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



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P


Pallilaliais


characterized by the repetition of a word or phrase.


Panic attacks


Discrete periods of sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During these attacks there are symptoms such as shortness of breath or smothering sensations; palpitations, pounding heart, or accelerated heart rate; chest pain or discomfort; choking; and fear of going crazy or losing control. Panic attacks may be unexpected (uncued), in which the onset of the attack is not associated with a situational trigger and instead occurs "out of the blue"; situationally bound, in which the panic attack almost invariably occurs immediately on exposure to, or in anticipation of, a situational trigger ("cue"); and situationally predisposed, in which the panic attack is more likely to occur on exposure to a situational trigger but is not invariably associated with it.


Paranoid ideation


Ideation, of less than delusional proportions, involving suspiciousness or the belief that one is being harassed, persecuted, or unfairly treated.


Paraschemazia


Paraschemazia characterized by a distortion of a patient's body image. It can be caused by hallucinogenic drugs such as LSD and mescalin, epileptic auras, and sometimes migraines.


Parasomnia


Abnormal behavior or physiological events occurring during sleep or sleep-wake transitions.


Parietal Lobe signs


Parietal lobe signs include various agnosias (such as visual agnosias, sensory neglect, and tactile agnosias), dyspraxias (such as dressing dyspraxia), body image disturbance, and hemipareses or hemiplegias.


Passivity phenomena


In these phenomena the individual feels that some aspect of themselves is under the external control of another or others. These may therefore include 'made acts and impulses' where the individual feels they are being made to do something by another, 'made movements' where their arms or legs feel as if they are moving under another's control, 'made emotions' where they are experiencing someone else's emotions, and 'made thoughts' which are categorised elsewhere as thought insertion and withdrawal.

Subjective experience that one's actions and/or thoughts are being controlled by some outside agency. Found in schizophrenia.




Persecutory delusion


A delusion in which the central theme is that one (or someone to whom one is close) is being attacked, harassed, cheated, persecuted, or conspired against.


Perseveration


Tendency to emit the same verbal or motor response again and again to varied stimuli.

Perseveration Describes an inappropriate repetition of some behaviour or thought or speech. Echolalia is an example of perseverative speech. Talking exclusively on one subject might be described as perseveration on a theme. Perseveration of thought indicates an inability to switch ideas, so that in an interview a patient may continue to give the same responses to later questions as he did to earlier ones. Perseveration is sometimes a feature of frontal lobe lesions.

Repetition of a word, theme or action beyond that point at which it was relevant and appropriate.


Personality


Enduring patterns of perceiving, relating to, and thinking about the environment and oneself. Personality traits are prominent aspects of personality that are exhibited in a wide range of important social and personal contexts. Only when personality traits are inflexible and maladaptive and cause either significant functional impairment or subjective distress do they constitute a Personality Disorder.


Phallic stage


The period, from about 21/2 to 6 years, during which sexual interest, curiosity, and pleasurable experience in boys center on the penis, and in girls, to a lesser extent, the clitoris.


Phobia


A persistent, irrational fear of a specific object, activity, or situation (the phobic stimulus) that results in a compelling desire to avoid it. This often leads either to avoidance of the phobic stimulus or to enduring it with dread.

An irrational, disproportionate fear of an object or situation leading to avoidance behaviour.




Piblokto


A culture specific syndrome of Eskimos involving attacks of screaming, crying, and running naked through the snow


Preconscious


Thoughts that are not in immediate awareness but that can be recalled by conscious effort.


Pregenital


In psychoanalysis, refers to the period of early childhood before the genitals have begun to exert the predominant influence in the organization or patterning of sexual behavior. Oral and anal influences predominate during this period.


Pressured speech


Speech that is increased in amount, accelerated, and difficult or impossible to interrupt. Usually it is also loud and emphatic. Frequently the person talks without any social stimulation and may continue to talk even though no one is listening.
Pressure of speech is manifest in a very rapid rate of delivery, a wealth of associations, which may be quite unusual„ (e.g. rhymes and puns) and often wanders off the point of the original conversation. This is highly suggestive of mania.


Prevalence


Frequency of a disorder, used particularly in epidemiology to denote the total number of cases existing within a unit of population at a given time or over a specified period.


Primary gain


The relief from emotional conflict and the freedom from anxiety achieved by a defense mechanism. Contrast with secondary gain.


Primary process


In psychoanalytic theory, the generally unorganized mental activity characteristic of the unconscious. This activity is marked by the free discharge of energy and excitation without regard to the demands of environment, reality, or logic.


Prodrome


An early or premonitory sign or symptom of a disorder


Projection


A defense mechanism, operating unconsciously, in which what is emotionally unacceptable in the self is unconsciously rejected and attributed (projected) to others.


Projective identification


A term introduced by Melanie Klein to refer to the unconscious process of projection of one or more parts of the self or of the internal object into another person (such as the mother). What is projected may be an intolerable, painful, or dangerous part of the self or object (the bad object). It may also be a valued aspect of the self or object (the good object) that is projected into the other person for safekeeping. The other person is changed by the projection and is dealt with as though he or she is in fact characterized by the aspects of the self that have been projected.


Projective tests


Psychological diagnostic tests in which the test material is unstructured so that any response will reflect a projection of some aspect of the subject's underlying personality and psychopathology


Prosopagnosia


Inability to recognize familiar faces that is not explained by defective visual acuity or reduced consciousness or alertness.


Pseudocyesis


Included in DSM-IV as one of the somatoform disorders. It is characterized by a false belief of being pregnant and by the occurrence of signs of being pregnant, such as abdominal enlargement, breast engorgement, and labor pains.


Pseudodementia


A syndrome in which dementia is mimicked or caricatured by a functional psychiatric illness. Symptoms and response of mental status examination questions are similar to those found in verified cases of dementia. In pseudodementia, the chief diagnosis to be considered in the differential is depression in an older person vs. cognitive deterioration on the basis of organic brain disease.


Pseudologia fantastica


is a condition in which a person grossly exaggerates his symptoms or even tells a lie abut his symptoms in order to get medical attention . Seen in malingering and Munchausen syndrome.


Psychomotor agitation


Excessive motor activity associated with a feeling of inner tension. When severe, agitation may involve shouting and loud complaining. The activity is usually nonproductive and repetitious, and consists of such behavior as pacing, wringing of hands, and inability to sit still.


Psychomotor retardation


Visible generalized slowing of movements and speech.

Slowing of thoughts and movements, to a variable degree. Occurs in depression but other causes include psychotropics, Parkinson's disease etc.




Psychosexual development


A series of stages from infancy to adulthood, relatively fixed in time, determined by the interaction between a person's biological drives and the environment. With resolution of this interaction, a balanced, reality-oriented development takes place; with disturbance, fixation and conflict ensue. This disturbance may remain latent or give rise to characterological or behavioral disorders.


Psychotic


This term has historically received a number of different definitions, none of which has achieved universal acceptance. The narrowest definition of psychotic is restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature. A slightly less restrictive definition would also include prominent hallucinations that the individual realizes are hallucinatory experiences. Broader still is a definition that also includes other positive symptoms of Schizophrenia (i.e., disorganized speech, grossly disorganized or catatonic behavior). Unlike these definitions based on symptoms, the definition used in DSM-II and ICD-9 was probably far too inclusive and focused on the severity of functional impairment, so that a mental disorder was termed psychotic if it resulted in "impairment that grossly interferes with the capacity to meet ordinary demands of life." Finally, the term has been defined conceptually as a loss of ego boundaries or a gross impairment in reality testing. Based on their characteristic features, the different disorders in DSM-IV emphasize different aspects of the various definitions of psychotic.
This term causes confusion, because it is used in two different senses. In the past it was used to describe illnesses that are severe (e.g. dementia, schizophrenia and severe mood disorder). The other usage, which is more accepted nowadays, is referring to symptoms (hallucinations and delusions) that are qualitatively different to normal experience as opposed to quantitatively different (e.g. anxiety, depression).


Psychotropic medication


Medication that affects thought processes or feeling states.

R




Rationalization


A defense mechanism, operating unconsciously, in which an individual attempts to justify or make consciously tolerable by plausible means, feelings or behavior that otherwise would be intolerable. Not to be confused with conscious evasion or dissimulation. See also projection.


Reaction formation


A defense mechanism, operating unconsciously, in which a person adopts affects, ideas, and behaviors that are the opposites of impulses harbored either consciously or unconsciously. For example, excessive moral zeal may be a reaction to strong but repressed asocial impulses.


Reality principle


In psychoanalytic theory, the concept that the pleasure principle, which represents the claims of instinctual wishes, is normally modified by the demands and requirements of the external world. In fact, the reality principle may still work on behalf of the pleasure principle but reflects compromises and allows for the postponement of gratification to a more appropriate time. The reality principle usually becomes more prominent in the course of development but may be weak in certain psychiatric illnesses and undergo strengthening during treatment. reality testing The ability to evaluate the external world objectively and to differentiate adequately between it and the internal world. Falsification of reality, as with massive denial or projection, indicates a severe disturbance of ego functioning and/or of the perceptual and memory processes upon which it is partly based.


Reciprocal inhibition

In behavior therapy, the hypothesis that if anxiety-provoking stimuli occur simultaneously with the inhibition of anxiety (e.g., relaxation), the bond between those stimuli and the anxiety will be weakened.


Regression

Partial or symbolic return to earlier patterns of reacting or thinking. Manifested in a wide variety of circumstances such as normal sleep, play, physical illness, and in many mental disorders.

Reinforcement The strengthening of a response by reward or avoidance of punishment. This process is central in operant conditioning.




Repetition compulsion


In psychoanalytic theory, the impulse to reenact earlier emotional experiences. Considered by Freud to be more fundamental than the pleasure principle. Defined by Jones in the following way: "The blind impulse to repeat earlier experiences and situations quite irrespective of any advantage that doing so might bring from a pleasure-pain point of view."


Repression


A defense mechanism, operating unconsciously, that banishes unacceptable ideas, fantasies, affects, or impulses from consciousness or that keeps out of consciousness what has never been conscious. Although not subject to voluntary recall, the repressed material may emerge in disguised form. Often confused with the conscious mechanism of suppression. resistance One's conscious or unconscious psychological defense against bringing repressed (unconscious) thoughts into conscious awareness.


Respondent conditioning (classical conditioning, Pavlovian conditioning)


Elicitation of a response by a stimulus that normally does not elicit that response. The response is one that is mediated primarily by the autonomic nervous system (such as salivation or a change in heart rate). A previously neutral stimulus is repeatedly presented just before an unconditioned stimulus that normally elicits that response. When the response subsequently occurs in the presence of the previously neutral stimulus, it is called a conditioned response, and the previously neutral stimulus, a conditioned stimulus.


Residual phase


The phase of an illness that occurs after remission of the florid symptoms or the full syndrome.


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