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hypersexuality A stronger than usual urge to have sexual activity. |
hypersomnia Excessive sleepiness, as evidenced by prolonged nocturnal sleep, difficul- ty maintaining an alert awake state during the day, or undesired daytime sleep epi- sodes. See also SOMNOLENCE. |
hypervigilance An enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviors whose purpose is to detect threats. Hypervigilance is also accompa- nied by a state of increased anxiety which can cause exhaustion. Other symptoms include abnormally increased arousal, a high responsiveness to stimuli, and a continual scanning of the environment for threats. In hypervigilance, there is a perpetual scanning of the envi- ronment to search for sights, sounds, people, behaviors, smells, or anything else that is rem- iniscent of threat or trauma. The individual is placed on high alert in order to be certain danger is not near. Hypervigilance can lead to a variety of obsessive behavior patterns, as well as producing difficulties with social interaction and relationships. |
hypomania An abnormality of mood resembling mania but of lesser intensity. See also |
hypopnea Episodes of overly shallow breathing or an abnormally low respiratory rate. |
ideas of reference The feeling that causal incidents and external events have a particu- lar and unusual meaning that is specific to the person. An idea of reference is to be dis- tinguished from a DELUSION OF REFERENCE, in which there is a belief that is held with delusional conviction. |
identity Experience of oneself as unique, with clear boundaries between self and others; stability of self—esteem and accuracy of self—appraisal; capacity for, and ability to regu- late, a range of emotional experience. |
illusion A misperception or misinterpretation of a real external stimulus, such as hear- ing the rustling of leaves as the sound of voices. See also HALLUCINATION. |
impulsivity Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establish- ing and following plans; a sense of urgency and self—harming behavior under emotion- al distress. Impulsivity is a facet of the broad personality trait domain DISINHIBITION. |
incoherence Speech or thinking that is essentially incomprehensible to others because word or phrases are joined together without a logical or meaningful connection. This disturbance occurs within clauses, in contrast to derailment, in which the disturbance is between clauses. This has sometimes been referred to a ”word salad” to convey the degree of linguistic disorganization. Mildly ungrammatical constructions or idiomatic usages characteristic of a particular regional or cultural backgrounds, lack of educa- tion, or low intelligence should not be considered incoherence. The term is generally not applied when there is evidence that the disturbance in speech is due to an aphasia. |
insomnia A subjective complaint of difficulty falling or staying asleep or poor sleep quality. |
824 Glossary of Technical Terms ological indicators of sex.intimacy Depth and duration of connection with others; desire and capacity for close- ness; mutuality of regard reflected in interpersonal behavior. |
intimacy avoidance Avoidance of close or romantic relationships, interpersonal attach- ments, and intimate sexual relationships. Intimacy avoidance is a facet of the broad personality trait domain DETACHMENT. |
irresponsibility Disregard for—and failure to honor—financial and other obligations or commitments; lack of respect for—and lack of follow-through on—agreements and promises; carelessness with others’ property. Irresponsibility is a facet of the broad per- sonality trait domain DISINHIBITION. |
language pragmatics The understanding and use of language in a given context. For example, the warning ”Watch your hands” when issued to a child who is dirty is in- tended not only to prompt the child to look at his or her hands but also to communicate the admonition ”Don’t get anything dirty." lethargy A state of decreased mental activity, characterized by sluggishness, drowsi- ness, inactivity, and reduced alertness. |
macropsia The visual perception that objects are larger than they actually are. Compare with MICROPSIA. |
magical thinking The erroneous belief that one’s thoughts, words, or actions will cause cause and effect. Magical thinking may be a part of normal child development. |
mania A mental state of elevated, expansive, or irritable mood and persistently in- creased level of activity or energy. See also HYPOMANLA. |
manipulativeness Use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one’s ends. Manipulativeness is a facet of the broad personality trait domain ANTAGONISM. |
mannerism A peculiar and characteristic individual style of movement, action, thought, or speech. |
melancholia (melancholic) A mental state characterized by very severe depression. |
micropsia The Visual perception that objects are smaller than they actually are. Com- pare with MACROPSIA. |
mixed symptoms The specifier ”with mixed features” is applied to mood episodes during which subthreshold symptoms from the opposing pole are present. Whereas these con- current ”mixed” symptoms are relatively simultaneous, they may also occur closely juxtaposed in time as a waxing and waning of individual symptoms of the opposite pole (i.e., depressive symptoms during hypomanic or manic episodes, and vice versa). |
mood A pervasive and sustained emotion that colors the perception of the world. Com- mon examples of mood include depression, elation, anger, and anxiety. In contrast to aflect, which refers to more fluctuating changes in emotional ”weather," mood refers to a pervasive and sustained emotional ”climate." Types of mood include dysphoric An unpleasant mood, such as sadness, anxiety, or irritability. |
elevated An exaggerated feeling of well—being, or euphoria or elation. A person with elevated mood may describe feeling ”high,” ”ecstatic,” ”on top of the world," or "up in the clouds.” euthymic Mood in the ”normal” range, which implies the absence of depressed or elevated mood. |
Glossary of Technical Terms 825 expansive Lack of restraint in expressing one’s feelings, frequently with an over- valuation of one’s significance or importance. |
irritable Easily annoyed and provoked to anger.mood-congruent psychotic features Delusions or hallucinations whose content is en- tirely consistent with the typical themes of a depressed or manic mood. If the mood is depressed, the content of the delusions or hallucinations would involve themes of per- sonal inadequacy, guilt, disease, death, nihilism, or deserved punishment. The content of the delusion may include themes of persecution if these are based on self—derogatory concepts such as deserved punishment. If the mood is manic, the content of the delusions or hallucinations would involve themes of inflated worth, power, knowledge, or iden- tity, or a special relationship to a deity or a famous person. The content of the delusion may include themes of persecution if these are based on concepts such as inflated worth or deserved punishment. |
mood-incongruent psychotic features Delusions or hallucinations whose content is not consistent with the typical themes of a depressed or manic mood. In the case of depres- sion, the delusions or hallucinations would not involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. In the case of mania, the delu- sions or hallucinations would not involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person. |
multiple sleep latency test Polysomnographic assessment of the sleep-onset period, with several short sleep-wake cycles assessed during a single session. The test repeat- edly measures the time to daytime sleep onset (”sleep latency”) and occurrence of and time to onset of the rapid eye movement sleep phase. |
mutism No, or very little, verbal response (in the absence of known aphasia). |
narcolepsy Sleep disorder characterized by periods of extreme drowsiness and frequent daytime lapses into sleep (sleep attacks). These must have been occurring at least three times per week over the last 3 months (in the absence of treatment). |
negative affectivity Frequent and intense experiences of high levels of a wide range of negative emotions (e.g., anxiety, depression, guilt/shame, worry, anger), and their be- havioral (e.g., self—harm) and interpersonal (e.g., dependency) manifestations. Nega- tive Affectivity is one of the five pathological PERSONALITY TRAIT DOMAINS defined in |
Section III ”Altemative DSM-5 Model for Personality Disorders.” negativism Opposition to suggestion or advice; behavior opposite to that appropriate to a specific situation or against the wishes of others, including direct resistance to efforts to be moved. |
night eating syndrome Recurrent episodes of night eating, as manifested by eating after awakening from sleep or excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better accounted for by ex- ternal influences such as changes in the individual’s sleep-wake cycle or by local social norms. |
nightmare disorder Repeated occurrences of extended, extremely dysphoric, and well- remembered dreams that usually involve efforts to avoid threats to survival, security or physical integrity and that generally occur during the second half of the major sleep episode. On awakening from the dysphoric dreams, the individual rapidly becomes oriented and alert. |
lated to any substance of abuse that shares some features with substance-induced addiction. |
826 Glossary of Technical Terms obsession Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted and that in most individ- uals cause marked anxiety or distress. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or ac- tion (i.e., by performing a compulsion). |
overeating Eating too much food too quickly.overvalued idea An unreasonable and sustained belief that is maintained with less than delusional intensity (i.e., the person is able to acknowledge the possibility that the be- lief may not be true). The belief is not one that is ordinarily accepted by other members of the person’s culture or subculture. |
panic attacks Discrete periods of sudden onset of intense fear 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 acceler- ated heart rate; chest pain or discomfort; choking; and fear of going crazy or losing con- trol. Panic attacks may be unexpected, in which the onset of the attack is not associated with an obvious trigger and instead occurs ”out of the blue,” or expected, in which the panic attack is associated with an obvious trigger, either internal or external. |
paranoid ideation Ideation, of less than delusional proportions, involving suspicious- ness or the belief that one is being harassed, persecuted, or unfairly treated. |
parasomnias Disorders of sleep involving abnormal behaviors or physiological events occurring during sleep or sleep-wake transitions. Compare with DYSSOMNIAS. |
perseveration Persistence at tasks or in particular way of doing things long after the be- havior has ceased to be functional or effective; continuance of the same behavior de- spite repeated failures or clear reasons for stopping. Perseveration is a facet of the broad personality trait domain NEGATIVE AFFECTIVITY. |
personality Enduring patterns of perceiving, relating to, and thinking about the envi- ronment and oneself. PERSONALITY TRAITS are prominent aspects of personality that are exhibited in relatively consistent ways across time and across situations. Personality traits influence self and interpersonal functioning. Depending on their severity, im- presence of a personality disorder. |
sonality Disorders,” a proposed diagnostic category for use when a personality disor- der is considered present but the criteria for a specific disorder are not met. Personality disorder—trait specified (PD-TS) is defined by significant impairment in personality functioning, as measured by the Level of Personality Functioning Scale and one or more pathological PERSONALITY TRAN" DOMAINS or PERSONALITY TRAIT FACETS. PD—TS is proposed in DSM-5 Section III for further study as a possible future replacement for other specified personality disorder and unspecified personality disorder. |
personality functioning Cognitive models of self and others that shape patterns of emo- tional and affiliative engagement. |
personality trait A tendency to behave, feel, perceive, and think in relatively consistent ways across time and across situations in which the trait may be manifest. |
personality trait facets Specific personality components that make up the five broad per- sonality trait domains in the dimensional taxonomy of Section III ”Altemative DSM-S |
Model for Personality Disorders." For example, the broad domain antagonism has the following component facets: MANIPULA'I'IVENESS, DECEITFULNESS, GRANDIOSITY, ATTEN- |
TION SEEKING, CALLOUSNESS, and HOSTILITY.Glossary of Technical Terms 827 personality trait domains In the dimensional taxonomy of Section III ”Alternative DSM- 5 Model for Rersonality Disorders,” personality traits are organized into five broad do- mains: NEGATIVE AFFECTIVITY, DETACHMENT, ANTAGONISM, DISINHIBITION, and PSY- |
CHOTICISM. Within these five broad trait domains are 25 specific personality trait facets (e.g., IMPULSIVITY, RIGID PERFECTIONISM). |
phobia A persistent fear of a specific object, activity, or situation (i.e., the phobic stimu- lus) out of proportion to the actual danger posed by the specific object or situation that results in a compelling desire to avoid it. If it cannot be avoided, the phobic stimulus is endured with marked distress. |
pica Persistent eating of nonnutritive nonfood substances over a period of at least 1 month. |
The eating of nonnutritive nonfood substances is inappropriate to the developmental level of the individual (a minimum age of 2 years is suggested for diagnosis). The eat- ing behavior is not part of a culturally supported or socially normative practice. |
polysomnography Polysomnography (PSG), also known as a sleep study, is a multipa- rametric test used in the study of sleep and as a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG. PSG monitors many body functions, including brain (electroencephalography), eye movements (electro-oculog- raphy), muscle activity or skeletal muscle activation (electromyography), and heart rhythm (electrocardiography). |
posturing Spontaneous and active maintenance of a posture against gravity (as seen in |
CATATONIA). Abnormal posturing may also be a sign of certain injuries to the brain or spinal cord, including the following: decerebrate posture The arms and legs are out straight and rigid, the toes point downward, and the head is arched backward. |
decorticate posture The body is rigid, the arms are stiff and bent, the fists are tight, and the legs are straight out. |
opisthotonus The back is rigid and arching, and the head is thrown backward. |
An affected person may alternate between different postures as the condition changes. |
pressured speech Speech that is increased in amount, accelerated, and difficult or impossi- ble 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. |
prodrome An early or premonitory sign or symptom of a disorder. |
pseudocyesis A false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy. |
psychological distress A range of symptoms and experiences of a person’s internal life that are commonly held to be troubling, confusing, or out of the ordinary. |
psychometric measures Standardized instruments such as scales, questionnaires, tests, and assessments that are designed to measure human knowledge, abilities, attitudes, or personality traits. |
psychomotor agitation Excessive motor activity associated with a feeling of inner tension. |
The activity is usually nonproductive and repetitious and consists of behaviors such as pac- ing, fidgeting, wringing of the hands, pulling of clothes, and inability to sit still. |
psychomotor retardation Visible generalized slowing of movements and speech.psychotic features Features characterized by delusions, hallucinations, and formal thought disorder. |
psychoticism Exhibiting a wide range of culturally incongruent odd, eccentric, or un- usual behaviors and cognitions, including both process (e.g., perception, dissociation) 828 Glossary of Technical Terms and content (e.g., beliefs). Psychoticism is one of the five broad PERSONALITY TRAIT DO- |
MAINS defined in Section III ”Alternative DSM—S Model for Personality Disorders.” purging disorder Eating disorder characterized by recurrent purging behavior to influ- ence weight or shape, such as self—induced vomiting, misuse of laxatives, diuretics, or other medications, in the absence of binge eating. |
racing thoughts A state in which the mind uncontrollably brings up random thoughts and memories and switches between them very quickly. Sometimes the thoughts are related, with one thought leading to another; other times they are completely random. |
A person experiencing an episode of racing thoughts has no control over them and is unable to focus on a single topic or to sleep. |
rapid cycling Term referring to bipolar disorder characterized by the presence of at least four mood episodes in the previous 12 months that meet the criteria for a manic, hypo- manic, or major depressive episode. Episodes are demarcated either by partial or full remissions of at least 2 months or by a switch to an episode of the opposite polarity (e.g., major depressive episode to manic episode). The rapid cycling specifier can be ap- plied to bipolar I or bipolar II disorder. |
rapid eye movement (REM) A behavioral sign of the phase of sleep during which the sleeper is likely to be experiencing dreamlike mental activity. |
repetitive speech Morphologically heterogeneous iterations of speech.residual phase Period after an episode of schizophrenia that has partly or completed re- mitted but in which some symptoms may remain, and symptoms such as listlessness, problems with concentrating, and withdrawal from social activities may predominate. |
restless legs syndrome An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs (for pediatric restless legs syn- drome, the description of these symptoms should be in the child’s own words). The symptoms begin or worsen during periods of rest or inactivity. Symptoms are partially or totally relieved by movement. Symptoms are worse in the evening or at night than during the day or occur only in the night/evening. |
restricted affectivity Little reaction to emotionally arousing situations; constricted situations. Restricted affectivity is a facet of the broad personality trait domain DETACH- |
rigid perfectionism Rigid insistence on everything being flawless, perfect, and without errors or faults, including one’s own and others’ performance; sacrificing of timeliness to ensure correctness in every detail; believing that there is only one right way to do things; difficulty changing ideas and / or viewpoint; preoccupation with details, orga- nization, and order. Lack of rigid perfectionism is a facet of the broad personality trait domain DISINH'IBITION. |
risk taking Engagement in dangerous, risky, and potentially self-damaging activities, un- necessarily and without regard to consequences; lack of concern for one’s limitations and denial of the reality of personal danger; reckless pursuit of goals regardless of the level of risk involved. Risk taking is a facet of the broad personality trait domain DISINHIBrI'ION. |
rumination (rumination disorders) Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re—chewed, re-swallowed, or spit out. In rumination disorders, there is no evidence that an associated gastrointestinal or an- other medical condition (e.g., gastroesophageal reflux) is sufficient to account for the repeated regurgitation. |
Glossary of Technical Terms 829 seasonal pattern A pattern of the occurrence of a specific mental disorder in selected seasons of the year. |
self-directedness, self—direction Pursuit of coherent and meaningful short—term and life goals; utilization of constructive and prosocial internal standards of behavior; ability to self—reflect productively. |
separation insecurity Fears of being alone due to rejection by and / or separation from significant others, based in a lack of confidence in one’s ability to care for oneself, both physically and emotionally. Separation insecurity is a facet of the broad personality trait domain NEGATIVE AFFECTIVITY. |
sex Biological indication of male and female (understood in the context of reproductive capacity), such as sex chromosomes, gonads, sex hormones, and nonambiguous inter- nal and external genitalia. |
sign An objective manifestation of a pathological condition. Signs are observed by the examiner rather than reported by the affected individual. Compare with SYMPTOM. |
sleep-onset REM Occurrence of the rapid eye movement (REM) phase of sleep within minutes after falling asleep. Usually assessed by a polysomnographic MULTIPLE SLEEP |
LATENCY TEST.sleep terrors Recurrent episodes of abrupt terror arousals from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream. |
There is intense fear and signs of autonomic arousal, such as mydriasis, tachycardia, rapid breathing, and sweating, during each episode. |
sleepwalking Repeated episodes of rising from bed during sleep and walking about, usually occurring during the first third of the major sleep episode. While sleepwalking, the person has a blank, staring face, is relatively unresponsive to the efforts of others to communicate with him or her, and can be awakened only with great difficulty. |
somnolence (or ”drowsiness”) A state of near—sleep, a strong desire for sleep, or sleep- ing for unusually long periods. It has two distinct meanings, referring both to the usual state preceding falling asleep and to the chronic condition that involves being in that state independent of a circadian rhythm. Compare with HYPERSOMNIA. |
specific food cravings Irresistible desire for special types of food. |
startle response (or "startle reaction”) An involuntary (reflexive) reaction to a sudden unexpected stimulus, such as a loud noise or sharp movement. |
stereotypies, stereotyped behaviors/movements Repetitive, abnormally frequent, non- goal-directed movements, seemingly driven, and nonfunctional motor behavior (e.g., hand shaking or waving, body rocking, head banging, self—biting). |
stress The pattern of specific and nonspecific responses a person makes to stimulus events that disturb his or her equilibrium and tax or exceed his or her ability to cope. |
stressor Any emotional, physical, social, economic, or other factor that disrupts the nor- mal physiological, cognitive, emotional, or behavioral balance of an individual. |
stressor, psychological Any life event or life change that may be associated temporally (and perhaps causally) with the onset, occurrence, or exacerbation of a mental disorder. |
stupor Lack of psychomotor activity, which may range from not actively relating to the environment to complete immobility. |
submissiveness Adaptation of one’s behavior to the actual or perceived interests and desires of others even when doing so is antithetical to one's own interests, needs, or desires. Submissiveness is a facet of the broad personality trait domain NEGATIVE AF- |
830 Glossary of Technical Terms subsyndromal Below a specified level or threshold required to qualify for a particular condition. Subsyndromal conditions (formesfrustes) are medical conditions that do not meet full criteria for a diagnosis—for example, because the symptoms are fewer or less the ”full-blown” syndrome. |
suicidal ideas (suicidal ideation) Thoughts about self—harm, with deliberate consider- ation or planning of possible techniques of causing one’s own death. |
suicide The act of intentionally causing one’s own death.suicide attempt An attempt to end one’s own life, which may lead to one’s death. |