DSM Glossary of Technical Terms

A pattern of observable behaviors that is the expression of a subjectively experienced feeling state (emotion). Common examples of _____ are sadness, elation, and anger. In contrast to mood, which refers to a more pervasive and sustained emotional "climate," ____ refers to more fluctuating changes in emotional "weather." What is considered the normal range of the expression of _____ varies considerably, both within and among different cultures.

Significant reduction in the intensity of emotional expression.

Absence or near absence of any signs of affective expression.

Discordance between affective expression and the content of speech or ideation.

Abnormal variability in affect with repeated, rapid, and abrupt shifts in affective expression.

Mild reduction in the range and intensity of emotional expression.

Excessive motor activity associated with a feeling of inner tension. The activity is usually nonproductive and repetitious and consists of such behavior as pacing, fidgeting, wringing of the hands, pulling of clothes, and inability to sit still.

A chemical entity extrinsic to endogenously produced substances that acts on a receptor and is capable of producing the maximal effect that can be produced by stimulating that receptor. A partial agonist is capable only of producing less than the maximal effect even when given in a concentration sufficient to bind with all available receptors.

A chemical entity extrinsic to endogenously produced substances that acts on a family of receptors (such as mu, delta, and kappa opiate receptors) in such a fashion that it is an agonist or partial agonist on one type of receptor and an antagonist on another.

An impoverishment in thinking that is inferred from observing speech and language behavior. There may be brief and concrete replies to questions and restriction in the amount of spontaneous speech (poverty of speech). Sometimes the speech is adequate in amount but conveys little information because it is overconcrete, overabstract, repetitive, or stereotyped (poverty of content).

Loss of memory.

Loss of memory of events that occur after the onset of the etiological condition or agent.

Loss of memory of events that occurred before the onset of the etiological condition or agent.

A chemical entity extrinsic to endogenously produced substances that occupies a receptor, produces no physiologic effects, and prevents endogenous and exogenous chemicals from producing an effect on that receptor.

The apprehensive anticipation of future danger or misfortune accompanied by a feeling of dysphoria or somatic symptoms of tension. The focus of anticipated danger may be internal or external.

An impairment in the understanding or transmission of ideas by language in any of its forms—reading, writing, or speaking—that is due to injury or disease of the brain centers involved in language.

An inability to produce speech sounds that require the use of the larynx that is not due to a lesion in the central nervous system.

Partial or complete loss of coordination of voluntary muscular movement.

The ability to focus in a sustained manner on a particular stimulus or activity. A disturbance in _____ may be manifested by easy distractibility or difficulty in finishing tasks or in concentrating on work.

An inability to initiate and persist in goal-directed activities. When severe enough to be considered pathological, _______ is pervasive and prevents the person from completing many different types of activities (e.g., work, intellectual pursuits, self-care).

Waxy flexibility—rigid maintenance of a body position over an extended period of time.

Episodes of sudden bilateral loss of muscle tone resulting in the individual collapsing, often in association with intense emotions such as laughter, anger, fear, or surprise.

Marked motor abnormalities including motoric immobility (i.e., catalepsy or stupor), certain types ofexcessive motor activity (apparently purposeless agitation not influenced by external stimuli),extreme negativism (apparent motiveless resistance to instructions or attempts to be moved) ormutism, posturing or stereotyped movements, and echolalia or echopra.

A loss of, or alteration in, voluntary motor or sensory functioning suggesting a neurological or general medical condition. Psychological factors are judged to be associated with the development of the symptom, and the symptom is not fully explained by a neurological or general medical condition or the direct effects of a substance. The symptom is not intentionally produced or feigned and is not culturally sanctioned.

Automatic psychological process that protects the individual against anxiety and from awareness of internal or external stressors or dangers.
________ _________ mediate the individual's reaction to emotional conflicts and to external stressors. Some (e.g., projection, splitting, and acting out) are almost invariably maladaptive. Others, such as suppression and denial, may be either maladaptive or adaptive, depending on their severity, their inflexibility, and the context in which they occur. Definitions of specific _______ _______ and how they would be recorded using the Defensive Functioning Scale are presented in Defensive Functioning Scale.

A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.

The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith). When a false belief involves a value judgment, it is regarded as a ______ only when the judgment is so extreme as to defy credibility. ______al conviction occurs on a continuum and can sometimes be inferred from an individual's behavior. It is often difficult to distinguish between a ______ and an overvalued idea (in which case the individual has an unreasonable belief or idea but does not hold it as firmly as is the case with a ______). ________ are subdivided according to their content

A delusion that involves a phenomenon that the person's culture would regard as totally implausible.

The delusion that one's sexual partner is unfaithful.

A delusion that another person, usually of higher status, is in love with the individual.

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

A delusion in which feelings, impulses, thoughts, or actions are experienced as being under the control of some external force rather than being under one's own control.

A delusion whose theme is that events, objects, or other persons in one's immediate environment have a particular and unusual significance. These delusions are usually of a negative or pejorative nature, but also may be grandiose in content. This differs from an idea of reference, in which the false belief is not as firmly held nor as fully organized into a true belief.

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

A delusion whose main content pertains to the appearance or functioning of one's body.

The delusion that one's thoughts are being broadcast out loud so that they can be perceived by others.

The delusion that certain of one's thoughts are not one's own, but rather are inserted into one's mind.

An alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).

("loosening of associations") A pattern of speech in which a person's ideas slip off one track onto another that is completely unrelated or only obliquely related. In moving from one sentence or clause to another, the person shifts the topic idiosyncratically from one frame of reference to another and things may be said in juxtaposition that lack a meaningful relationship. This disturbance occurs between clauses, in contrast to incoherence, in which the disturbance is within clauses.
An occasional change of topic without warning or obvious connection does not constitute derailment.

An alteration in the perception or experience of the external world so that it seems strange or unreal (e.g., people may seem unfamiliar or mechanical).

Confusion about the time of day, date, or season (time), where one is (place), or who one is (person).

A disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic.

The inability to maintain attention, that is, the shifting from one area or topic to another with minimal provocation, or attention being drawn too frequently to unimportant or irrelevant external stimuli.

Imperfect articulation of speech due to disturbances of muscular control.

Distortion of voluntary movements with involuntary muscular activity.

Primary disorders of sleep or wakefulness characterized by insomnia or hypersomnia as the major presenting symptom. ________ are disorders of the amount, quality, or timing of sleep.

Disordered tonicity of muscles.

The pathological, parrotlike, and apparently senseless repetition (echoing) of a word or phrase just spoken by another person.

Repetition by imitation of the movements of another. The action is not a willed or voluntary one and has a semiautomatic and uncontrollable quality.

A recurrence of a memory, feeling, or perceptual experience from the past.

A nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations, distracting stimuli, or plays on words. When severe, speech may be disorganized and incoherent.

A persistent aversion toward some or all of those physical characteristics or social roles that connote one's own biological sex.

A person's inner conviction of being male or female.

Attitudes, patterns of behavior, and personality attributes defined by the culture in which the person lives as stereotypically "masculine" or "feminine" social roles.

An inflated appraisal of one's worth, power, knowledge, importance, or identity. When extreme, _________ may be of delusional proportions.

A sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ.
________ should be distinguished from illusions, in which an actual external stimulus is misperceived or misinterpreted. The person may or may not have insight into the fact that he or she is having a _________.

One person with auditory ________ may recognize that he or she is having a false sensory experience, whereas another may be convinced that the source of the sensory experience has an independent physical reality.

The term is not ordinarily applied to the false perceptions that occur during dreaming, while falling asleep (hypnagogic), or when awakening (hypnopompic). 

A hallucination involving the perception of sound, most commonly of voices. Some clinicians and investigators would not include those experiences perceived as coming from inside the head and would instead limit the concept of true ________ hallucinations to those sounds whose source is perceived as being external. However, as used in DSM-IV, no distinction is made as to whether the source of the voices is perceived as being inside or outside of the head.

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

A hallucination involving the perception of odor, such as of burning rubber or decaying fish.

A hallucination involving the perception of a physical experience localized within the body (such as a feeling of electricity). A ______ hallucination is to be distinguished from physical sensations arising from an as-yet undiagnosed general medical condition, from hypochondriacal preoccupation with normal physical sensations, and from a tactile hallucination.

A hallucination involving the perception of being touched or of something being under one's skin. The most common ______ hallucinations are the sensation of electric shocks and formication (the sensation of something creeping or crawling on or under the skin).

A hallucination involving sight, which may consist of formed images, such as of people, or of unformed images, such as flashes of light. ______ hallucinations should be distinguished from illusions, which are misperceptions of real external stimuli.

Painful sensitivity to sounds.

Excessive sleepiness, as evidenced by prolonged nocturnal sleep, difficulty maintaining an alert awake state during the day, or undesired daytime sleep episodes.

The feeling that casual incidents and external events have a particular and unusual meaning that is specific to the person. This is to be distinguished from a delusion of reference, in which there is a belief that is held with delusional conviction.

A misperception or misinterpretation of a real external stimulus, such as hearing the rustling of leaves as the sound of voices. See also hallucination.

Speech or thinking that is essentially incomprehensible to others because words 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 as "word salad" to convey the degree of linguistic disorganization. Mildly ungrammatical constructions or idiomatic usages characteristic of particular regional or cultural backgrounds, lack of education, or low intelligence should not be considered ________. The term is generally not applied when there is evidence that the disturbance in speech is due to an aphasia.

A subjective complaint of difficulty falling or staying asleep or poor sleep quality. 

Difficulty in falling asleep.

Awakening in the middle of the night followed by eventually falling back to sleep, but with difficulty.

Awakening before one's usual waking time and being unable to return to sleep.

A condition in which an individual shows intermingling, in various degrees, of the characteristics of each sex, including physical form, reproductive organs, and sexual behavior.

The visual perception that objects are larger than they actually are.

The erroneous belief that one's thoughts, words, or actions will cause or prevent a specific outcome in some way that defies commonly understood laws of cause and effect. _____ ______ may be a part of normal child development.

The visual perception that objects are smaller than they actually are.

A pervasive and sustained emotion that colors the perception of the world. Common examples of ____ include depression, elation, anger, and anxiety. In contrast to affect, which refers to more fluctuating changes in emotional "weather," ____ refers to a more pervasive and sustained emotional "climate."

An unpleasant mood, such as sadness, anxiety, or irritability.

An exaggerated feeling of well-being, or euphoria or elation. A person with ______ mood may describe feeling "high,""ecstatic,""on top of the world," or "up in the clouds."

Mood in the "normal" range, which implies the absence of depressed or elevated mood.

Lack of restraint in expressing one's feelings, frequently with an overvaluation of one's significance or importance.

Easily annoyed and provoked to anger.

Delusions or hallucinations whose content is entirely consistent with the typical themes of a depressed or manic mood. If the mood is depressed, the content of the delusions or hallucinations would involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment.
The content of the delusion may include themes of persecution if these are based on self-derogatory concepts such as deserved punishment.
If the mood is manic, the content of the delusions or hallucinations would involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person.
The content of the delusion may include themes of persecution if these are based on concepts such as inflated worth or deserved punishment.

Delusions or hallucinations whose content is not consistent with the typical themes of a depressed or manic mood. In the case of depression, the delusions or hallucinations would not involve themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. In the case of mania, the delusions or hallucinations would not involve themes of inflated worth, power, knowledge, or identity, or a special relationship to a deity or a famous person.
Examples  include persecutory delusions (without self-derogatory or grandiose content), thought insertion, thought broadcasting, and delusions of being controlled whose content has no apparent relationship to any of the themes listed above.

Involuntary rhythmic movements of the eyes that consist of small-amplitude rapid tremors in one direction and a larger, slower, recurrent sweep in the opposite direction. May be horizontal, vertical, or rotary.

An unreasonable and sustained belief that is maintained with less than delusional intensity (i.e., the person is able to acknowledge the possibility that the belief may not be true). The belief is not one that is ordinarily accepted by other members of the person's culture or subculture.

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

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

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

Enduring patterns of perceiving, relating to, and thinking about the environment and oneself.

These traits are prominent aspects of _______ that are exhibited in a wide range of important social and personal contexts. Only when _______ traits are inflexible and maladaptive and cause either significant functional impairment or subjective distress do they constitute a ______ Disorder.

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

Speech that is increased in amount, accelerated, and difficult or impossible to interrupt. Usually it is also loud and emphatic. Frequently the person talks without any social stimulation and may continue to talk even though no one is listening.

An early or premonitory sign or symptom of a disorder.

Visible generalized slowing of movements and speech.

This term has historically received a number of different definitions, none of which has achieved universal acceptance. The narrowest definition of ______ is restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature. A slightly less restrictive definition would also include prominent hallucinations that the individual realizes are hallucinatory experiences. Broader still is a definition that also includes other positive symptoms of Schizophrenia (i.e., disorganized speech, grossly disorganized or catatonic behavior).

Unlike these definitions based on symptoms, the definition used in DSM-II and ICD-9 was probably far too inclusive and focused on the severity of functional impairment, so that a mental disorder was termed _____ if it resulted in "impairment that grossly interferes with the capacity to meet ordinary demands of life." Finally, the term has been defined conceptually as a loss of ego boundaries or a gross impairment in reality testing. Based on their characteristic features, the different disorders in DSM-IV emphasize different aspects of the various definitions of _______.

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

A person's biological status as male, female, or uncertain. Depending on the circumstances, this determination may be based on the appearance of the external genitalia or on karyotyping.

An objective manifestation of a pathological condition. ____s are observed by the examiner rather than reported by the affected individual.

Repetitive, seemingly driven, and nonfunctional motor behavior (e.g., hand shaking or waving, body rocking, head banging, mouthing of objects, self-biting, picking at skin or body orifices, hitting one's own body).

Any life event or life change that may be associated temporally (and perhaps causally) with the onset, occurrence, or exacerbation of a mental disorder.

A state of unresponsiveness with immobility and mutism.

A subjective manifestation of a pathological condition. _____s are reported by the affected individual rather than observed by the examiner.

A grouping of signs and symptoms, based on their frequent co-occurrence, that may suggest a common underlying pathogenesis, course, familial pattern, or treatment selection.

A condition in which a sensory experience associated with one modality occurs when another modality is stimulated, for example, a sound produces the sensation of a particular color.

An involuntary, sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.

Severe gender dysphoria, coupled with a persistent desire for the physical characteristics and social roles that connote the opposite biological sex.