PSYCHIATRIC NURSING

UPUMP REVIEW 101

TYPICAL SIGNS AND SYMPTOMS OF PSYCHIATRIC ILLNESS DEFINED
I. CONSCIOUSNESS: State of awareness
A. DISTURBANCES OF o Apperception: Perception modified by one’s own emotions & thoughts
CONSCIOUSNESS o Sensorium: State of cognitive functioning of the special senses
1. Disorientation Disturbance of orientation in time, place, or person.
2. Clouding of consciousness Incomplete clearmindedness w/ disturbances in perception & attitudes
3. Stupor Lack of reaction to & unawareness of surroundings.
4. Delirium Bewildered, restless, confused, disoriented reaction associated with fear & hallucinations.
5. Coma Profound degree of unconsciousness.
6. Coma Vigil Coma in w/c a px appears to be asleep but ready to be aroused (akinetic mutism)
7. Twilight state Disturbed consciousness w/ hallucinations
8. Dreamlike state Often used as a synonym for complex partial seizure or psychomotor epilepsy
9. Somnolence Abnormal drowsiness
10. Confusion Disturbance of consciousness in w/c reactions to environmental stimuli are inappropriate:
manifested by a disordered orientation in relation to TPP
11. Drowsiness A state of impaired awareness associated with a desire or inclination to sleep
12. Sundowning Syndrome in older people that usually occurs at night & is characterized by drowsiness,
confusion, ataxia & falling as the result of being overly sedated w/ medications (Sundowner’s
Syndrome)
B. Disturbances of Attention Is the amount of effort exerted in focusing on certain portions of an experience;

Ability to sustain a focus on one activity ; Ability to concentrate

1. Distractibility Inability to concentrate attention; state in w/c attention is drawn to unimportant or irrelevant
external stimuli
2. Selective inattention Blocking out only those things that generate anxiety
3. Hypervigilance Excessive attention & focus on all internal & external stimuli, usually 2ndary to delusional or
paranoid states
4. Trance Focused attention & altered consciousness, usually seen in hypnosis, dissociative d/o’s, &
ecstatic religious experiences
C. Disturbances in suggestibility Compliant & uncritical response to an idea or influence
1. Folie a deux ( folie a trois) Communicated emotional illness bet 2 (3) persons
2. Hypnosis Artificially induced modification of consciousness characterized by a heightened suggestibility
II. Emotion: Complex feeling state w/ psychic, somatic, & behavioral components that is r/t affect & mood
A. Affect Observed expression of emotion
1. Appropriate affect Condition in w/c the emotional tone is in harmony w/ the accompanying idea, thought, or
speech
2. Inappropriate affect Disharmony bet the emotional feeling tone & the idea, thought, or speech accompanying it
3. Blunted affect Disturbance in affect manifested by a severe reduction in the intensity of externalized feeling
tone
4. Restricted or Constricted Reduction in intensity of feeling tone les severe than blunted affect but clearly reduced
5. Flat affect Absence or near absence of any signs of affective expression; voice monotonous, face
immobile
6. Labile affect Rapid & abrupt changes in emotional feeling tone, unrelated to external stimuli
B. MOOD A pervasive & sustained emotion, subjectively experienced & reported by a px & observed by
others
1. Dysphoric mood an unpleasant mood
2. Euthymic mood normal range of mood, implying absence of depressed or elevated mood
3. Expansive mood a person's expression of feelings without restraint, frequently with an overestimation of their
significance or importance.
4. Mood swings (labile mood) oscillations between euphoria & depression or anxiety
5. Elevated mood Air of confidence & enjoyment; a mood more cheerful than usual
6. Euphoria intense elation with feelings of grandeur
7. Ecstasy Feeling of intense rapture

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8. Depression psychopathological feeling of sadness
9. Irritable A state in w/c a person is easily annoyed & provoked to anger
10. Anhedonia loss of interest in and withdrawal from all regular and pleasurable activities, often associated with
depression
11. Grief or mourning sadness appropriate to a real loss
12. Alexithymia a person's inability to or difficulty in describing being aware of emotions or mood.
13. Suicidal ideation thoughts or act of taking one's own life.
14. Elation Feelings of joy, .euphoria, triumph, intense self-satisfaction, or optimism.

C. OTHER EMOTIONS
1. Anxiety Feeling of apprehension caused by anticipation of danger, which may be in tern al or external.
2. Free-floating anxiety Pervasive, unfocused fear not attach e d lo any idea.
3. Fear A n x ie ty caused by consciously recognized a n d realistic danger.
4. Agitation severe anxiety associated with motor restlessness.
5. Tension increased and unpleasant motor and psychological activity.
6. Panic acute, episodic, intense attack of anxiety associated with overwhelming feelings of dread and
autonomic discharge.
7. Apathy dulled emotional tone associated with detachment or indifference
8. Ambivalence coexistence of two opposing impulses toward the same thing in the same thing in the same person at
the same time.
9. Abreaction emotional release or discharge after recalling a painful experience.
10. Shame failure to live up to self-expectations.
11. Guilt emotion secondary to doing what is perceived as wrong.
12. Impulse control ability to resist an impulse, drive, or temptation to perform an action.
13. Melancholia severe depressive state; used in the term involutional melancholia both descriptively and also in
reference to a distinct diagnostic entity
D. PHYSIOLOGICAL DISTURBANCES signs of somatic (usually autonomic) dysfunction, most often associated w ith depression(Also
ASSOCIATED WITH MOOD: called vegetative signs).
1. Anorexia loss of or decrease in appetite.
2. Hypcrphagia increase in appetite and intake of food.
3. Insomnia lack of or diminished ab ility to sleep.
a. Initial difficulty in falling asleep
b. Middle difficulty in sleeping through the night without waking up and difficulty in going back to sleep.
c. Terminal early morning awakening
4. Hypersomnia excessive sleeping
5. Diurnal variation mood is regularly worst in the morning, immediately after awakening, and improves as the day
progresses.
6. Diminished libido decreased sexual interest, drive, and performance (increased libido is o f ten associated with manic
states).
7. Constipation inability to defecate or difficulty in defecating.
8. Fatigue a feeling of weariness, sleepiness, or irritability following a period of m ental or bodily activity.
9. Pica craving and eating of nonfood substances, such as paint and clay (usually girls)
10. Pseudocyesis rare condition in which a patient has the signs and symptoms of pregnancy, such as abdominal
distention, breast enlargement, pigmentation, cessation of menses, and morning sickness.
11. Bulimia insatiable hunger and voracious eating; seen in bulim ia nervosa and a typical depression
12. Adynamia
III. MOTOR BEHAVIOR BEHAVIOR aspect of the psyche that includes impulses, motivations, wishes, drives, instincts, and cravings,
(CONATION): as-expressed by a person's behavior or motor activity.
1. Echopraxia pathological imitation of movements of one person by another.
2. Catatonia and postural abnormalities seen in catatonic schizophrenia and some cases of brain diseases, such as encephalitis.
a. Catalepsy general term for an immobile position that is constantly maintained
b. Catatonic excitement agitated, purposeless motor activity uninfluenced by external stimuli
c. Catatonic stupor markedly slowed motor activity, often ID a point of immobility and seeming unawareness of
surroundings
d. Catatonic rigidity Voluntary assumption of a rigid posture,-held against all efforts to be moved.
e. Catatonic posturing voluntary assumption of an inappropriate or bizarre posture, generally maintained for long periods
f. Cerea flexibilitas (waxy condition of a person who can be molded into a position that is then maintained; when an
flexibility) examiner moves the person's limb, the limb feels as if it were made of wax.
g. Akinesia lack of physical movement, as in the extreme immobility of catatonic schizophrenia; may also occur
as an extrapyramidal side effect of antipsychotic medication.
3. Negativism motiveless resistance to all attempts to be moved or to all instructions

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4. Cataplexy temporary loss of muscle tone and weakness precipitated by a variety of emotional states.
5. Stereotypy repetitive fixed pattern of physical action or speech.
6. Mannerism ingrained, habitual involuntary movement.
7. Automatism automatic performance of an act or acts generally representative of unconscious symbolic activity.
8. Command automatism automatic following of suggestions (also automatic obedience).
9. Mutism voicelessness without structural abnormalities.
10. Overactivity
a. Psychomotor agitation Excessive & motor & cognitive overactivity, usually nonproductive & in response to inner
tension.
b. Hyperactive (hyperkinesis) Restless, aggressive, destructive activity, often associated with some underlying brain
pathology
c. Tic Involuntary, spasmodic motor movement
d. Sleepwalking (somnambulism) motor activity during sleep.

e. Akathisia subjective feeling of muscular tension secondary to antipsychotic or other medication, which can
cause restlessness, pacing, repeated sitting and standing; can be mistaken for psychotic agitation
f. Compulsion uncontrollable impulse to perform an act repetitively
i. Dipsomania compulsion to drink alcohol
ii. Kleptomania compulsion to steal
iii. Nymphomania excessive and compulsive need for coitus in a woman
iv. Satyriasis excessive and compulsive need for coitus in a man
v. Trichotillomania compulsion to pull out hair
vi. Ritual automatic activity, compulsive in nature, anxiety reducing in origin
g. Ataxia failure of muscle coordination; irregularity of muscle action
H. Polyphagia pathological overeating
i. Tremor rhythmical alteration in movement, which is visually faster than one beat a second; typically,
tremors decrease during periods of relaxation and sleep and increase during periods of anger and
increased tension. |
1 1 . Hypoactivity (Hypokinesis) decreased motor and cognitive activity, as in psychomotor retardation; visible slowing of thought,
speech, and movements.
12. Mimicry simple, im itative motor activity of childhood.
13. Aggression forceful, goal-directed action that may be verbal or physical; the motor counterpart of the affect
of rage, anger, or hostility
14. Acting Out direct expression of an unconscious wish or impulse in action; living out unconscious fantasy
impulsively in behavior
15. Abulia reduced impulse to act and think, associated with indifference about consequences of action; a
result of neurological deficit
16. Anergia lack of energy (anergy)
17. Astasia abasia the inability to stand or walk in a normal manner, even though normal leg movements can be
performed in a sitting or lying down position. The gait is bizarre and is not suggestive of a
specific organic lesion; seen in conversion disorder.
18. Coprophagia eating of filth or feces
19. Dyskinesia difficulty in performing voluntary movements, as in extrapyramidal disorders.
20. Muscle rigidity state in which the muscles remain immovable; seen in schizophrenia.
21. Twirling a sign present in autistic children who continually rotate in the direction in which their head is
turned.
22. Bradykinesia slowness of motor activity w ith n decrease in normal spontaneous movement.
23. Chorea random and involuntary quick, jerky, purposeless movements.
24. Convulsion An involuntary, violent muscular contraction or spasm
a. Clonic convulsion convulsion in which the muscles alternately contract and relax
b. Tonic convulsion convulsion in which the muscle contraction is sustained
25. Seizure an attack or sudden onset of certain symptoms, such as convulsions, loss of consciousness, and
psychic or sensory disturbances; seen in epilepsy and can be substance-induced
a. Generalized tonic-clonic seizure generalized onset of tonic-clonic movements of the limbs, tongue biting, and incontinence followed
by slow, gradual recovery of consciousness and cognition; also called grandmal seizure and
psychomotor seizure
b. Simple partial seizure localized ictal onset of seizure without alteration:; in consciousness.
c. Complex partial seizure Localized ictal onset of seizure with alterations in consciousness
26. Dystonia slow, sustained contractions of the trunk or limbs; seen in medication-induced dystonia
Goal-directed flow of ideas, symbols, and associations initiated by a problem or task and leading
toward a reality-oriented conclusion; when a logical sequence occurs, thinking is normal; parapraxis

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 IV. THINKING (unconsciously motivated lapse from logic is also called a freudian slip) considered part of normal
thinking.
A. GENERAL DISTURBANCES IN FORM OR PROCESS OF THINKING
1. Mental disorder Clinically significant behavior or psychological syndrome associated with distress or disability, not just
an expected response to a particular event or limited to relations between a person and society.
2. Psychosis inability to distinguish reality from fantasy; impaired reality testing, with the creation of a new reality (as
opposed to neurosis: mental disorder in which reality testing is intact; behavior may not violate gross
social norms, but is relatively enduring or recurrent without treatment)
3. Reality testing Objective evaluation and judgment of the world outside the self.
4. Formal thought disorder disturbance in the form of thought rather than the content of thought; thinking characterized by loosened
associations, neologisms, and illogical constructs; thought process is disordered and the person is defined
as psychotic
5. Illogical thinking Thinking containing erroneous conclusions or intern al contradictions; psychopathological only when it
is marked & when not caused by cultural values or intellectual deficit.
6. Dereism mental activity not concordant w ith logic or experience
7. Autistic thinking Preoccupation with inner, private world; term used somewhat synonymously with dereism.
8. Magical thinking A form of dereistic thought; thinking similar to that of the preoperational phase in children(jean
piaget), in which thoughts, words, or actions assume power (e.g. to cause or prevent events)

9. Primary process thinking

General term for thinking that is dereistic, illogical;-magical; normally found in dreams, abnormally in psy-
chosis.
10. Emotional insight Deep level of understanding or awareness that is likely to lead to positive changes in personality and
behavior.
B. SPECIFIC DISTURBANCES IN FORM OF THOUGHT
1. Neologism New word created by a patient, often by combining syllables of other words, for idiosyncratic psychological
reasons.
2. Word salad incoherent mixture of words and phrases.
3. Circumstantiality indirect speech that is delayed in reaching the point but eventually gets from original point to desired
goal; characterized by an over inclusion of details and parenthetical remarks.

4. Tangetiality Inability to have goal-directed associations of thought; speaker never gets from desired point to desired
goal.
5. Incoherence Thought that generally is not understandable; running together of thoughts or words; with no logical or
grammatical connection, resulting in disorganization.
6. Perseveration Persisting response to a p re v io u s s t im u lu s after a new s t im u lu s has been presented; often associated w i t h
co gn itive disorders.
7. Verbigeration meaningless repetition of specific words or phrases
8. Echolalia psychopathological repeating of words or phrases of one person by another; tends to be repetitive and
persistent; may be spoken with mocking or staccato intonation
9. condensation Fusion of various concepts into one
10. irrelevant answer Answer that is not in harmony with question asked (person appears to ignore or not attend to
question).
11. Loosening of association Flow of thought in which ideas shift from one subject to another in a completely unrelated way: when
sever speech may be incoherent.
12. derailment
13. flight of ideas Rapid, continuous verbalizations or plays on words produce constant shifting from one idea to
another; ideas tend to be connected, & in the less severe from a listener may be able to follow them.
14. Clang association Association of words similar in sound but not in meaning; words have no logical connection; nay include
rhyming and punning.
15. Blocking Abruption eruption in train of thinking before a though or idea is finished; after a brief pause, person
indicates no recall of what was being said or was going to be said (also known as thought deprivation).
16. Glossolalia expression of a revelatory message through unintelligible words (also known as speaking in tongues); not
considered a disturbance in thought if associated with practices of specific Pentecostal religions
C. SPECIFIC DISTURBANCES IN CONTENT OF THOUGHT
1. Poverty of content Thought that gives little information because of vagueness, empty repetitions, or obscure
phrases.
2. Overvalued idea Unreasonable, sustained false belief maintained less firmly than a delusion
3. Delusion false belief, based on incorrect inference about external reality, not consistent with patient's
intelligence, and cultural background; cannot be corrected by reasoning
a. Bizarre delusion an absurd, totally implausible, strange false belief (for example, invaders from space have

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 implanted electrodes in a person's brain).
b. Systematized delusion False belief of beliefs united by a single event or theme (for example, a person is being
persecuted by the CIA, the FBI, or the Mafia).
c. Mood-congruent delusion Delusion with mood-appropriate content (for example, a depressed patient believes that he or
she is responsible for the destruction of the world).
d. Mood-incongruent delusion Delusion with content that has no association to mood or is mood neutral (for example, a
depressed patient has delusions of thought control or thought broadcasting).
e. Nihilistic delusion False feeling that self, others, or the world is nonexistent or, coming to an end.
f. delusion of poverty A person’s false belief that he or she is bereft or will be deprived of all material
possessions.
g. somatic delusion False belief involving functioning of the body
h. paranoid delusion
i. delusion of persecution
ii. delusion of grandeur
iii. delusion of reference A person’s false belief that the behavior of others refers to himself or herself; that events,
objects, or other people have a particular & unusual significance, usually of a negative
nature; derived from idea of reference, in which a person falsely feels that others are
talking about him or her ( for example, belief that people on TV or radio are talking to or
about the person)
i. Delusion of self accusation False feeling of remorse or guilt
j. delusion of control False feeling that a person’s will, thoughts, or feelings are being controlled by external
forces.
i. thought withdrawal Delusion that thoughts are being removed from a person’s mind by other people or forces

ii. thought insertion Delusion that thoughts are being implanted in a person’s mind by other people or forces
iii. thought broadcasting Delusion that a person’s thoughts can be heard by others, as though they were being
broadcast over the air.
iv. thought control Delusion that a person’s thoughts are being controlled by other people or forces.
K . delusion of infidelity (delusional False belief derived from pathological jealousy about a person’s lover being unfaithful.
jealousy)
l. erotomania Delusional belief, more common in women than in men, that someone is deeply in love
with them (also known as Clerambault-Kandinsky complex)
m. pseudologia phantastica A type of lying in which a person appears to believe in the reality of his or her fantasies and
acts on them, associated with Munchausen’s syndrome, repeated feigning of illness.
4. Trend or preoccupation of thought Centering of thought content on a particular idea, associated with a strong affective tone,
such as a paranoid trend or a suicidal or homicidal preoccupation
5. Egomania Pathological self-preoccupation
6. monomania Preoccupation with a single object
7. hypochondria Exaggerated concern about health that is based not on real organic pathology but, rather,
on unrealistic interpretations of physical signs or sensations as abnormal.
8. obsession Pathological persistence of an irresistible thought or feeling that cannot be eliminated from
consciousness by logical effort; associated with anxiety
9. compulsion Pathological need to act on an impulse that, if rested, produces anxiety; repetitive behavior
in response to an obsession or performed according to certain rules, with no true end in
itself other than to prevent something from occurring in the future
10. coprolalia Compulsive utterance of obscene words
11. phobia Persistent, irrational, exaggerated, & invariably pathological dread of a specific stimulus or
situation; results in a compelling desire to avoid the feared stimulus.
a. specific phobia Circumscribed dread of a discrete object or situation ( dread of spiders or snakes)
b. social phobia Dread of public humiliation, as in fear of public speaking, performing, or eating in public.
c. acrophobia
d. agoraphobia Dread in open places
e. algophobia Dread of pain
f. ailurophobia Dread of cats
g. erythrophobia Dread of red (refers to a fear of blushing)
h. panphobia Dread of Everything
i. claustrophobia Dread of closed places
j. xenophobia Dread of strangers
k. zoophobia Dread of animals

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 l. needle phobia The persistent, intense, pathological fear of receiving an injection.
12. Noesis A revelation in which immense illumination occurs in association with a sense that a person
has been chosen to lead & command
13. Unio Mystica An oceanic feeling of mystic with an infinite power; not considered a disturbance in
thought content if congruent with person’s religious or cultural milieu.
V. Speech
A. DISTURBANCES IN SPEECH
1. Pressure of speech Rapid speech that is increased in amount & difficult to interrupt
2. Volubility(logorrhea) Copious, coherent, logical speech
3. poverty of speech Restriction in the amount of speech used; replies may be monosyllabic
4. nonspontaneous speech Verbal responses given only when asked or spoken to directly; no self-initiation of speech
5. Poverty of content of speech speech that is adequate in amount that conveys little information because of
vagueness, emptiness, or stereotyped phrases.
6. Dysprosody loss of normal speech melody (called prosody).
7. dysarthria Difficulty in articulation, not in word finding or in grammar
8. excessive loud or soft speech loss of modulation of normal speech volume; may reflect a variety of pathological
conditions ranging from psychosis to depression to deafness.
9. Stuttering frequent repetition or prolongation of a sound or syllable, leading to markedly
impaired speech fluency
10. cluttering Erratic & dysrhytmic speech, consisting of rapid & jerky spurts
B. APHASIC DISTURBANCES: DISTURBANCES IN LANGUAGE OUTPUT
1. Motor aphasia Disturbance of speech caused by a cognitive disorder in which understanding
remains but ability to speak is grossly impaired; halting, laborious, and inaccurate
speech (also known as Broca's, nonfluent, and expressive aphasia).
2. Sensory aphasia Organic loss of ability to comprehend the meaning of words; fluid and
spontaneous but incoherent and nonsensical speech (also known as Wernicke's,
fluent, and receptive aphasia).
3. Nominal aphasia Difficulty in finding correct name for an object (also termed anomia and amnestic
aphasia).
4. Syntactical aphasia Inability to arrange words in proper sequence.
5. Jargon aphasia Words produced are totally neologistic; nonsense words repeated with various
intonations and inflections.

6. Global aphasia Combination of a grossly non-fluent aphasia and a severe fluent aphasia.

7. Alogia Inability to speak because of a mental deficiency or an episode of dementia

8. copropregia Involuntary use of vulgar or obscene language; seen in Tourette’s disorder and some cases
schizophrenia
VI. Perception:
A. DISTURBANCES OF process of transferring physical stimulation into psychological information; mental process
PERCEPTION by w/c sensory stimuli are brought to awareness.
1. Hallucination False sensory perception not associated with real external stimuli; there may or may
no! be a delusional-interpretation of the hallucinatory experience
a. Hypnagogic hallucination False sensory perception not associated with real external stimuli; there may or may not be
delusional interpretation of the hallucinatory experience.
b. Hypnopompic hallucination False perception occurring while awakening from sleep
c. Auditory hallucination False perception of sound, usually voices but also other noises, such as music; most
common hallucination in psychiatric disorders.
d. Visual hallucination False perception involving sight consisting of both formed images (for example,
people) and unformed images (for example, flashes of Light); most common in
medically determined disorders.
e. O lfactory hallucination False perception of smell; most common in medical disorders.
f. Gustatory hallucination False perception of taste, such as unpleasant taste, caused by an uncinate seizure; most
common in medical disorders.
g. Tactile (haptic) hallucination False perception of touch or surface sensation, as from an amputated limb (phantom limb);
crawling sensation on or under the skin (formication)
h. Somatic hallucination False sensation of things occurring in or to the body, most often visceral in origin (also
known as cenesthesic hallucination)
i. Lilliputian hallucination False perception in which objects are seen as reduced in size (also termed micropsia)
j. Mood-congruent hallucination Hallucination in which the content is consistent with either a depressed or a manic
mood (for example, a depressed patient hears voices saying that the patient is a bad

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 person; a manic patient hears voices saying that the patient is of inflated worth, power,
and knowledge).
k. Mood-incongruent hallucination Hallucination in which the content is not consistent with either depressed or manic mood
(in depression, hallucinations not involving such themes as guilt, deserved punishment or
inadequacy; in mania, hallucinations not involving such themes as inflated worth or power.
l. Hallucinosis Hallucinations, most often auditory, that are associated with chronic alcohol abuse and that
occur within a clear sensorium, as opposed to delirium tremens, hallucinations that occur
in the text of a clouded sensorium.
m. Trailing phenomenon Perceptual abnormality associated with hallucinogenic drugs in which moving objects are
seen as series of discrete and discontinuous images.
n. command hallucination
2. Illusion Misperception or misinterpretation of real external sensory stimuli
B. DISTURBANCES ASSOCIATED WITH : agnosia – an inability to recognize & interpret the significance of sensory impressions.
COGNITIVE DISORDER & MEDICAL
CONDITIONS
1. Anosognosia (ignorance of illness) A person's inability to recognize a neurological deficit as occurring to himself or
herself.
2. Somatognosia (ignorance of the body) A person’s inability to recognize a body part as his or her own (autotopagnosia)
3. Visual agnosia Inability to recognize objects or persons.
4. Astereognosis inability to recognize objects by touch.
5. Prosopagnosia inability to recognize faces
6. apraxia Inability to carry out specific tasks
7. Simultagnosia inability to comprehend more than one element of a visual scene at a time or to
integrate the parts into a whole
8. Adiadochokinesia inability to perform rapid alternating movements.
9. Aura warning sensations such as automatisms, fullness in the stomach, blushing, and
changes in respiration; cognitive sensations, and affective states usually experienced
before a seizure; a sensory prodrome that precedes a classic migraine headache.
C. DISTURBANCES ASSOCIATED WITH somatization of repressed material or the development of physical symptoms and
CONVERSION AND DISSOCIATIVE distortions involving the voluntary muscles or special sense organs; not under
PHENOMENA: voluntary control an{! not explained by any physical disorder.
1'. Hysterical anesthesia loss of sensory modalities resulting from emotional conflicts
2. Macropsia state in which objects seem larger than they are
3. Micropsia State in which objects seem smaller than they are (both macropsia and micropsia can
also be associated with clear organic conditions, such as complex partial seizures).
4. Depersonalization A person's subjective sense of being unreal, strange, or unfamiliar.
5. Derealization A subjective sense that the environment is strange or unreal; a feeling of changed
reality.

6. Fugue Taking on a new identity with amnesia for the old identity; often involves travel or
wandering to new environments.
7. Multiple personality One person who appears at different times to be tow or more entirely different
personalities and characters(called DID in the 4th edition DSM-IV)
8. Dissociation Unconscious defense mechanism involving the segregation of any group of mental or
behavioral processes from the rest of the person’s psychic activity; may entail the
separation of an idea from its accompanying emotional tone, as seen in dissociative &
conversion disorders.
VII. Memory: function by which information stored in the brain is later recalled to consciousness
A. DISTURBANCES OF MEMORY
1. Amnesia Partial or total inability to recall past experiences; may be organic or emotional in
origin.
a. Anterograde Amnesia for events occurring after a point in time
b. Retrograde Amnesia for -vents occurring before a point in time.
2. Paramnesia Falsification of memory by distortion of recall.
a. Fausse reconnaissance false recognition
b. Retrospective falsification Memory becomes unintentionally (unconsciously) distorted by being filtered
through a person's present emotional, cognitive, and experiential state.
c. Confabulation Unconscious filling of gaps in memory by imagined (r untrue experiences that a
person believes but that have no basis in fact; most often associated with | organic
pathology.

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 d. Déjà vu Illusion of visual recognition in which a new situation is incorrectly regarded as a
repetition of a previous memory.

e. Déjà entendu Illusion of auditory recognition.

f. Déjà pense Illusion that a new thought is recognized as a thought previously fell or expressed.
g. Jamais vu false feeling of unfamiliarity with a real situation that a person has experienced

h. False memory A person's recollection and belief by the patient of an event that did not actually
occur.
3. Hypermnesia Exaggerated degree of retention and recall.
4. Eidetic image Visual memory of almost hallucinatory vividness
5. Screen memory a consciously tolerable memory covering for a painful memory
6. Repression A defense mechanism characterized by unconscious forgetting of unacceptable ideas or
impulses.
7. Lethologica Temporary inability to remember a name or a proper noun.
8. Blackout Amnesia experienced by alcoholics about behavior during drinking bouts; usually
indicates that reversible brain damage has occurred.
B. LEVELS OF MEMORY
1. Immediate Reproduction or recall of perceived material within seconds to minutes
2. Recent Recall of events over past few days
3. Recent past Recall of events over past few months
4. Remote Recall of events in distant past
VIII. INTELLIGENCE: ability to understand, recall, mobilize, and constructively integrate previous
learning in meeting new situations.
a. Mental retardation lack of intelligence to a degree in which there is interference with social and
vocational performance: mild (IQ of 50 or 55 to approximately 70), moderate (IQ of
35 or 40 to 5O or 55), severe (IQ of 20 or 25 to 35 or 40), or pro-found (IQ below 20
or 25); obsolete terms are idiot (mental age less than 3 years), imbecile (mental age of
3 to 7 years), and moron (mental age of about 8).
b. Dementia Organic and global deterioration of intellectual functioning without clouding of
consciousness.
I. Dyscalculia (acalculia) Loss of ability to do calculations; not caused by anxiety or impairment in
concentration.
2. Dysgraphia (agraphia) Loss of ability to write in cursive style; loss of word structure.
3. Alexia Loss of a previously possessed reading facility; not explained by defective visual
activity.
c. Pseudodementia Clinical features resembling a dementia not caused by an organic condition; most
often caused by depression (dementia syndrome of depression).
d. Concrete thinking literal thinking; limited use of metaphor without understanding of nuances of
meaning; one-dimensional thought.
e. Abstract thinking Ability to appreciate nuances of meaning; multidimensional thinking with ability to use
metaphors and hypotheses appropriately.
IX. INSIGHT A person's ability to understand the true cause and meaning of a situation (such as a set of
symptoms).
a. Intellectual insight Understanding of the objective reality of a set of circumstances without the ability to
apply the understanding in any useful way to master the situation

B. True insight
understanding of the objective reality of a situation, coupled with the motivation and the
emotional impetus to master the situation.
C. Impaired insight diminished ability to understand the objective reality of a situation
X. JUDGMENT Ability to assess a situation correctly and to act appropriately in the situation.
A. Critical judgment Ability to assess, discern, and choose among various options in a situation
b. Automatic judgment Reflex performance of an action.
c. Impaired judgment Diminished ability to Understand a situation correctly and to act appropriately.

DEFENSE Means and ways of avoiding emotional stress, destructive impulses, or threat to self-esteem
MECHANISMS
NARCISSISTIC DEFENSES
Denial Avoidance of the awareness of some painful aspects of reality by negating the sensory data

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Distortion External reality is grossly reshaped to suit inner needs including the unrealistic beliefs, hallucinations, wishful thinking,
delusions
Splitting External objects are divided into extreme category to the other
"all good" and "all bad" accompanied by abrupt shifting of an object from one
Projection Unconscious blaming of unacceptable inclinations or thoughts on an external object
IMMATURE DEFENSES
Acting Out The person expresses an unconscious wish or impulse through action to avoid being conscious of an accompanying effect.
Blocking A temporary or transient inhibition of thinking which resembles repression but differs in that tension arises when the
impulse, affect or thoughts are inhibited
Hypochondriasis Reproach arising from bereavement, loneliness, or unacceptable aggressive impulses toward others is transformed into
self-reproach and complaints of pain, somatic illness, and neurasthenia.
Introjection Accepting another person's attitudes, beliefs, and values as one's own
Passive-Aggressive Aggression towards others is expressed indirectly through passivity, masochism, and turning against the self.
Behavior
Regression Person moves back to the previous developmental stage in order to feel safe or have needs met.
Fixation The immobilization of a portion of a personality resulting from unsuccessful completion of tasks in a development stage.
Somatization Converting psychic derivatives into bodily symptoms & tending to react with somatic manifestations, rather than psychic
manifestations
Schizoid Fantasy Through fantasy, the person indulges autistic retreat to resolve conflicts and obtain gratification.
NEUROTIC DEFENSES
Controlling An excessive attempt to manage or regulate events or objects in the environment to minimize anxiety and to resolve inner
conflicts
Displacement Involves the ventilation of intense feelings towards persons less threatening than the one whom aroused those feelings
Dissociation A temporary but drastic modification of a person's character or of one's sense of personal identity takes place to avoid
emotional distress
Compensation Presence of overachievement in
one area to offset real or perceived deficiencies in another area
Externalization The tendency to perceive elements of one's own personality, including instinctual impulses, conflicts, moods, attitudes
and styles of thinking in the external environment
Identification Modeling actions and opinions of influential others, while searching for identity, or aspiring to reach a personal, social, or
occupational goal
Inhibition Limitation or renunciation of ego functions that occur consciously
Intellectualization Excessive use of intellectual processes to avoid affective expressions or experiences by paying attention to the external
reality
Isolation Separation of the idea from the repressed affect that accompanies it
Rationalization Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-respect
Reaction Formation Acting the opposite of what one feels
Repression Excluding emotionally painful or anxiety provoking thoughts and feelings from conscious awareness
Substitution Replacing the desired gratification with one that is more readily available
Sexualization An object or function is endowed with sexual significance that did not previously have or that it possessed to a similar
degree in order to ward off anxieties associated with prohibited impulses or their derivatives.
MATURE DEFENSES
Anticipation Planning for future inner discomfort that is goal-directed and implies careful planning or worrying and premature but
realistic affective expectation of dire and potentially dreadful outcomes
Humor Permits the overt expression of unpleasant effect on others;
Asceticism Eliminating the pleasurable effects of experiences. There is moral element in assigning values to specific pleasures.
Sublimation Substituting a socially acceptable activity for an impulse that is unacceptable
Suppression A conscious or semiconscious decision to postpone attention to a conscious impulse or conflict

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