorder, recurrent; and cyclothymic disorder.

A bipolar disorder includes a manic episode at some time during its course. In any

particular patient, the bipolar disorder may take the form of a single manic episode (rare), or it may consist of recurrent episodes that are either manic or depressive in nature (but at least one must have been predominantly manic).

bisexuality
Originally a concept of Freud, indicating a belief that components of both sexes could be found in each person. Today the term is often used to refer to persons who are capable of achieving orgasm with a partner of either sex. See also gender role; homosexuality.
blocking
A sudden obstruction or interruption in spontaneous flow of thinking or speaking, perceived as an absence or deprivation of thought.
bonding
The unity of two people whose identities are significantly affected by their mutual interactions. Bonding often refers to the an attachment between a mother and her child.
brief psychotherapy
Any form of psycbotberapy whose end point is defined either in terms of the number of sessions (generally not more than 15) or in terms of specified objectives; usually goal-oriented, circumscribed, active, focused, and directed toward a specific problem or symptom.
bulimia nervosa
An eating disorder characterized by recurrent episodes of binge eating followed by compensatory behavior such as purging (i.e., self-induced vomiting or the use of diuretics and laxatives) or other methods to control weight (e.g., strict dieting, fasting, or vigorous exercise).
burnout
A stress reaction developing in persons working in an area of unrelenting occupational demands. Symptoms include impaired work performance, fatigue, insomnia, depression, increased susceptibility to physical illness, and reliance on alcohol or other drugs of abuse for temporary relief.

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