Encyclopedia of Psychology An encyclopedia of psychology and mental health terms. 2016-05-15T19:41:45Z http://psychcentral.com/encyclopedia/feed/atom/ Traci Pedersen <![CDATA[Depersonalization]]> http://psychcentral.com/encyclopedia/2008/depersonalization/ 2016-05-15T01:59:49Z 2016-05-13T21:35:28Z Depersonalization is a harmless, but often very troubling, mental state characterized by a disruption in one’s self-perception and awareness. The sufferer’s thoughts, emotions and actions feel detached, unreal or foreign, as if they are not a part of oneself.

Depersonalization, as well as derealization (the feeling that the external world is unreal), is the most prominent symptom in dissociative disorders, such as dissociative identity disorder (previously known as multiple personality disorder). Depersonalization may also occur as a result of extreme anxiety, panic, sleep deprivation, other mental disorders and certain types of drug use or withdrawal. In some patients, for example, long-term use of benzodiazepines can induce chronic depersonalization and perceptual disturbances. Withdrawal from benzodiazepines can result in the same.

People who are suffering from depersonalization feel separated from their own physicality, meaning that their own feelings, emotions, bodily sensations and movements feel detached from themselves. These symptoms are very disturbing and lead to even higher levels of anxiety, further exacerbating the feelings of detachment.

While anyone experiencing stress or severe insomnia can have short bouts of mild to moderate depersonalization, those who have undergone trauma or prolonged anxiety may begin having more severe, chronic depersonalization/derealization symptoms. When symptoms are long-term, it is known as depersonalization-derealization disorder.

Depersonalization is a fairly common mental state, coming in third only after anxiety and depression. In one study, researchers found that students who scored high on the depersonalization/derealization subscale of the Dissociative Experiences Scale had a more pronounced cortisol response.

When depersonalization sets in, it is often advisable to notice one’s physical surroundings and to purposefully remain in the present moment. For example, it is helpful to name the objects in one’s immediate surroundings — chair, table, phone, cat. Say aloud your name, the date, your address, etc. Stay grounded and present. Depersonalization can be scary, but it is not harmful.

Example: A woman awakens from a frightening dream and feels strangely unlike her usual self. When she gets up to wash her face, she gets the strange feeling that she is outside of her body, watching herself from the bathroom doorway.

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Traci Pedersen <![CDATA[Derealization]]> http://psychcentral.com/encyclopedia/?p=976 2016-05-08T14:08:07Z 2016-05-08T14:08:07Z Derealization (DR) is a psychiatric condition in which a person’s perception of reality is altered in such a way that everything feels unfamiliar or unreal. DR is typically not a stand-alone disorder, but a side effect of severe anxiety, panic or certain types of drug use or withdrawal. It may also occur with some neurological disorders, such as epilepsy, head injury or migraine.

DR is a dissociative symptom, meaning that it produces feelings of detachment from the self or the environment. The feelings of detachment that come with derealization are said to be like an invisible veil or fog has been placed between oneself and the outside world. Some sufferers say it feels like the external world is just a TV show, as if one is simply an observer of an unfamiliar world. A person who is experiencing derealization will often say there is a lack of emotional connection to familiar people, places and things. Feelings of deja vu are also common.

The symptoms of DR tend to be very frightening and disturbing, and the sufferer often has a hard time believing that they are only the result of anxiety and not something much more serious. This anxiety intensifies the derealization, which in turn intensifies the anxiety, often resulting in a vicious cycle.

Another closely related dissociative disorder is called depersonalization — feelings of unreality in one’s own self rather than the external world. Although derealization and depersonalization often occur together, they are considered distinct symptoms. While most people who experience derealization or depersonalization recover fairly quickly, there are some individuals who continue to have symptoms long-term, typically after a major trauma. When this happens, it is called depersonalization-derealization disorder.

Example: One month after his panic attacks began, Jeff started to have episodes in which he would feel as if nothing was real.

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Traci Pedersen <![CDATA[Anorexia Nervosa]]> http://psychcentral.com/encyclopedia/2008/anorexia-nervosa/ 2016-05-15T19:41:45Z 2016-04-28T15:27:31Z Anorexia nervosa, or simply anorexia, is an eating disorder characterized by an extremely low body weight, an irrational fear of gaining weight and severe food restrictions. Symptoms of anorexia may include eating tiny amounts of food or only certain foods, weighing oneself incessantly, excessive exercising, forcing oneself to vomit or using laxatives. Even when anorexia patients are severely underweight, they often see themselves as being too heavy.

Diagnosis of anorexia and severity of the disorder is based on a patient’s body mass index (BMI). Adults with with an extreme case of anorexia tend to have a BMI of less than 15. A BMI of 15-16 would indicate a slightly less lethal but still severe case of anorexia. A BMI of 16-17 would indicate a moderate form of the disorder, and a BMI of 17 or slightly higher would indicate a mild form.

Anorexia is more common among females and is estimated to affect about 0.9% to 4.3% of women in Western countries compared to 0.2% to 0.3% of men. However, men are at greater risk of being under referred, underdiagnosed or misdiagnosed. The disorder typically emerges in the teen years or during young adulthood. Long-term complications of anorexia might include menstruation problems, infertility, anemia, kidney and liver damage, osteoporosis and heart problems.

The disorder appears to stem from a mixture of genetic, cultural and environmental factors. The disorder may be triggered by stressful life events. Higher rates of anorexia are seen among groups that value smaller, fat-free frames such as modeling, dancing and some high-intensity sports. Anorexia was directly related to about 600 deaths worldwide in 2013. It is also indirectly linked to other causes of death, including suicide.

Treatment often involves addressing the underlying psychological issues (such as body dysmorphic disorder) and helping the patient return to a healthy weight. Medications may be used to help with anxiety and depression, which are very common in patients with anorexia. In severe cases, patients may need to check in to a hospital in order to gain weight, overcome malnutrition and receive correct behavioral therapy. When a patient is severely underweight, quick weight gain can be dangerous.

Example: Allison was admitted to the hospital for her long-term anorexia when her BMI eventually dipped below 15.

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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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