A


Affect:

A person's observed moment to moment emotional expression expressed in posture, face, body movements, and tone of voice. Compare to definition of mood.

Akathisia:

A condition characterised by motor restlessness. For example, restless legs, rocking from foot to foot, aching legs, pacing, or inability to sit or stand. Symptoms develop within a few weeks of starting or raising the dose of a neuroleptic medication or of reducing the dose of medication used to treat extra-pyramidal symptoms.

Alertness and level of consciousness: refers to an individual's ability to be aware of (and respond to) the environment around them. Disturbances of consciousness usually indicate organic brain impairment.

Anhedonia:

Loss of interest in and withdrawal from all regular and pleasurable activities. In evaluating anhedonia, inquiring whether the person has lost the sense of pleasure is not enough. The clinician must document that the patient has actually given up previously enjoyed pastimes. When mild, anhedonia evidences with a decreased interest in life. Later, patients complain that they have lost all interest in things.

Anxiety:

Apprehension, tension, or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognised. Primarily of intra-psychic origin, in distinction to fear, which is the emotional response to a consciously recognised 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.

Apathy / apathetic:

Dulled emotional tone associated with detachment or indifference; seen in certain types of schizophrenia and depression.

Apparent age:

How old the person looks compared to their actual age.

Appearance:

Appearance refers to the physical characteristics of the person. It includes:

  • bodily habits
  • physical disabilities
  • dress
  • stature
  • grooming, and
  • cleanliness.

Attention and concentration:

Ability to sustain focus on one activity. A disturbance in attention may appear as having difficulty in finishing tasks that have been started, being easily distracted, or having difficulty in concentrating.

Also see Concentration.

Attitude towards clinician:

Attitude toward clinician refers to the person's approach to the interview and interaction with the clinician, if the person is willing or unwilling to engage, is responsive to questions, etc. The person's attitude toward the interview and interaction with the clinician will affect the information elicited. Attitude may change during the course of the interview as anxiety reduces (or increases). The development of rapport is an important factor in attitude.

Attribution:

An idea or belief about the cause of a certain behaviour.

Auditory hallucination:

The perception of sound or voice, ranging from an indistinct buzzing to a conversation loud enough to preclude attention to real sounds/conversations. Three types of auditory hallucinations are:

  1. audible thoughts described as hallucinated voices that speak aloud what the person is thinking;
  2. voices that give a running commentary on the person's actions; and
  3. hearing two or more voices arguing with each other often about the person, who is referred to in the third person.

Avolition:

The 'inability to initiate and persist in goal-directed activities'. When severe enough to be considered pathological, avolition is pervasive and prevents the person from completing many different types of activities. Avolition is one of the negative symptoms of schizophrenia.

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B


Behaviour:

Behaviour and activity refers to the level and quality of the person's physical movement. Noting the activity level and the type of movement the individual displays are useful indicators of concurrent mood states or of physical problems.

Some individuals cannot sit still, whereas others barely move, and others move in abnormal ways. Abnormal activity and movements can be indicative of a neurologic problem, as well as, mood states. Some individuals, for example, may also be behaving in unusual ways because they are responding to hallucinations and delusions.

Blunted affect:

A state in which externally expressed emotion is present but much diminished in intensity. Differentiated from flat affect in which there is no emotional expression.

Bizarre:

Conspicuously or grossly unconventional or unusual.

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C


Capacity:

Capacity is the ability to make one's own decisions.

An adult over the age of 18 has the right to make their own decisions and choices e.g. what to wear, what to eat, where to live, how to act. Adults have the right to make a decision, think it through and act. This is regardless of what others may think of their decision making process or outcomes. Adults are presumed to have capacity to make their own decisions.

Catatonic signs:

Marked motor abnormalities, generally limited to those occurring as part of a non-organic psychotic disorder. This term includes:

  • catatonic excitement (apparently purposeless agitation not influenced by external stimuli),
  • stupor (decreased reactivity and fewer spontaneous movements, often with apparent unawareness of the surroundings),
  • negativism (apparent motiveless resistance to instructions or attempts to be moved),
  • posturing (the person's assuming and maintaining an inappropriate or bizarre stance),
  • rigidity (the person's maintaining a stance or posture against all efforts to be moved), and
  • waxy flexibility, or cerea flexibilitas (the person's limbs can be put into positions that are maintained).

Chronological age:

The person's actual age.

Circumstantiality:

Talking at length around a point before getting to it; characterised by over-inclusion of detail. The speaker does not lose the point, and clauses remain logically connected, but to the listener it seems that the end will never be reached. Characterised by an over-inclusion of detail. Documented in thought form and flow section of MSE.

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.

Clang association:

Statements are connected by sound not by meaning. 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. Documented in thought form and flow section of MSE.

For example, in response to the statement 'That will probably remain a mystery,' a person said, 'History is one of my strong points'.

Cognition:

The ability to know and think, and occurs through the use of intellect, logic, reasoning, memory and all of the higher cortical functions.

Cognitive Assessment:

The process of systematically gathering test scores and related data in order to make judgements about an individual's ability to perform various mental activities involved in the processing, acquisition, retention, conceptualization, and organisation of sensory, perceptual, verbal, spatial, and psychomotor information.

Compulsion:

Pathological need to act on an impulse that, if resisted, produces anxiety; repetitive behaviour that a person feels compelled to undertake. Usually in response to an obsession. The individual is aware that the action is unreasonable.

It can include behaviour such as hand washing or mental acts such as praying or repeating words silently that aim 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 recognised to be excessive or unreasonable.

Concentration:

The act or process of concentrating, especially the fixing of close, undivided attention.

Also see Attention and concentration.

Concrete interpretation:

The person remains literal and emphasises a concrete situation although not the same situation as is referred to in the proverb.

Congruent mood and affect:

Where the emotions observed correspond to contents of speech and thought.

Conscious:

A state of general wakefulness and responsiveness to environment.

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D


Delusion:

Fixed false belief based on incorrect inference about external reality. The delusions are not consistent with patient's intelligence and cultural background and cannot be corrected by reasoning. Occurs in some psychotic states 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. Can range from being quite bizarre and fragmented to being plausible and organised.

Types of delusions include: bizarre, jealous, erotomanic, grandiose, control, reference, persecution, somatic, thought broadcasting and thought insertion.

Systematised delusions are a stable set of delusions in which various psychotic features tend to interrelate, and the person is able to discuss most things in terms of his/her delusional system. Documented in thought content section of MSE.

Non-systematised delusions are those that change rapidly in content; their organisation is difficult to elucidate and the psychotic elements are not particularly interrelated. Non-systematised delusions usually extend into many areas of life, and new data - new people and situations - are constantly incorporated to further support the presence of the delusion. The patient usually has concurrent mental confusion, hallucinations, and some affective lability.

Dimensions of Delusions:

  • Conviction - How convinced person is of belief.
  • Extent - Do delusions involve many areas of person's life?
  • Bizarreness - A delusion that involves a phenomenon that the person's culture would regard as physically impossible. Bizarre delusions suggest schizophrenia.
  • Disorganization - Are beliefs internally consistent, logical, and systematised?
  • Pressure - How preoccupied person is with belief.

Types of delusions:

  • Passivity experiences/delusions of control - False belief that a person's will, thoughts, or feelings are being controlled by external forces. These include thought broadcasting, thought insertion or thought withdrawal.
  • Grandiose/ delusions of grandeur - False belief that the behaviour of others refers to oneself or that events, objects, or other people have a particular and unusual significance, usually of a negative nature. Derived from idea of reference in which persons falsely feel that others are talking about them. For example, a belief that a television program or newspaper article has special meaning for him/her or that a person on the television or radio are talking about/or to them.

Depression:

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 conditions, a syndrome of associated symptoms secondary to an underlying illness, or a specific mental illness. Slowed thinking, decreased pleasure, decreased purposeful physical activity, guilt and hopelessness, and disorders of eating and sleeping may be seen in the depressive syndrome.

Depersonalisation:

Sensation of unreality concerning oneself, parts of oneself, or ones environment that occurs under extreme stress or fatigue. Seen in schizophrenia, depersonalisation disorder and schizotypal personality disorder.

Derailment:

Pattern of speech in which a person's ideas slip off one track onto another that is completely unrelated or only obliquely related. Thoughts are disconnected or illogically connected. In its worst form, derailment develops into loosening of associations and then further deteriorates into word salad. Documented in thought form and flow section of MSE.

Despondent:

Feeling dejected. Without or almost without hope.

Disinhibition:

Acting according to one's inner drives or feelings, without regard for restraints imposed by cultural norms or superego. Removal of an inhibitory, constraining, or limiting influence.

Dissociation:

Unconscious defence mechanism involving the segregation of any group of mental or behavioural processes from the rest of the person's psychic activity. May entail the separation of an idea form its accompanying emotional tone.

Disorientation:

The loss of awareness of the position of the self in relation to space, time, or other person; confusion.

Distractibility:

Inability to maintain attention; shifting from one area or topic to another with minimal stimulus.

Dyprosody:

Unusual rhythms found in a person's speech.

Dysphoria / dysphoric:

Feeling of unpleasantness or discomfort; a mood of general dissatisfaction and restlessness.

Dystonia:

Abnormal positioning or spasm of the muscles of the head, neck, limbs, or trunk, the dystonia develops within a few days of starting or raising the dose of a neuroleptic medication, because of dysfunction of the extrapyramidal system.

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E


Echolalia:

Mechanical and meaningless repetition of the words of another person (as in schizophrenia). Involuntary parrotlike repetition of a word or sentence just spoken by another person.

Ecstasy / ecstatic:

Intense joy or delight.

Egocentric interpretation:

The individual references themself when interpreting a proverb.

Erotomania:

Belief in nonexistent romance: the delusion of being loved by and romantically involved in a relationship with a person, especially somebody famous or of high social position.

Euphoria / euphoric:

An exaggerated feeling of physical and emotional well-being, that is inappropriate to real events. Also seen in organic mental disorders, toxic and drug-induced states and bipolar disorders.

Euthymia / euthymic:

A normal range of mood that includes the expected little ups and downs of life, but not with the major or prolonged shifts of mood.

Executive functioning:

Cognitive abilities such as planning, organising, sequencing, and abstracting. Diminished in dementia and can be impaired in schizophrenia.

Expansive mood:

Expression of feelings without restraint, frequently seen with an overestimation of their significance or importance. Seen in mania and grandiose delusional disorder.

Eye contact:

Visual contact with another person's eyes

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F


Fear:

Unpleasant emotional and physiological response to recognised sources of danger, to be distinguished from anxiety. See also phobia.

Flat affect:

A state in which there is no emotional expression. Lack of signs of affective expression: the voice may be monotonous, no gesticulation, and the face, immobile.

Flight of ideas:

A nearly continuous flow of accelerated speech with abrupt changes from one topic to another, usually based on understandable associations, distracting stimuli, or plays on words. When severe this may lead to disorganised and incoherent speech.

Flight of ideas is characteristic of manic episodes, but it may occur also in organic mental disorders, schizophrenia, other psychoses, and, rarely, acute reactions to stress.

Free floating anxiety:

Severe, generalised, persistent anxiety not specifically ascribed to a particular object or event and often a precursor of panic. See generalised anxiety disorder.

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G


Gait:

Refers to the persons manner of walking.

Garrulous:

Excessively or tiresomely talkative.

Generalised anxiety disorder:

The essential feature of an anxiety disorder is the presence of excessive anxiety and worry. An individual with an anxiety disorder will find it difficult to control this tendency to worry, and their anxiety will be accompanied by symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension and disturbed sleep among others.

Grandiose delusion:

A delusion of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.

Grandiosity:

Exaggerated belief or claims of one's importance or identity, often manifested by delusions of great wealth, power, or fame.

Grooming:

Refers to the care the person takes in their personal appearance. It covers aspects of appearance such as hair, fingernails, clothing, teeth etc.

See also appearance

Gustatory hallucination:

A hallucination involving the perception of taste (usually unpleasant).

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H


Hallucination:

Unprovoked perceptual experiences that occur in a person's mind through any sense (sight, hearing, smell, taste, touch) in the absence of external stimulation.

Hallucinations may involve any of the senses (sight, hearing, smell, taste, touch).

Hygiene:

Refers to the individual's attention to activities which preserve health such as showering, washing hair, cleaning teeth.

Hyperactivity:

Excessive motor activity that may be purposeful or aimless; movements and utterances are usually more rapid than normal. Hyperactivity is a prominent feature of attention-deficit disorder and hypo / hypermania.

Hypochondriasis:

One of the somatoform disorders, characterised by persisting worry about health or fear of having some disease despite appropriate medical reassurance and lack of findings on physical or laboratory examination. Fear of contracting a disease is considered to be a phobia rather than hypochondriasis.

Hypomania:

Mood abnormality with the qualitative characteristics of mania but somewhat less intense. It is characterised by unrealistic optimism, pressure of speech and activity, and a decreased need for sleep. Some people show increased creativity during hypomanic states, whereas others show poor judgement, or irritability.

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I


Ideas of reference:

Misinterpretation of incidents and events in the outside world as having direct personal reference to oneself; frequently seen in paranoid patients. For example, remarks that one overhears, or people that one encounters seem to be concerned with and usually hostile to self. If present with sufficient frequency or intensity or if organised and systematised, they constitute delusions of reference. Documented in the thought content section of MSE.

Illogical:

A pattern of speech in which conclusions reached do not follow from the facts.

Illusion:

A misperception of a real external stimulus. Example: the rustling of leaves is heard as the sound of voices. Contrast with hallucination.

Immediate memory:

The recall of perceived material within a period of 30 seconds to 25 minutes after presentation.

Impulsivity:

Displaying behaviour characterised by little or no forethought, reflection, or consideration of the consequences. Rapid, unplanned responses to stimuli. Is of clinical interest because of the danger the person's actions may present to self and others. Should be considered in a risk assessment, especially if the person is also prone to violence, or is currently angry or hostile.

Incongruent affect:

Emotional tone out of harmony with the idea, thought, or speech accompanying it.

Incoherence:

Lacking in unity or consistency; often applied to speech or thinking that is not understandable owing to any of the following: lack of logical connection between words or phrases, excessive use of incomplete sentences; many irrelevancies or abrupt changes in subject matter; idiosyncratic word usage; or distorted grammar. See also loosening of associations.

Insight:

Self-understanding; the ability to be self-aware - that is, conscious of one's own feelings, ideas, and underlying motivations about a particular issue. It involves the capacity to examine many aspects, viewpoints, and consequences of an issue before forming an opinion or making a decision. In this context, refers to the extent to which the patient recognises he has a mental illness or disability.

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J


Judgement:

Mental act of comparing choices between a given set of values in order to select a course of action.

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L


Labile affect:

Abnormal variability, with repeated, rapid, and abrupt shifts in affective expression. Fluctuating rapidly between extremes, unrelated to external stimuli. For instance, shifting rapidly from laughing to tearful.

Lethargy:

The quality or state of being lazy, sluggish, or indifferent.

Long term memory:

The part of the mind that retains information permanently or nearly so; a system in the brain that can store and retrieve vast amounts of information on a relatively enduring basis.

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. When severe may lead to disorganised and incoherent speech. Documented in thought form/flow section of MSE.

Lugubrious:

Mournful, dismal, or gloomy, especially in an affected, exaggerated, or unrelieved manner.

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M


Magical thinking:

A conviction that thinking equates with doing. Occurs in dreams in children, in primitive peoples, and in individuals under a variety of conditions. Many superstitions are examples of culturally validated magical thinking. Characterised by lack of realistic relationship between cause and effect.

Malingering:

Deliberately pretending to have an illness or disability in order to receive financial or other gain, or to avoid punishment or responsibility.

Mania:

A mental state of elevated, expansive or irritable mood and persistently increased level of activity or energy. Can also be characterized by such symptoms as severe insomnia, grandiose notions, increased speed and/or volume of speech, flight of ideas increased sexual desire, markedly increased energy and activity level, poor judgement, and inappropriate social behaviour.

Memory:

The ability, process, or act of remembering or recalling; especially the ability to reproduce what has been learned or explained.

Mini Mental State Examination (MMSE):

The Mini-Mental Status Exam is a five-minute screening test that is designed to evaluate basic mental function in a number of different areas. Some of the areas tested involve a person's ability to recall facts, to write and to calculate numbers.

The test provides a quick way to determine if more in-depth neurological testing is needed. Anyone suspected of mental decline or potential dementia is a candidate for this test although the test is best suited for people older than 60.

Read more about the MMSE

View the mini MSE

Mood:

An individual's reported pervasive and sustained emotional state. Mood refers to an inner state that persists for some time. A pervasive and sustained emotion on the continuum between sad and happy. Can markedly influence virtually all aspects of a person's behaviour and perception of the world. Compare to definition of affect.

Statements about the person's mood should include depth, intensity, duration and fluctuations. Common adjectives used to describe mood include depressed, despairing, irritable, anxious, angry, guilty, frightened and perplexed.

Mood may be labile (e.g. laughing out loud and expansive one moment, tearful the next).

Motor coordination:

The harmonious functioning of body parts that involve movement, including gross motor movement, fine motor movement, and motor planning.

Mutism:

No verbal response, yet individual indicates awareness of question. May result from a variety of peripheral muscle and Central Nervous System conditions and from functional disorders.

Mutism may occur in profound depression, catatonic states, and conversion reactions. Selective mutism is characterised by persistent refusal to speak in specific situations in which speaking is expected, despite the demonstration of speaking ability in other situations. Context is considered insofar as the diagnosis is not made if the failure to speak is attributed to lack a of knowledge of the spoken language, e.g. second language of an immigrant.

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N


Negative symptoms:

Most commonly refers to a group of symptoms characteristic of schizophrenia that include diminished emotional expression and avolition, alogia, anhedonia and asociality.

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.

Nihilistic delusion:

A conviction of non-existence of the self, part of the self, or others, or of the world. 'I no longer have a brain' is an example.

Cotard's Syndrome is a nihilistic delusion in which one believes that one's body, or parts of it, is disintegrating, or that one is bereft of all resources, or one's family has been exterminated, and so forth. It has been reported in depressive disorders, schizophrenia, and lesions of the non-dominant lobe.

Neuro-vegetative symptoms:

Neuro-vegetative symptoms are recorded in the mood and affect component and relate to what the person tells you about their sleep, appetite, weight, mood, interest, motivation, energy, concentration, memory, psychomotor activity and libido.

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O


Obsession:

Recurrent and persistent thought, impulse, or image experienced as intrusive and distressing.

Recognised as being excessive and unreasonable even though it is the product of one's mind. This thought, impulse, or image cannot be expunged by logic or reasoning. Associated with anxiety.

Olfactory hallucination:

Experience of a particular and unusual smell such as of burning rubber or decaying fish. Can occur in schizophrenia, temporal lobe epilepsy.

See also gustatory hallucination.

Orientation:

Awareness of one's self in relation to time, place, and person.

Overvalued idea:

An unreasonable and sustained belief that is maintained with less than delusional intensity. For example, the person is able to acknowledge the possibility that the belief may not be true.

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P


Panic:

Sudden, overwhelming anxiety of such intensity that it produces terror and physiological changes.

Paranoia:

Unrealistic suspiciousness and guardedness, not necessarily of delusional proportions.

Paranoid delusions:

A condition characterised by an intricate, complex, and elaborate system of thinking based on (and often proceeding logically from) misinterpretation of an actual event. Belief that a person or persons is/are persecuting them. Despite its chronic course, this condition does not seem to interfere with thinking and personality. Includes persecutory delusions and delusions of reference, control and grandeur

Passivity phenomena:

A range of delusions about one's will, thoughts, feelings or actions being controlled by some outside agency. Thought passivity may take several forms: in thought insertion, thoughts are experienced as having been placed within one's mind from the outside; in thought withdrawal, thoughts are whisked out of the mind; in thought broadcasting, one experiences thoughts as escaping one's mind to be heard by others. These experiences are often combined with specific delusions of control, seemingly to explain the passivity experiences.

Perception:

Conscious awareness of the elements in the environment by the mental processing of sensory stimuli.

Persecutory:

Beliefs that centre on the theme that one is being deliberately wronged, conspired against, or harmed by another person or agency.

Perseveration:

Individual repeats either their own words, phrase or theme regardless of the context or question asked, even if the subject is changed. Perseveration is seen in major depressive disorder, frontal lobe damage, and schizophrenia, catatonic type. Documented in thought form and flow section of MSE.

Phobia:

Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety response or panic attack even though the subject recognises that the fear is excessive or unreasonable. The phobic stimulus is avoided or endured with marked distress.

Two types of phobia have been differentiated:

  • specific phobia (simple phobia), and
  • social phobia.

Specific phobia is subtyped on the basis of the object feared. E.g. The natural environment (animals, insects, storms, water, etc.); blood, injection, or injury; situations (cars, airplanes, heights, tunnels, etc.); and other situations that may lead to choking, vomiting, or contracting an illness are all specific phobias.

In social phobia (social anxiety disorder), the persistent fear is of social situations that might expose one to scrutiny by others and induce one to act in a way or show anxiety symptoms that will be humiliating or embarrassing.

Positive symptoms:

In psychosis and schizophrenia: hallucinations, delusions, and thought disorder.

Poverty of speech:

Restricted amount of spontaneous speech. Replies to questions are brief and monosyllabic. It is presumed that this results from underlying poverty of thought.

Poverty of thought:

Marked reduction in the amount of thought. Thinking is vague, concrete, over-abstract, repetitive, or stereotyped. Also known as poverty of ideas and poverty of content of thought.

Premorbid:

Preceding the occurrence of disease.

Preoccupation:

Centring of thought on a particular idea, associated with strong emotional reactions in the individual.

Pressured speech:

Speech is extremely rapid, difficult to interrupt, loud and hard to understand. Occurs in mania. Sometimes it exceeds the ability of the vocal musculature to articulate, leading to jumbled and cluttered speech. At other times it exceeds the ability of the listener to comprehend as the speech expresses a flight of ideas (as in mania) or unintelligible jargon.

Problem solving:

A specific form of intellectual activity used when a person faces a situation that cannot be handled in terms of past learning. Problem solving strategies are considered crucial in any psychotherapeutic endeavour.

Pseudoabstraction (proverb interpretation):

When an individual interpret one proverb with another.

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 non-productive and repetitious, and consists of such behaviour as pacing, wringing of hands, and inability to sit still.

Psychomotor retardation:

A generalised slowing of physical and emotional reactions. Specifically, the slowing of movements such as eye blinking; frequently seen in depression.

Psychosis:

A group of symptoms that reflects a change in a person's sense of reality and may lead to changes in their mood, thoughts, perceptions and beliefs. It may be characterised by hallucinations, delusions and illusions.

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R


Racing thoughts:

The subjective experience of thoughts moving very quickly from topic to topic. Racing thoughts are reported most often by people with mania, hypomania, anxiety and drug intoxication. As the person becomes increasingly unwell will potentially become flight of ideas.

Range (affect):

In the normal range of affect, there is variation in facial expression, tone of voice, use of hands, and body movements.

Recall:

The process of bringing a memory into consciousness (see conscious). Recall is often used to refer to the recollection of facts, events, and feelings that occurred in the immediate past.

Restricted:

A clear reduction in the expressive range and intensity of affect. The person is able to demonstrate some types of emotion but appears unable to demonstrate others. For example, sadness but not happiness or anger

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S


Short-term memory:

The recognition, recall, and reproduction of perceived material 10 seconds or longer after initial presentation.

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.

Somatoform disorder:

These disorders are characterised by physical complaints that appear to be medical in origin but that cannot be explained in terms of a physical disease, the results of substance abuse, or by another mental disorder.

Somnolence:

Sleepiness, the state of feeling drowsy, or being ready to fall asleep.

Speech:

The faculty or act of expressing or describing thoughts, feelings, or perceptions by the articulation of words.

Speech latency:

Long pauses between phrases or before beginning sentences.

Staccato:

Abnormal speech in which the person pauses between words, breaking the rhythm of the phrase or sentence.

Stature:

The person's height and build.

See also appearance

Strengths perspective:

A strengths perspective or practice model rests on the assumption that there are strengths and resources present for all people, in all situations and forms of distress.

A strengths based approach to mental health work relies on awareness, utilisation and enhancement of existing strengths (personal) and resources (environmental).

Stupor:

Marked decrease in reactivity to and awareness of the environment, with reduced spontaneous movements and activity. It can be seen as a type of catatonic behaviour in schizophrenia, but it can also be observed in serious physical illnesses.

Suicidal ideation:

Thoughts about killing oneself. Can range from specific plans to passive feelings or ideation, such as 'I wish I was dead'.

Suicidal intent:

Level of individual degree of risk of acting on suicidal ideation at a particular time.

Suicide plan:

Individual strategy inclusive of time frame and means to kill oneself.

Systematised delusion:

A stable set of delusions in which various psychotic features tend to interrelate, and the person is able to discuss most things in terms of his/her delusional system. Are usually restricted or circumscribed to well-delineated areas and are ordinarily associated with a clear sensorium and absence of hallucinations.

They are often isolated from other aspects of behaviour the patient with a closed systematised delusional system may go about life relatively unperturbed, the patient with a non-systematised delusion frequently has poor social functioning and often behaves in response to the delusional beliefs.

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T


Taciturn:

Habitually silent, reserved, or uncommunicative; not inclined to conversation.

Tactile hallucination:

Perception of being touched or of something being under one's skin such as the sensation of pins being stuck into one's finger. The sensation of something crawling under one's skin is called formication; it occurs most frequently in alcohol withdrawal syndrome and in cocaine withdrawal.

Tangentiality:

Replying to a question in an oblique or irrelevant way. The person does not get around to answering the question.

Documented in thought form/flow section of MSE.

Thought alienation:

The collective grouping for thought insertion, withdrawal and broadcasting.

Thought blocking:

A sudden obstruction or interruption in spontaneous flow of thinking or speaking, perceived as an absence or deprivation of thought.

Thought broadcasting:

The experience that one's thoughts are being transmitted from one's mind and broadcast to everyone.

Thought content:

Refers to what the person is talking about, rather than how the person is thinking. Preoccupations, obsessions, phobias, rituals and delusions are examples of disturbance in thought content.

Thought disorder:

Any disturbance of thinking that affects language, communication, or thought content. Manifestations range from simple blocking and mild circumstantiality to profound loosening of associations, incoherence, and delusions; characterised by a failure to follow semantic and syntactic rules that is inconsistent with the person's education, intelligence, or cultural background.

Thought form/flow:

Form means the "arrangement of parts". Disturbances in the form of thought are disturbances in the logical process of thought - more simply, disturbances in the logical connections between ideas. Circumstantial speech, flight of ideas, loosening of associations, perseverance and blocking are examples of disturbances in thought form.

Thought insertion:

The subjective feeling that thoughts in one's mind are not one's own, often explained by a secondary delusion of insertion by some outside agency. The experience of alien thoughts being inserted into the mind.

Thought latency:

Delay or hesitancy preceding the production of a verbal response or statement.

Thought process: Individuals pattern of thoughts, not specific content. Refer to 'thought form/flow'.

Thought withdrawal:

The experience of thoughts being removed or extracted from one's mind.

Tic:

An involuntary, sudden, rapid, recurrent, nonrhythmic stereotyped motor movement or vocalization. A tic may be an expression of an emotional conflict, the result of neurologic disease, or an effect of a drug (especially a stimulant or other dopamine agonist).

Tremor:

Any abnormal repetitive shaking movement of the body. May be related to illnesses such as thyroid disease, or caused by fever, hypothermia, drugs or fear.

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V


Visual hallucination:

Perception of an image such as people (formed) or a flash of light (unformed). Previously thought to have been uncommon in schizophrenia, but now found to be prevalent in high numbers in subjects with chronic schizophrenia. Also occur in people with visual system disease (eg, macular degeneration) unrelated to primary psychiatric disorder. Common with substance induced psychosis.

Voluble:

Fluent or having a ready flow of speech.

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W


Word salad:

Speech is an incoherent, essentially incomprehensible jumble of words and phrases recounted with normal intonation. A mixture of words and phrases that lack comprehensive meaning or logical coherence; commonly seen in schizophrenic states. Documented in thought form and flow section of MSE.

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