Encyclopedia of Psychology An encyclopedia of psychology and mental health terms. 2018-04-06T14:13:42Z https://psychcentral.com/encyclopedia/feed/atom/ WordPress Traci Pedersen <![CDATA[Suicidal Ideation]]> http://psychcentral.com/encyclopedia/?p=1023 2018-01-08T20:41:06Z 2016-07-10T23:35:06Z Suicidal ideation, or suicidal thinking, is the contemplation of ending one’s own life. These types of thoughts may arise in people who feel completely hopeless or believe they can no longer cope with their life situation. Suicidal ideation can vary greatly from fleeting thoughts to preoccupation to detailed planning.

Most people with suicidal ideation do not carry out an actual attempt, but some do. For every 25 attempts, there is one suicide death, according to the Centers for Disease Control and Prevention (CDC). Suicide is the tenth leading cause of death for all ages in the United States, and the third leading cause of death among 15 to 24 year-olds.

It is important to take people seriously when they express having suicidal thoughts. Research has shown that about one-fifth of people who die by suicide had talked to their doctor or other healthcare professional about their decision.

Symptoms or warning signs may include hopelessness, racing thoughts, insomnia or oversleeping, mania, loss of appetite or overeating, loneliness, alcohol abuse, excessive fatigue or low self-esteem.

Research has found a variety of risk factors for suicidal ideation including the following:

  • mood and mental disorders, such as depression, bipolar disorder or borderline personality disorder;
  • adverse life or family events, such as divorce, death of a loved one or loss of a job;
  • chronic illness or pain;
  • previous suicide attempt;
  • military experience;
  • witnessing family violence;
  • strained or non-existent relationship with opposite-sex parent in early to late adolescence;
  • owning a gun;
  • being the victim of abuse or bullying;
  • unplanned pregnancy;
  • and drug or alcohol abuse.

Patients with borderline personality disorder face an extraordinarily high risk of suicidal ideation and suicide attempts. One study showed that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts.

Example: The psychiatric patient had a long history of depression and suicidal ideation with one one failed attempt.

Traci Pedersen <![CDATA[Xenophobia]]> http://psychcentral.com/encyclopedia/2008/xenophobia/ 2018-01-08T20:41:06Z 2016-07-01T04:58:18Z Xenophobia is the fear or dislike of people who are different from oneself, particularly foreigners. The term xenophobia originates from the Greek words xénos (stranger) and phóbos (fear), so it essentially means the fear of strangers; however, it is more often used to describe hatred or hostility.

Xenophobia comprises multiple aspects of prejudice and may be based on any racist, religious, ethnic, cultural or national discrimination. Xenophobic attitudes and behaviors are often triggered by a fear that outsiders or foreigners are a threat to one’s community or national identity. People with xenophobic attitudes often want to secure the perceived purity of their own culture or nation.

For example, an American man who feels threatened or angry that his company has hired Russian interns would be considered xenophobic. Perhaps, deep down he fears that his cultural and religious values are being threatened by what he perceives as an influx of different types of people. He fears being outnumbered or losing his current way of life.

Studies have shown that economic inequalities and poor social conditions can lead to mass fear and tension, giving rise to racism and xenophobia. People who are perceived to be outsiders, such as refugees, asylum-seekers, migrants, displaced persons, and non-nationals, are often targeted.

Example: Her xenophobia is so pronounced, she even refuses to dine in ethnic restaurants.

Traci Pedersen <![CDATA[Client]]> http://psychcentral.com/encyclopedia/2008/client/ 2018-01-08T20:41:06Z 2016-06-30T23:36:43Z In psychology, a client is a person who uses the services of a therapist or social service agency. And although it is often used interchangeably with patient, the term client originally evolved as a way to set apart someone seeking the services of a non-physician therapist, as compared to a physician who cares for the sick (patient). In fact, there is still some debate on whether people under a psychiatrist’s care are considered patients or clients. In almost any case, however, both are considered acceptable terms.

Example: The therapist likes to spend at least one hour with each client.

Traci Pedersen <![CDATA[Psychotic Depression]]> http://psychcentral.com/encyclopedia/?p=927 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Psychotic depression is defined as a major depressive episode with features of psychosis, such as hallucinations and/or delusions. It mainly occurs in patients with bipolar disorder or major depressive disorder. An estimated 10 to 15 percent of people with severe depression will eventually develop symptoms of psychosis.

Hallucinations may be visual, auditory, olfactory (smell) or tactile (touch). Delusions are usually consistent with the patient’s depressive mood (mood-congruent delusions) but may be inconsistent (mood-incongruent delusions). Examples of mood-congruent delusions might include those of guilt, illness, inferiority or punishment. In contrast, a mood-incongruent delusion might be one of grandeur (such as believing oneself to be a king or a god).

About half of patients with psychotic depression experience more than one kind of delusion, and, in most cases, delusions occur without any hallucinations. Many individuals with psychotic depression also feature severe anhedonia — the inability to experience pleasure — and psychomotor retardation.

Psychotic depression is sometimes confused with or misdiagnosed as schizoaffective disorder, as the two conditions feature similar symptoms. The main difference between the two disorders lies in the primary symptom (depression or psychosis) and the order in which the symptoms present themselves.

In psychotic depression, the primary symptom is depression. Psychotic symptoms typically develop after the patient has had several bouts of severe depression without psychosis. Once psychotic symptoms occur, however, they tend to present themselves with each future depressive episode.

In contrast, the primary symptom in schizoaffective disorder is psychosis. Psychotic symptoms must be present for at least two weeks without any mood symptoms. The prognosis is considered worse for patients with schizoaffective disorder compared to those with psychotic depression.

Onset typically occurs between the ages of 20 and 40 with patients typically experiencing an average of 4 to 9 episodes in a lifetime. Family members of patients with psychotic depression are at greater risk for both psychotic depression and schizophrenia.

Example: The psychiatric patient who had been diagnosed with clinical depression refused to eat his dinner because he believed it had been poisoned. The doctor soon realized that the patient had psychotic depression rather than just major depressive disorder.

Traci Pedersen <![CDATA[Delusional Disorder]]> http://psychcentral.com/encyclopedia/?p=924 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Delusional disorder is a psychotic illness characterized by non-bizarre delusions. These are fixed false beliefs that could potentially happen in real life, such as being spied on or poisoned.  The illness lacks many symptoms typically found in other types of psychoses, such as hallucinations, severe cognitive problems, mood instability or flatness.

Non-bizarre delusions are different from bizarre delusions, in which the patient believes a thought that could never be true (such as a man believing he is pregnant with an alien baby).

Some patients with delusional disorder may continue to function and socialize in a seemingly normal way. However, their inner world may cause quite a bit of emotional turmoil. The disorder does not affect the patient’s IQ.

According to the DSM, delusional disorder may be broken down into six subtypes:

  • Erotomanic: Believing someone, often rich or famous, is in love with them.
  • Grandiose: Believing in oneself as the most interesting, beautiful, perfect or intelligent person, etc. ever.
  • Jealous: Believing a partner is cheating.
  • Persecutory: Believing that someone is out to get them or someone they love.
  • Somatic: Believing they have a disease or other medical problem.
  • Mixed: Having more than one subtype.

A diagnosis of delusional disorder is is not given if the patient is also experiencing auditory or visual hallucinations. However, some patients may have olfactory or tactile hallucinations related to the content of their delusions. The delusions also cannot be due to the effects of a drug.

Treatment often involves atypical antipsychotic medication, such as risperidone (Risperdal), quetiapine (Seroquel) or olanzapine (Zyprexa). The patient may also receive cognitive therapy which has proven to be quite helpful.

Example: The patient was convinced that the CIA was watching his every move, even in the hospital bed.

Traci Pedersen <![CDATA[Paraphrenia]]> http://psychcentral.com/encyclopedia/?p=922 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Paraphrenia is a late-onset mental disorder similar to schizophrenia in that it features the positive symptoms of the disease, such as delusions and/or hallucinations, but lacks the negative symptoms, such as the deterioration of intellect or personality.

Compared to schizophrenia, paraphrenia is less hereditary, has a slower rate of progression and doesn’t manifest until the patient is much older, with most patients developing the disorder around the age of 60 or older. Patients also seem more grounded and are better-oriented to time and space compared to patients with schizophrenia. Paraphrenia affects 2-4% of elderly people. While it occurs in both genders, it is more common in women.

Paraphrenia is not included in the DSM-5. More recently, clinicians have been classifying it as very late-onset schizophrenia-like psychosis. In fact, patients who present with these particular symptoms have been diagnosed with a variety of other illnesses, including atypical psychosis, schizoaffective disorder, delusional disorder or persistent persecutory state.

The hallucinations in paraphrenia are often auditory with approximately 75% of patients reporting such an experience. Visual, olfactory and tactile hallucinations have been reported as well.

Those who develop the disease in late life are often described as having eccentric and/or solitary personalities prior to the illness. Many are described as having been argumentative, overly-sensitive, overly religious, suspicious or cold.

It is very common for paraphrenia patients to experience delusions revolving around the idea of persecution. For example, a patient with this disease might believe that the police are staked out in his hedge at night waiting for him to come out, or be convinced that a neighbor is tapped into his phone line, listening to everything he says. Feelings of grandiose, hypochondriacal and erotic delusions have also been reported.

Example: Patricia had long been living alone before she developed full-blown psychosis. Her family members had been estranged for some time, and whenever they tried to contact her, she accused them of trying to steal her money.

Traci Pedersen <![CDATA[Ageism]]> http://psychcentral.com/encyclopedia/?p=920 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Ageism is a form of discrimination toward an individual or group based on their age. The term often refers to the treatment of older people but is occasionally used to define prejudice against young people as well.

The term ‘ageism’ was coined in 1969 by Robert Neil Butler, the first director of the National Institute on Aging and a Pulitzer Prize winning-author. He defined ageism as having three connected elements: prejudicial attitudes toward older people, old age and the aging process; discrimination against older people; and practices and policies that perpetuate stereotypes of older people.

Some particularly persistent stereotypes toward older people include the following: being unable to contribute to society, having a poor memory, being slow and inactive, being out-of-date, and lacking knowledge of technology.

Stereotypes against younger people may include thinking they are too young to contribute any wisdom or knowledge, believing that they cannot think for themselves, or that they will be unruly and misbehave.

There are several forms of ageism, including adultism, gerontocracy and jeunism. Adultism is a favoring of adults over children and teenagers. Gerontocracy is a form of government wherein the leaders are all significantly older than the average adult population. Jeunism is the favoring of younger people and youthful beauty over older people. This can be seen in modern culture, politics, jobs, and anywhere that beauty is preferred over other traits that older adults may offer.

A new definition of ageism was introduced by Iversen, Larsen, & Solem in 2009: “Ageism is defined as negative or positive stereotypes, prejudice and/or discrimination against (or to the advantage of) elderly people on the basis of their chronological age or on the basis of a perception of them as being ‘old’ or ‘elderly’. Ageism can be implicit or explicit and can be expressed on a micro-, meso- or macro-level” (Iversen, Larsen & Solem, 2009).

Example: The actress, who had starred in several movie sequels over a span of generations, was harshly criticized by some people for not looking as attractive as her younger self and for not “aging well.”

Traci Pedersen <![CDATA[Parkinson’s Disease]]> http://psychcentral.com/encyclopedia/?p=917 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Parkinson’s disease (PD) is a degenerative disorder of the central nervous system that mainly affects a patient’s movement. Symptoms include shaking, rigidity, slowness of movement (bradykinesia), changes in speech and writing, and problems with walking. Symptoms arise from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain. The reasons for this cell death are still unclear.

Most cases occur in people over 50 years of age, and when it is found in younger people, it is referred to as young onset PD. In the later stages of the disease, other problems often arise in addition to the motor symptoms, including difficulties with behavior, emotion, sleep and cognition. Depression is very common among PD patients, and dementia often occurs in the later stages.

There is no cure for PD, but some medications such as L-DOPA (precursor to the neurotransmitters dopamine, norepinephrine, and epinephrine) as well as dopamine agonist drugs can improve symptoms in the early stages of the disease. In the later stages, however, these drugs become ineffective as the dopaminergic neurons continue to die, and taking them may lead to bad side effects, such as involuntary writhing movements.

In severe cases that are unresponsive to drug treatment, surgery and deep brain stimulation have been found to help alleviate certain symptoms. Patients may also take medications to relieve some of the non-motor symptoms of PD, such as insomnia and emotional problems.

Some groups of people have a greater or lower risk of developing PD. People who have been exposed to certain pesticides and herbicides and those who carry the virus hepatitis C are at greater risk of PD. Those who eat a Mediterranean diet seem to have some protection from the disease, as do smokers, because of the neuroprotective effect of nicotine on dopaminergic neurons. In fact, nicotine is being explored as a treatment for the disease.

Alternative therapies, such as yoga, meditation, tai chi, acupuncture and massage have been shown to help alleviate symptoms. Taking the supplement coenzyme Q10 may be beneficial for people in the early stages of the disease.

Example: After starting several alternative therapies, including acupuncture and Tai Chi, Roger’s Parkinson’s symptoms and depression have become less severe.

Traci Pedersen <![CDATA[Alzheimer’s Disease]]> http://psychcentral.com/encyclopedia/?p=915 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Alzheimer’s disease (AD) is a neurodegenerative disease occurring in older people that leads to memory loss, disorientation, mood swings, problems with speaking, apathy and lack of interest in self-care.

The disease tends to start slowly — with initial symptoms often mistaken for normal aging — and worsens over time. As AD progresses, bodily functions are lost and the disease often results in death. The average life expectancy after diagnosis is three to nine years.

AD affects about 6% of people ages 65 and older and accounts for 60%-70% of dementia cases. In 2010, the disease affected 21 to 35 million individuals worldwide.

While there is evidence of genetic heritability, AD is most strongly affected by environmental factors. Smokers and those who have suffered from head injuries, depression, diabetes or hypertension are at greater risk for developing the disease.

There is evidence that certain behaviors and eating habits may lower the risk of developing Alzheimer’s. These include mental exercises (reading, playing board games or crossword puzzles and learning a second language), physical exercise, maintaining a healthy weight and eating a Mediterranean diet. There is also evidence that consuming coconut oil can temporarily lower symptoms in Alzheimer’s and dementia patients.

In cases of severe Alzheimer’s disease, patients may exhibit behavioral problems or psychosis. Although these patients are sometimes treated with antipsychotic medications, this type of therapy is considered a last resort and is usually not recommended as these drugs are shown to offer little benefit and carry an increased risk of death.

Example: Sonya continues to visit her beloved grandfather in the nursing home even though he struggles to remember her name due to Alzheimer’s disease.

Traci Pedersen <![CDATA[Tourette Syndrome]]> http://psychcentral.com/encyclopedia/?p=913 2018-01-08T20:43:05Z 2016-06-17T06:37:22Z Tourette syndrome (TS) is a neurological disorder characterized by having the repetitive urge to engage in motor (movement) tics and/or phonic (sound-based) tics. Many TS patients say they perform the tics to ‘release’ a feeling of built-up tension.

The disorder typically emerges in childhood and affects approximately 0.4% to 3.8% of children ages 5 to 18. Severe adulthood cases are rare. The tics, which may range from very mild to very severe, may come and go, alternate or go into a state of remission.

The most common tics among school-age children include eye blinking, throat clearing, coughing, sniffing and facial or body movements. Although the media has focused mainly on TS patients who yell out inappropriate or obscene words — a condition known as coprolalia — these types of tics are actually fairly rare, occurring in only 10 percent of TS patients.

Genetic and environmental factors contribute to the development of TS, but the exact causes are still unknown. TS is often accompanied by other mental health disorders, with the most common being attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD).

TS is named after Georges Albert Édouard Brutus Gilles de la Tourette (1857–1904), a French physician and neurologist. He was the first to publish an account of the disorder in 1885, wherein he described the cases of nine TS patients.

According to the Diagnostic and Statistical Manual of Mental Disorders, TS is diagnosed when multiple motor tics and at least one phonic tic are present for more than one year. There is no cure for TS. Treatment aims to manage symptoms and may include education, psychobehavioral therapy and/or medication.

Example: After Joseph began clearing his throat every few minutes, his mom suspected he may have symptoms of Tourette’s syndrome like her brother.