Psychiatric Terminology: Affect and Abuse

Psychiatric Terminology

• Abuse is the excessive use of a substance deviating from societal norms
• Affect refers to the emotional range outwardly manifested with ideas

Types of Affect

• Blunt affect is characterized by slow or dull emotional expression
• Flat affect is when there is an absence or near absence of affective expression signs
• Inappropriate affect means the outward expression incongruent with the emotional feeling
• Labile affect is defined as an unstable mood with rapid changes
• Broad affect shows the full range of emotional expression
• Restricted affect shows one type of expression

Further Terminology

• Agitation is excitement coupled with severe motor restlessness
• Akathisia is motor restlessness, typically expressed as the inability to sit still
• Akinesia means there is an absence of movement
• Alogia refers to the inability to speak
• Ambivalence is the state of having opposing feelings or emotions, like love and hate
• Anhedonia is the feeling of no joy
• Anxiety is a feeling of apprehension or tension and is often related to the fear of the unknown
• Apathy is characterized by a lack of feeling, interest, concern, or emotion
• Associative looseness is a sign of disorganized thinking and involves jumping from one unrelated idea to another

Associative Looseness Example

• "Cannot see the sky...oh my love...just asking...mmm maybe tomorrow" exemplifies associative looseness

Bipolar Disorder

• Bipolar disorder, also known as manic-depressive disorder, is characterized by one episode of manic behavior, potentially with a history of depression

Circumstantiality

• Circumstantiality involves a client eventually answering a question but only after providing an excessive amount of unnecessary details

Circumstantiality Example

• Nurse: "Where are you going for the weekend?"
• Patient: "I feel like visiting my sister...I just remembered she ask me a favor...a picnic maybe, in the beach, in hours it gets crowded. That is why I don’t prefer in that place. So, I decided instead to go to my brothers place a nice and big house but now I prefer to stay in my own house."

Clang Association

• Clang association involves the rhyming of words

Clang Association Example

• "I am reading a book, in a shady nook, with the food I cooked" is an example of clang association

Further Terminology

• Confusion is a state of being bewildered and unclear
• Coprolalia is repeating words that are socially unacceptable
• Confabulation is the unconscious filling of gaps in memory or untrue experiences, which a person believes but lacks a basis in reality

Confabulation example

• Nurse: “How are you Tess?” (who spent the day in her apartment)
• Tess: “Well, I came from my friends house who just arrived from Canada. She gave me a lot of gifts, we ate out…it was a wonderful day. I will be going with her when she goes back"

Cyclothymia and Dependence

• Cyclothymia involves mood swings of hypomania and depression
• Dependence is a state where a drug user takes or increases the dosage of a drug to prevent the onset of withdrawal symptoms
• Disinhibition is a state in which a person cannot suppress urges or statements that are socially unacceptable
• Disorientation includes disturbances in orientation of time, place, or person
• Dysthymia is a 2-year chronic depressed mood disturbance
• Delusion is a fixed false belief that has no basis in reality

Types of Delusions

• Paranoid delusion is the belief that someone is going to kill them
• Grandiose delusion is a false belief of being powerful

Grandeur Delusion example

• A grandiose delusion is the false belief one is powerful
• This might be seen in this thought "I am the most handsome male in my class"

Further Types of Delusions

• Religious delusion includes thoughts such as "The devil told me to do this"
• Somatic delusion includes thoughts like "I might get sick"
• Ideas of reference include that one hurt their neighbor because "The lady I saw in the television told me to do it"

Depression

• Depression is a mood disorder characterized by sadness, despair, apathy, and discouragement
• Denial involves avoiding disagreeable realities and refusing to recognize them

Desensitization and Movement Disorders

• Desensitization is a strategy involving gradual exposure to stress-provoking stimuli
• Dyskinesia is abnormal involuntary skeletal movement typically producing a jerky motion
• Dystonia is rigidity of muscles that controls posture, gait, and ocular movement

Echolalia

• Echolalia is the repetition of words heard

Echolalia Example

• Nurse: “Can you please keep the door open.” Patient: “Can you please keep the door open.”

Echopraxia and ECT

• Echopraxia is repetitive, meaningless movement or imitating others
• ECT (Electro Convulsive Therapy) involves administering doses of electric shock to clients with manic-depressive disorders

Euphoria and EPSE

• Euphoria is a subjective, exaggerated feeling of well-being characterized by confidence, elation, and assurance
• EPSE, or Extra Pyramidal Side Effects, involves drug-induced parkinsonism
• Exhibitionism involves the display of body parts to attract others

Fear and Fetishism

• Fear is a response to an objective threat or external stimulus
• Fetishism involves adoring something that serves as a substitute for the original love object

Flight of Ideas

• Flight of ideas involves a flow of verbalization jumping from one unrelated topic to another with a connection between some topics that is hard to identify

Flight of Ideas Example

• “What is today?…might not be taking a bath…I will be cooking at home…the dog kept on barking… there are flowers around me…the food for sure will be delicious.” demonstrates flight of ideas

Flooding and Gait

• Flooding is a method of exposure to fear
• Gait refers to the manner of progression in walking

Hallucinations

• Hallucinations are false sensory perceptions without external stimuli
• Visual hallucinations involve seeing things that aren't there
• Auditory hallucinations involve hearing voices that are not present
• Olfactory hallucinations involve smelling things that do not exist
• Tactile hallucinations involve feeling touched but with an absence of stimuli
• Gustatory hallucinations involve experiencing taste in the absence of stimuli

Helplessness and Hopelessness

• Helplessness denotes being incapable and powerless
• Hopelessness is despairing and having no hope
• Hypervigilance is being alert to danger
• Hypomania is an elevated state less intense than full mania

Sleep Issues

• Hypersomnia is increased and prolonged sleeping
• Insomnia is the inability to sleep or disrupted sleep patterns
• Illusion is a misinterpretation of a real sensory stimulus

Illusion Example

• A patient insisting that a gray sock on the floor is a mouse, is an example of illusion

Libido and Limit Setting

• Libido is energy typically associated with sexual instinct
• Limit setting involves establishing a structured environment with clear ground rules
• Lucid intervals refer to periods where a patient's reasoning and judgment appear normal for a brief time

Malingering, Mania, and Masochism

• Malingering is when someone deliberately pretends to have an illness or a disability
• Mania is a mood disorder characterized by irritability, elation, and hyperactivity
• Masochism involves gaining sexual pleasure from being physically hurt

Mutism and Negativism

• Mutism is a refusal to speak
• Negativism is motiveless resistance to all instruction

Oculogyric Crisis

• Oculogyric Crisis involves the eyes rolling back in a locked position
• Obsession is recurrent, disturbing thoughts that are difficult to push out of the mind
• Compulsion is repetitive behavior performed to decrease anxiety

Neologism, Paranoia, and Pica

• Neologism is inventing new words that are meaningful only to the person
• An example of neologism: ("I cannot stay with you because you are a nic-no-kets")
• Paranoid is extreme suspiciousness of others and their actions
• Pica involves the ingestion of non-edible food

Phobia and Postpartum Depression

• Phobia is an exaggerated fear of a non-dangerous object or situation
• Postpartum depression occurs within 30 days or less in the postpartum period
• Psychomotor retardation is characterized by slow speech and body movement

Psychosis and Psyche

• Psychosis is a mental illness where the patient loses contact with reality and demonstrates bizarre behavior
• Psyche refers to the mind
• Primary gain involves relieving anxiety to feel better
• Secondary gain involves relieving anxiety with the help of others

Perseveration example

• Perseveration is resistance to changing the topic and verbally repeating a sentence

Perseveration

• N – How are you? P – I am fine.
• N – From, where are you? P – I am fine.
• N – What is your name? P–I am fine

Preoccupation, Religiosity, and Resilience

• Preoccupation means being engrossed
• Religiosity involves being preoccupied with religious ideas or content

Resilience, SSRIs, and Sadism

• Resilience is the capacity of an individual to move forward despite psychosocial diversity or genetic vulnerability
• SSRI means Selective Serotonin Reuptake Inhibitors
• Sadism is gaining sexual pleasure by inflicting pain on another person
• Somatic is an adjective referring to the body
• Somnambulism is when a person sleepwalks
• Stereotype is a persistent repetition of senseless acts or words
• Suicide is a self-inflicted death

Sialorrhea, Xerostomia, and Tardive Dyskinesia

• Sialorrhea is excessive drooling of saliva
• Xerostomia is a reduction of saliva
• Tardive Dyskinesia (TD) is an irreversible neurologic disorder
• TCA means Tricyclic Antidepressant

Tolerance and Transference

• Tolerance is the need to increase the amount of a substance to achieve the same effects
• Transference is an unconscious emotional reaction to a current situation that is actually based on a previous experience

Countertransference and Thought Blocking

• Countertransference is a reaction based on the nurse's past experience
• Thought blocking is a sudden cessation of thought in the middle of a sentence

Thought Blocking example

• Losing train of thought mid sentence

Thought Broadcasting, Control, and Insertion

• Thought broadcasting involves a delusional belief that others can hear or know what the client is thinking
• Thought control involves a delusional belief that others can control a person's thoughts against their will
• Thought insertion involves a delusional belief that others have the ability to put thoughts into a person's mind against their will

Thought Stopping, Tics, and Word Salad

• Thought stopping is a technique used to stop a client from thinking of unwelcome thoughts
• Tic is an involuntary, recurrent muscular spasm; motor and vocal tics
• Word salad is combining words or phrases with no connection or sense

Word Salad Example

• I am fine....apple tree...books...toys for sale...be okay is an example of word salad
• Worthlessness is feeling of having no value