Appendix 1: Terms in the field of Psychiatry and Neurology – Glossary of Psychiatry A

L

La belle indifférence	Literally, "beautiful indifference." Seen in certain patients with conversion disorders (hysteriaor dissociative disorders) who show an inappropriate lack of concern about their disabilities. labile Rapidly shifting (as applied to emotions); unstable.
Labile affect	An affect type that indicates abnormal sudden rapid shifts in affect.
Latah	A culture specific syndrome of Southeast Asia involving startle-induced disorganization, hypersuggestibility, automatic obedience, and echopraxia.
Latent content	The hidden (i.e., unconscious) meaning of thoughts or actions, especially in dreams or fantasies. In dreams, it is expressed in distorted, disguised, condensed, and symbolic form.
Learned helplessness	A condition in which a person attempts to establish and maintain contact with another by adopting a helpless, powerless stance.
Lethologica	Temporary inability to remember a proper noun or name.
L'homme qui rit	meaning "The man who laughs" in French, a patient displays inappropriate laughter accompanied by release phenomena of the frontal subdominant lobe.
Libido	The psychic drive or energy usually associated with the sexual instinct. (Sexual is used here in the broad sense to include pleasure and love-object seeking.)
Lilliputian hallucinations	Lilliputian hallucinations are characterized by abnormal perception of objects as being shrunken in size but normal in detail.
Locus coeruleus	A small area in the brain stem containing norepinephrine neurons that is considered to be a key brain center for anxiety and fear.
Logoclonia,	the patient often repeats the last syllable of a word.
Logorrhoea (syn. "volubility,"	is characterized by a patient's fluent and rambling speech using numerous words.
Long-term memory	The final phase of memory in which information storage may last from hours to a lifetime.
Loosening of associations	A disturbance of thinking shown by speech in which ideas shift from one subject to another that is unrelated or minimally related to the first. Statements that lack a meaningful relationship may be juxtaposed, or speech may shift suddenly from one frame of reference to another. The speaker gives no indication of being aware of the disconnectedness, contradictions, or illogicality of speech.

M

Macropsia	The visual perception that objects are larger than they actually are.
Made experiences	See 'Passivity phenomena'.
Magical thinking	A conviction that thinking equates with doing. Occurs in dreams in children, in primitive peoples, and in patients under a variety of conditions. Characterized by lack of realistic relationship between cause and effect.
Mania	An affective disorder characterised by intense euphoria, overactivity and loss of insight. Mania a potu is an alcohol intoxication state with violent and markedly disinhibited behavior. This condition is different from violent behavior in otherwise normal individuals who are intoxicated.
Manifest content	The remembered content of a dream or fantasy, as contrasted with latent content, which is concealed and distorted.
Masochism	Pleasure derived from physical or psychological pain inflicted on oneself either by oneself or by others. It is called sexual masochism and classified as a paraphilia when it is consciously sought as a part of the sexual act or as a prerequisite to sexual gratification. It is the converse of sadism, although the two tend to coexist in the same person.
Memory consolidation	The physical and psychological changes that take place as the brain organizes and restructures information that may become a permanent part of memory.
Mental retardation	A major group of disorders of infancy, childhood, or adolescence characterized by intellectual functioning that is significantly below average (IQ of 70 or below), manifested before the age of 18 by impaired adaptive functioning (below expected performance for age in such areas as social or daily living skills, communication, and self-sufficiency). Different levels of severity are recognized: an IQ level of 50/55 to 70 is Mild; an IQ level of 35/40 to 50/55 is Moderate; an IQ level of 20/25 to 35/40 is Severe; an IQ level below 20/25 is Profound.
MHPG (3-methoxy-4-hydroxyphenylglycol)	A major metabolite of brain norepinephrine excreted in urine.
Magical thinking	The erroneous belief that one's thoughts, words, or actions will cause or prevent a specific outcome in some way that defies commonly understood laws of cause and effect. Magical thinking may be a part of normal child development.
Malingering	The conscious mimicry of physical disease to achieve some material gain. Mannerism - a sometimes bizarre elaboration of normal activities.
Micropsia Middle insomnia	The visual perception that objects are smaller than they actually are. Awakening in the middle of the night followed by eventually falling back to sleep, but with difficulty.
Mirroring	1) The empathic responsiveness of the parent to the developing child's grandiose-exhibitionistic needs. Parental expressions of delight in the child's activities signal that the child's wishes and experiences are accepted as legitimate. This teaches the child which of his or her potential qualities are most highly esteemed and valued. Mirroring validates the child as to who he or she is and affirms his or her worth. The process transforms archaic aims to realizable aims, and it determines in part the content of the self-assessing, self-monitoring functions and their relationships to the rest of the personality. The content of the superego is the residue of the mirroring experience. 2) A technique in psychodrama in which another person in the group plays the role of the patient, who watches the enactment as if gazing into a mirror. The first person may exaggerate one or more aspects of the patient's behavior. Following the portrayal, the patient is usually encouraged to comment on what he or she has observed.
Mitgehen	is an extreme form of mitmachen in which very slight pressure leads to movement in any direction, also called the "anglepoise" effect. This is done despite instructions that the patient resist the pressure, as the patient often views the slight pressure as forceably grasping and moving the patient.
Mitmachen,	the patient's body can be put into any posture, despite instructions given that the patient resist.
Mood	A pervasive and sustained emotion that colors the perception of the world. Common examples of mood include depression, elation, anger, and anxiety. In contrast to affect, which refers to more fluctuating changes in emotional "weather," mood refers to a more pervasive and sustained emotional "climate." Types of mood include: dysphoric, elevated, euthymic, expansive, irritable. Pervasive and sustained emotion in the continuum between sad and happy.
Mood-congruent psychotic features	Delusions or hallucinations whose content is entirely consistent with the typical themes of a depressed or manic mood. If the mood is depressed, the content of the delusions or hallucinations would involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. The content of the delusion may include themes of persecution if these are based on self-derogatory-concepts such as deserved punishment. If the mood is manic, the content of the delusions or hallucinations would involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person. The content of the delusion may include themes of persecution if these are based on concepts such as inflated worth or deserved punishment.
Mood-incongruent psychotic features	Delusions or hallucinations whose content is not consistent with the typical themes of a depressed or manic mood. In the case of depression, the delusions or hallucinations would not involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. In the case of mania, the delusions or hallucinations would not involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person. Examples of mood-incongruent psychotic features include persecutory delusions (without self-derogatory- or grandiose content), thought insertion, thought broadcasting, and delusions of being controlled whose content has no apparent relationship to any of the themes listed above.
Moria	is the condition characterized by euphoric behavior, such as fivolity and the inability to act seriously.In addition there is a lack of foresight and a general indifference. It is found in frontal lobe lesions,often alongwith Witzelsucht particularly when the orbital surface is damaged. Recent research has shown its presence in fronto-temporal dementia.
Mutism	May be elective or involuntary; like slowing it is a feature of retardation and shares its causes, or may result from schizophrenia, hysteria or be behavioural (e.g. elective in children).

N

Negative symptoms	Most commonly refers to a group of symptoms characteristic of schizophrenia that include loss of fluency and spontaneity of verbal expression, impaired ability to focus or sustain attention on a particular task, difficulty in initiating or following through on tasks, impaired ability to experience pleasure to form emotional attachment to others, and blunted affect.
Negativism	Opposition or resistance, either covert or overt, to outside suggestions or advice. May be seen in schizophrenia.
Neologism	A novel word often invented and used in schizophrenic thought disorder.
Neuroleptic Malignant Syndrome	A syndrome ascribed to neuroleptics. The syndrome includes hyperpyrexia (temperature over 39 degrees Celsius), autonomic instability and muscular rigidity. The syndrom is not dose related and appears to be related to a very wide variety of substances including antidepressants, antipsychotics and lithium. There is a significant risk of mortality. Whether the syndrome is a variant of the lethal catatonia syndrome (described before the advent of modern neuroleptics) is a debated point.
Neologism	In psychiatry, a new word or condensed combination of several words coined by a person to express a highly complex idea not readily understood by others; seen in schizophrenia and organic mental disorders. A word holding no generally recognisable meaning, either completely new in form. or the condensation of pre-existing words e.g. 'conterbole' (meaning a difficult question) and found mainly in schizophrenia and structural brain disease.
Neurotic disorder	A mental disorder in which the predominant disturbance is a distressing symptom or group of symptoms that one considers unacceptable and alien to one's personality. There is no marked loss of reality testing ; behavior does not actively violate gross social norms, although it may be quite disabling. The disturbance is relatively enduring or recurrent without treatment and is not limited to a mild transitory reaction to stress. There is no demonstrable organic etiology.
Nihilistic delusion	The delusion of nonexistence of the self or part of the self, or of some object in external reality.
Nystagmus	Involuntary rhythmic movements of the eyes that consist of small-amplitude~ rapid tremors in one direction and a larger, slower, recurrent sweep in the opposite direction. Nystagmus may be horizontal, vertical, or rotary.

O

Object relations	The emotional bonds between one person and another, as contrasted with interest in and love for the self; usually described in terms of capacity for loving and reacting appropriately to others. Melanie Klein is generally credited with founding the British object-relations school.
Obsession	An unpleasant or nonsensical thought which intrudes into a person's mind, despite a degree of resistance by the person who recognises the thought as pointless or senseless, but nevertheless a product of their own mind. Obsessions may be accompanied by compulsive behaviours which serve to reduce the associated anxiety. A recurrent persistent thought, image, or impulse that enters consciousness unbidden, is recognised as being ones own and often remains despite efforts to resist.
Obsessive Compulsive Disorder (OCD)	An illness characterised by the presence of obsessions and/or compulsions.
Oedipal stage	Overlapping some with the phallic stage, this phase (ages 4 to 6) represents a time of inevitable conflict between the child and parents. The child must desexualize the relationship to both parents in order to retain affectionate kinship with both of them. The process is accomplished by the internalization of the images of both parents, thereby giving more definite shape to the child's personality. With this internalization largely completed, the regulation of self-esteem and moral behavior comes from within.
Oedipus complex	Attachment of the child to the parent of the opposite sex, accompanied by envious and aggressive feelings toward the parent of the same sex. These feelings are largely repressed (i.e., made unconscious) because of the fear of displeasure or punishment by the parent of the same sex. In its original use, the term applied only to the boy or man.
Olfactory hallucination	A hallucination involving the perception of odor, such as of burning rubber or decaying fish.
Ontogenetic	Pertaining to the development of the individual.
Operant conditioning (instrumental conditioning)	A process by which the results of the person's behavior determine whether the behavior is more or less likely to occur in the future.
Oral stage	The earliest of the stages of infantile psychosexual development, lasting from birth to 12 months or longer. Usually subdivided into two stages: the oral erotic, relating to the pleasurable experience of sucking; and the oral sadistic, associated with aggressive biting. Both oral eroticism and sadism continue into adult life in disguised and sublimated forms, such as the character traits of demandingness or pessimism. Oral conflict, as a general and pervasive influence, might underlie the psychological determinants of addictive disorders, depression, and some functional psychotic disorders.
Orientation	Awareness of one's self in relation to time, place, and person.
Overcompensation	A conscious or unconscious process in which a real or imagined physical or psychological deficit generates exaggerated correction. Concept introduced by Adler.
Overdetermination	The concept of multiple unconscious causes of an emotional reaction or symptom.
Overvalued idea	An unreasonable and sustained belief that is maintained with less than delusional intensity (i.e., the person is able to acknowledge the possibility that the belief may not be true). The belief is not one that is ordinarily accepted by other members of the person's culture or subculture An idea that takes disproportionate precedence in the individual's mind despite its often trivial content. It is firmly held but may be swayed with considerable effort.