Encyclopedia of Psychology An encyclopedia of psychology and mental health terms. 2016-04-24T18:08:34Z http://psychcentral.com/encyclopedia/feed/atom/ Traci Pedersen <![CDATA[Tics]]> http://psychcentral.com/encyclopedia/2008/tics/ 2016-04-24T18:08:34Z 2016-04-24T18:05:47Z A tic is a brief, purposeless and often repetitive muscle movement or vocalization, such as eye blinking, throat clearing, or shoulder shrugging. When tics are persistent and difficult to control, the sufferer is often diagnosed with a tic disorder. Tic disorders are neurological conditions that usually emerge during childhood, but in some cases — often due to another medical condition — onset can occur in adulthood.

Most people with tic disorders report feeling a building-up of tension in a particular part of the body and must perform the tic in order to obtain relief — similar to having an overwhelming urge. So while the tic appears somewhat voluntary, it is also in a sense involuntary. Some experts call this phenomenon “semi-voluntary” or “unvoluntary.”

Tics may be classified as motor tics or phonic (or verbal) tics. Motor tics are brief, meaningless and jerky muscle movements, such as eye blinking, arm or leg jerking, face grimacing, neck stretching, eyebrow raising, etc. Phonic tics are those that make a sound using the mouth/airway and/or voice. These might include sounds such as clicking, throat clearing, grunting, squealing, moaning, snorting, etc.

Tics may also be classified as simple or complex. Simple tics involve only one type of repetitive motor or phonic tic, while complex tics involve a cluster of movements or sounds and appear more coordinated. For example, this could be a repetitive tic that involves stretching the neck, blinking the eyes and clicking the tongue, either all at once or in particular order.

Tourette syndrome (TS) is one of the most well-known and potentially severe types of tic disorders. In order to be diagnosed with TS, a person must present with two or more motor tics and at least one phonic tic with symptoms lasting for at least one year. Symptoms also must begin before 18 years of age. Over 85 percent of people with TS have co-morbid conditions, such as obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), depression or anxiety.

People with OCD may exhibit symptoms that are typically associated with tic disorders. In fact, tic-related OCD is considered a subgroup of OCD, distinguishable from non-tic-related OCD by the content and type of obsessions and compulsions. Those with tic-related OCD tend to have more intrusive thoughts and experience more hoarding and counting rituals than those with non-tic-related OCD.

Lesser known forms of tic behaviors that sometimes emerge in people with TS, OCD or autism include echolalia (repeating another person’s words), echopraxia (repeating or imitating another person’s actions), palilalia (repeating one’s own words), lexilalia (repeating words out loud after reading them) or klazomania (compulsive shouting).

Coprolalia (saying aloud socially objectionable words or phrases) is a highly publicized symptom of Tourette syndrome; however, only about 10% of TS patients exhibit coprolalia. A similar version of this is copraxia (performing obscene or inappropriate gestures).

Many patients with tic disorders notice an increase in symptoms during times of relaxation or boredom and a decrease during moments of intense concentration. Neurologist and author Oliver Sacks, for example, wrote of a surgeon with severe Tourette syndrome whose tics remitted almost completely while performing surgery.

Example: Tommy was diagnosed with Tourette syndrome after experiencing a year of stressful and unwanted tics of eye blinking, head shaking and tongue clicking.

 

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Traci Pedersen <![CDATA[Profound Mental Retardation]]> http://psychcentral.com/encyclopedia/?p=968 2016-04-13T16:34:17Z 2016-04-13T16:34:17Z Profound mental retardation is the rarest and most severe form of intellectual disability, comprising just under two percent of all individuals with mental retardation. (Severity is typically categorized as mild, moderate, severe or profound.) A person with profound mental retardation has an IQ score of less than 25. Many are blind, deaf, mute and/or physically disabled.

Many people with profound retardation have an underlying neurological disorder, such as Down syndrome, Cerebral Palsy or Fragile X syndrome, that is at least partially responsible for their intellectual disability. Prenatal conditions and complications, such as severe malnutrition, rubella, toxoplasmosis or fetal alcohol syndrome, may also lead to mental retardation.

Signs of profound retardation are often discovered at birth or soon after. Simple speech and communication is very difficult for these individuals, and they often have to rely on basic gestures or sounds to communicate their needs to others. Children with profound intellectual disability are unable to read, write or do basic math. Their education will often focus on life skills, such as how to respond to potentially dangerous situations or events. Individuals with profound mental retardation are unable to work, live alone or care for themselves.

While many people with profound retardation are immobile, some are able to move around with the assistance of wheelchairs or walkers. A large portion of these individuals live in highly supervised homes and receive assistance for their basic needs, such as eating, bathing and getting dressed. Even when a person with profound retardation lives at home with family, they often require the help of a nurse or other specialist.

The American Association on Mental Retardation (AAMR) has developed another widely accepted diagnostic classification system which focuses on the level of support required rather than the individual’s limitations. The categories include the following: intermittent support (mild retardation), limited support (moderate retardation), extensive support (severe retardation), and pervasive support (profound retardation). Pervasive support refers to lifelong, highly-supervised daily support.

Example: The group home offers 24-hour care for individuals with both severe and profound mental retardation.

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Traci Pedersen <![CDATA[Flat Affect]]> http://psychcentral.com/encyclopedia/2008/flat-affect/ 2016-04-03T20:50:52Z 2016-04-03T20:12:54Z Flat affect is having a lack of emotional expression. It is a symptom typically observed in people with schizophrenia, autism, depression or traumatic brain injury. A person with flat affect may appear unresponsive to the world around them.

The psychology term “affect” refers to one’s expression of emotion as demonstrated through facial expression, tone of voice or body language. It represents the degree to which our outer emotional expressions match how we are feeling on the inside. Less severe versions of flat affect are restricted affect (reduced emotional expression) and blunted affect (severity is somewhere between restricted and flat).

Flat affect is different from apathy (lack of emotion) in that feelings may simply be unexpressed rather than totally lacking. For example, a person with flat affect may feel anxious or surprised, but will not express these emotions through facial expressions, tone of voice or body language. This is supported by the ongoing theory that flat affect is the result of a brain abnormality involving motor function rather than emotional processing.

In schizophrenia, flat affect is considered a negative symptom (indicating a lack of something) and is a strong determinant of a patient’s treatment outcome — those with flat affect often fare more poorly than those without flat affect. Research has shown that flat affect is more common in men than women.

One study found that when schizophrenia patients with flat affect are speaking, they are less fluent and use less inflection. These patients also used fewer words and spoke in smaller sentences. Another study found that schizophrenia patients with flat affect have reduced activation in the limbic system when viewing emotional stimuli.

Example: George, who suffered a severe traumatic brain injury a month ago, is starting to heal in many ways but still exhibits flat affect.

 

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Traci Pedersen <![CDATA[Insanity]]> http://psychcentral.com/encyclopedia/2009/insanity/ 2016-03-17T01:50:00Z 2016-03-16T06:53:45Z Insanity is an informal term denoting mental instability. Today, medical professionals tend to avoid the term “insanity” in favor of “psychopathology.”  Mental disorders that were previously encompassed by the term “insanity” include schizophrenia, bipolar disorder, other types of psychosis and some neurocognitive disorders, such as dementia.

The term “insanity” is still commonly used within legal settings, however. The insanity defense, also called the mental disorder defense, is an attempt to reduce the severity of a charge or sentencing due to the fact that the defendant is not responsible for his actions because of severe mental illness.

Most courts accept major mental disorders, such as psychosis, for an insanity defense, but do not accept depression, anxiety or a less severe personality disorder. One major deciding factor in the insanity defense is whether or not the illness itself interfered with the defendant’s ability to know right from wrong. The insanity defense is used in less than 1 percent of felony cases, and only a fraction of these are actually successful. Those who are found not guilty of a crime due to insanity, are almost always committed to a psychiatric hospital indefinitely.

Example: The judge declared the defendant not guilty because of temporary insanity.

 

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Traci Pedersen <![CDATA[Alpha Brainwaves]]> http://psychcentral.com/encyclopedia/2008/alpha-brain-waves/ 2016-03-15T16:06:16Z 2016-03-15T02:09:45Z Alpha brainwaves are most abundant when the brain is in a “resting” state — when you are awake, calm, alert and having quietly flowing thoughts, such as when you are daydreaming or watching TV.

Brain waves are measured in hertz (Hz), with each Hz representing one cycle per second. Alpha waves fall in the midrange frequency zone (8 Hz to 12 Hz) among the five different types of waves: gamma, beta, alpha, theta and delta (listed from highest to lowest frequency).

When alpha waves are abundant, your sensory inputs are minimal and your mind feels at rest. This relaxed mental state is anywhere from 4 to 20 Hz lower than the highly-focused beta-wave state, which occurs when you are taking a test, for example. So if you were quietly daydreaming and then had to start your homework, your alpha waves would lessen and the beta waves would take over.

Since alpha waves are associated with more tranquil mental states, increasing these waves is the goal of many brainwave treatment programs for mental illness. Alpha wave biofeedback (a method of learning to control one’s mental state by monitoring your own brain waves) has been found to successfully treat anxiety and depression. Mindfulness and meditation are other ways to enhance alpha wave production naturally.

Higher levels of alpha brainwaves are linked to greater creativity as well. If you are experiencing a creative block or writer’s block you may have too much beta and too little alpha activity. A recent study by researchers at the University of North Carolina School of Medicine found that administering a low dose of electrical currents (10 Hz) to the brains of healthy adults enhanced alpha brain activity and boosted creativity by 7.4%.

Example: The patient’s anxiety and racing thoughts diminished after participating in only one session of alpha wave biofeedback.

 

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Traci Pedersen <![CDATA[Delta Brainwaves]]> http://psychcentral.com/encyclopedia/2008/delta-brain-waves/ 2016-03-13T18:09:54Z 2016-03-11T03:33:09Z Delta brainwaves are the slowest, lowest frequencies (.5 Hz to 3 Hz) of the five different types of brainwaves: gamma, beta, alpha, theta and delta (listed from highest to lowest frequency). Delta waves are prominent during dreamless sleep and the deepest stages of meditation. They are also central to unconscious bodily functions such as digestion and heartbeat.

All five brainwaves are essentially present in the brain, even in trace amounts, at all times; however, depending on one’s current state of mind, one type will be particularly dominant.  Brainwaves can be observed with an electroencephalograph (EEG), a tool which records electrical activity in the brain through electrodes built into a cap. If any of the five brainwaves are overactive or underactive, problems can occur in cognition and/or mental health.

When delta waves are functioning optimally, we obtain restful sleep, have a boosted immune system and increased empathy. Delta brainwaves are believed to stimulate healing and regeneration, which is why restorative sleep is so important for the healing process. Delta  waves are most prominent in infants and very young children. As we get older, however, we produce less delta, even during deep sleep.

When people have too little delta activity, sleep will be more restless and they will be unable to feel refreshed and rejuvenated upon waking. Too much delta activity could lead to severe attention deficit hyperactivity disorder (ADHD) and learning problems. Traumatic brain injury (TBI) may also lead to an overflow of delta brainwaves, in which the person will have trouble staying awake.

Example: The patient had an abundance of delta brainwaves after experiencing traumatic brain injury from the car accident. She was in a coma for three days.

 

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Traci Pedersen <![CDATA[Encoding]]> http://psychcentral.com/encyclopedia/2008/encoding/ 2016-03-13T02:46:44Z 2016-03-09T01:32:07Z In psychology, encoding (or memory encoding) is considered the first of three stages in the memory process. The second and third stages are storage and retrieval.

In order to form a memory, the brain must process, or encode, new facts and other types of information into a storable form so that it can be recalled at a later time. There are three ways in which the brain can do this: visual coding (sight), acoustic (sound) coding and semantic (meaning) coding.

For example, when trying to remember a password, you have several options to encode the information into your memory. You could form a mental image of the number/letters in a row (visual coding), repeat it aloud over and over, perhaps in a sing-song voice (acoustic coding), or give the numbers and/or letters some type of meaning, such as “9rh” stands for “9 rabbits hopping” (semantic coding).

Finding ways to encode information is key to enhancing one’s memory. Research has shown that acoustic coding is the brain’s primary strategy for short term memory (STM), while semantic coding is the most successful strategy for long term memory (LTM).

Example: The teacher was always creating new games to help the children encode new information into their memories.

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Traci Pedersen <![CDATA[Hallucinogen]]> http://psychcentral.com/encyclopedia/?p=941 2016-02-11T22:22:13Z 2016-02-11T22:22:13Z A hallucinogen is a psychoactive agent that may cause hallucinations and profound changes in perceptions, thoughts, emotions and/or consciousness. Some natural hallucinogens are found in plants and mushrooms, while others are man-made.

The broad term hallucinogen can be further divided into three basic subtypes: psychedelics, dissociatives and deliriants. Psychedelics are sometimes referred to as “typical” or “traditional” hallucinogens. Some of these include psilocybin (active ingredient in magic mushrooms), DMT, LSD and mescaline (active ingredient in the cactus peyote).

Traditional hallucinogens are thought to work by disrupting the interaction of nerve cells and serotonin, a neurotransmitter involved in the regulation of mood, hunger, muscle control, sensory perception and body temperature.

Dissociatives have historically been used as anesthetics and are known to produce feelings of sedation and detachment. They typically induce a dream-like state or trance. These include ketamine, PCP and nitrous oxide (laughing gas).

Deliriants, which include the anticholinergic drugs diphenhydramine (Benadryl) and dimenhydrinate (Dramamine) as well as uncured tobacco, are known for triggering a state of delirium, often accompanied by dysphoria and unpleasant hallucinations.

Throughout history, many cultures have used plant-based hallucinogens, such as magic mushrooms, ayahuasca or peyote, in their cultural ceremonies to promote healing and spiritual growth. Participants in these ceremonies report experiencing spiritual guidance, visions and/or feelings of detachment.

Currently, most hallucinogens are classified as either Schedule I or Schedule II controlled substances by the U.S. government. However, some hallucinogens have been making a comeback in scientific studies by demonstrating significant therapeutic potential.

For example, LSD-assisted psychotherapy has been found to effectively reduce anxiety in terminally-ill patients. Other studies have shown psilocybin to lessen feelings of depression, help people overcome alcohol and smoking addictions and help previously violent offenders stop aggressive behavior.

Example: Scientists are increasingly conducting studies to test the effects of hallucinogens on willing participants who struggle with mental illness or addiction.

 

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Traci Pedersen <![CDATA[Attention Deficit Hyperactivity Disorder (ADHD)]]> http://psychcentral.com/encyclopedia/?p=939 2016-02-09T21:14:30Z 2016-02-09T21:14:30Z Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental psychiatric condition characterized by attention deficits, hyperactivity and impulsivity not considered appropriate for a person’s age.

ADHD affects approximately 6 to 7 percent of all children and is about three times more common in boys than girls. About 30 to 50 percent of people diagnosed with ADHD in childhood continue to have symptoms in adulthood.

Common symptoms include inattention, hyperactivity, restlessness, impulsivity and disruptive behavior. Many ADHD patients experience academic and relationship difficulties. Symptoms may be difficult to define as these traits also tend to appear — to a lesser extent — in children without ADHD. Knowing where to draw the line between normal and unhealthy behavior can be a difficult task for parents, teachers and doctors.

In order to be diagnosed with ADHD, symptoms must be observed for at least six months and must surpass those of typically developing children of the same age. Symptoms must also interfere with the person’s academic, work or social life.

Based on a person’s most prominent symptoms, ADHD may be divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive and combined type.

The inattentive subtype features all or many of the following symptoms: easily distracted, forgets things, misses details, has difficulty focusing on one task, daydreams often, easily confused, has listening difficulties, struggles to follow instructions, easily loses things, etc.

The hyperactive subtype features all or many of the following symptoms: excessive fidgeting or squirming, nonstop talking, dashing around and touching everything in sight, unable to engage in quiet activities, etc.

People with all subtypes of ADHD tend to have social difficulties and experience a harder time maintaining friendships. About half of children and teens with ADHD experience social rejection by their peers compared to 10–15% of non-ADHD children and adolescents. People with inattentive ADHD may have difficulties processing verbal and nonverbal language which can negatively affect social interaction. They may drift off during conversations or miss social cues.

There is strong evidence that behavioral therapy helps relieve ADHD symptoms, and it is recommended as the first-line treatment for preschool children and for those with only mild symptoms. Regular exercise has also been linked to better behavior and stronger motor skills in people with ADHD. As for pharmaceutical drugs, stimulant medication is the treatment of choice.

ADHD and its treatment have been considered controversial for decades now. There are many disagreements regarding the causes of ADHD and the use of stimulant medication.

Example: Josiah has a hard time sitting still and paying attention in class. After school, his mother takes him to the park to let him run off his extra energy.

 

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Traci Pedersen <![CDATA[Migraine]]> http://psychcentral.com/encyclopedia/?p=937 2016-02-08T15:58:49Z 2016-02-08T15:58:49Z Migraine is a neurological disorder characterized by the recurrence of debilitating headaches. The pain, which can last from three to 72 hours, is moderate to severe and often pulsating in nature. Other symptoms may include nausea, vomiting, and sensitivity to light, sound and/or smell. About fifteen percent of the world’s population have experienced a migraine headache.

Migraines are due to a combination of environmental and genetic factors with about two-thirds of patients having family members with the disorder. Experts believe that migraines are a neurovascular condition that leads to increased activity in the brain’s cerebral cortex and a dysfunction in the pain neurons in the brainstem.

Hormones may play a role as well. For example, while migraines are slightly more common among boys before puberty, they become two to three times more common in women than men post-puberty. Migraines also become less common during pregnancy, another factor suggesting the role of hormones.

The severity of pain, length, and frequency of migraines is extremely variable among patients. Some people experience only a few migraines in a lifetime while others suffer from them every week.

There are four basic stages during a migraine, although not all stages are experienced in every patient. These include the prodrome phase, the aura phase, the pain phase and the postdrome phase.

The prodrome phase occurs days or hours before the headache begins. Over half of migraine sufferers experience this phase and their symptoms vary widely. During this phase, patients may experience irritability, depression, stiff neck, fatigue, cravings, sensitivity to smells or noise, digestive problems or even euphoria.

Approximately one-third of migraine sufferers experience the aura phase. The aura occurs just before onset of the headache and typically last fewer than 60 minutes. This is typically a visual phenomenon but may also be a sensory, language or motor disturbance.

The pain phase, or the headache phase, involves moderate to severe throbbing pain in either one side (unilateral headache) or both sides of the head (bilateral headache) and sometimes the neck. Bilateral headaches occur more often in migraines without an aura. The pain may last anywhere from a few hours to several days. Physical activity often causes the pain to become more intense. Nausea occurs in about 90 percent of sufferers. Many patients also experience fatigue and sensitivity to light, smells and sound.

After the pain has subsided, some patients experience a postdrome phase that may involve head soreness and a feeling of being “hung-over.” This may include gastrointestinal problems, depression, weakness and/or foggy thinking. However, some patients feel unusually refreshed or euphoric after an attack.

Treatment for the occasional migraine may involve simple pain medication such as ibuprofen, Tylenol or caffeine. For those with frequent and/or severe migraines, preventative medications and more powerful pain-relieving drugs are often needed. In some severe cases, surgery may be required. Patients with frequent migraines learn to avoid personal triggers, including certain foods or situations.

Example: Joan’s headaches became so severe that she couldn’t leave the house for days. She would lay in bed for hours with the curtains drawn tightly shut. Her husband watched TV in the other room as she couldn’t handle sound or light.

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