Psychology, Mental Health and Distress

First edition

by John Cromby, David Harper & Paula Reavey

Searchable Online Glossary

Use the alphabetical list below to find words beginning with each letter.

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z



A

acceptance and commitment therapy
a third-wave behavioural therapy which emphasizes the need to adopt an accepting stance towards oneself

accidie
in medieval times, a mixture of misery, boredom and disgust characterized by a loss of faith in God and a failure to perform required duties

acculturation
a process of psychological transition in which an individual moves from one culture to another; also the exchange or merging of cultural values, behaviours and features that occur when different cultural groups come into direct contact

active placebo
a drug administered to a control group which should not lead to any active improvement but which produces some subjective effects, leading participants to think they are on an active medication: this is a more methodologically rigorous comparison than wholly inert placebos

aetiology
the study of causation of medical diseases

affect synchrony
the reciprocal, mutual regulation of emotional states in two people, commonly an infant and a carer

agonists
drugs which activate neurotransmitter receptors

Alcoholics Anonymous
a self-help movement set up in the USA in 1935 by Bill Wilson and Dr Bob Smith, who had both struggled to find ways of coping with their problem drinking

Alexithymia
a psychiatric term to describe individuals who seem to have difficulty recognizing and interpreting emotions

alienist
a term used to describe a doctor working in state-run asylums during the 19th century (from the French aliene - insane)

alters
the distinct personalities displayed in persons given a diagnosis of Dissociative Identity Disorder

ameliorative
enabling people to cope better without fundamental changes in their relationship to society

amyostatic-akinetic form
a form of encephalitis lethargica, the symptoms of which included rigidity, without a real paralysis, emotions which were mentally present but not facially expressed - also termed 'Parkinsonism'

anomie
Durkheim's term for mismatches between small-group norms and those of wider society, and an absence of a distinct social ethic to unite people: in both senses, anomie refers to phenomena operating at the level of societies rather than individuals

anorexia nervosa
a psychiatric diagnosis given to people who do not maintain a healthy body weight (as defined by the Body Mass Index) and characterized by experiences of persistent and excessive fear of weight gain anti-histamine a drug used in treating allergies

anti-psychiatry
a set of disparate work, mostly published in the 1960s, which rejected the view that mental health problems are illnesses or diseases: see Chapter 1

antipsychotic
a term more recently preferred by drug companies instead of the term 'neuroleptic' or 'major tranquillizer'

Approved Mental Health Professional
in the UK a mental health professional - usually a social worker but sometimes a community mental health nurse or other qualified person - trained to implement elements of the Mental Health Act

arbitrary inference
drawing conclusions in the absence of appropriate evidence

assumptive framework
a worldview within which certain things are implicit and simply taken for granted

asylum
an institution for those seen as mad; the term is derived from the Latin word for refuge or sanctuary

attachment
the idea that the nature of one's early relationships can strongly influence one's mental health as an adult by providing 'templates' for the ways in which we are able as adults to relate to other people; see attachment theory

attachment relationship
in attachment theory, a relationship which, more than others, sets the conditions for the development of systems of emotional control and stress regulation

attachment theory
a psychoanalytic approach pioneered by John Bowlby which proposes that a baby's relations with its parents or carers need to constitute an 'environment of adaptiveness' that is sufficient to enable it to develop adequate life-long mechanisms for regulating emotion and coping with stress

attrition
a reduction or decrease in numbers of participants as some participants drop out, or fail to complete a study

atypical anti-depressants
drugs which increase levels of norepinephrine and dopamine, as well as raising serotonin

atypical antipsychotics
a varied grouping of neuroleptic drugs, described as atypical because they are said to cause fewer unwanted effects than the older 'typical' drugs; some nevertheless appear to act in a similar fashion to the older drugs, and have prominent dopamine-blocking properties

auditory hallucinations
a psychiatric term used to refer to a form of hallucination that involves perceiving sounds without auditory stimulus; a common form involves hearing one or more talking voices

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B

behaviour therapy
a psychotherapy based on the principles of operant conditioning

behavioural genetic research
the study of correlations between diagnostic categories and patterns of genetic relatedness

behaviourism
a philosophy of psychology based on the proposition that psychology should focus only on observable behaviours

benzodiazepines
drugs which increase the levels of gamma-amino butyric acid or GABA; the best known of these drugs is diazepam (brand name 'Valium')

Berkson's bias
the fact that, since people with multiple symptoms are probably more likely to seek help than those with only a few symptoms, the observed correlation between symptoms is likely to be inflated in clinical samples when compared with samples drawn at random from the community

biblio-therapy
a form of self-help therapy, based on self-help books

binge eating disorder
a psychiatric diagnosis given to people who consume large quantities of food (up to 4000 calories) within a very short period (e.g. 2-3 hours). Purging and dieting does not necessarily accompany binging episodes

biological
pertaining to biology

biological disorder
an organic pathology; when something is physically wrong with the body, or causes problems with the body

biological model
a model of distress which prioritizes biological (neurological, brain structural and physiological) explanations. See biomedical

biological psychiatry
an approach to distress which emphasizes the importance of biological causation and of biological treatments

biomedical
an approach to medicine which emphasizes physical processes, such as the pathology, biochemistry and physiology of a disease. See biological model

biomedical model
a model of distress which assumes that it is caused by diseases or illnesses of the brain or mind

biopsychosocial model
an approach to distress which purports to show how biological, psychological and social influences interact, but which critics say frequently prioritizes biological infl uences over others; see Chapter 4

bipolar disorder
a psychiatric diagnosis given to people who experience extreme fl uctuations of mood. Can be differentiated into bipolar I disorder, given to people who experience psychosis and extreme mania; and bipolar II disorder, given to people who experience elevated moods that are considered hypomanic and excluding anyone having psychotic experiences

bisexuality
where a person can be sexually attracted to a member of any gender

body image
an individual's perception of their body shape and size and the sexual attractiveness of their own body

body image distortion (BID)
a psychiatric term to describe a person who appears to hold an inaccurate and exaggerated view of their body weight and size

body mass index (BMI)
a measure of body fat currently used in the UK

bulimia nervosa
a psychiatric diagnosis given to people who restrict their intake of food, sometimes for long periods of time, but then eat excessively for short periods, followed by purging behaviours, such as the use of laxatives and vomiting

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C

cannabis psychosis
a psychiatric diagnosis that may be given when a psychotic experience is thought to have been primarily caused or triggered by cannabis use

capitalism
an economic system based on the principles of the free market

Cartesian dualism
a term that means the same as mind-body dualism and which is drawn from the name of the philosopher Rene Descartes, who first formalized this view

catastrophic misinterpretation
where ordinary bodily sensations are mistaken for serious problems - for example, thinking that chest pain caused by indigestion is actually a heart attack

catecholaminic
of or relating to catecholamines: a subset of the monoamine neurotransmitters, such as epinephrine and dopamine, that have similar effects on the sympathetic nervous system

categorical models
models of distress that clearly distinguish it from mental health and assume that it falls into discrete categories (e.g. as opposed to dimensions)

causal attributions
everyday common-sense explanations for behaviour and its consequences

child sexual abuse
using a child for the purpose of sexual gratification: this can include exposure, using the child in pornography, verbal and physical contact between an adult and child, or contact between a child five years older than another child

Cialis
the commercial name for the drug tadalafil, used to treat male erectile dysfunction

circadian rhythms
the biorhythms or 'body clocks' that govern sleeping, wakefulness, and levels of energy and activity

cisgender
refers to individuals whose gender assigned at birth matches their social and personally ascribed gender role or identity

classical conditioning
the behaviourist principle of how associations can be learned by the temporal pairing of an external stimulus, such as a bell, with an involuntary reflex, such as a dog's salivation

client
a term sometimes used to describe a person who receives an intervention for distress; it is often used in the context of psychological therapies

client-centred therapy
a form of humanistic psychotherapy in which the therapist adopts core values of genuineness in their responses, empathy for their client, and unconditional positive regard for their client (derived from the work of Carl Rogers)

clinical psychology
a relatively young subdiscipline of psychology which emerged in the USA and UK with the Second World War, which aims to use psychological theory to reduce distress and enhance and promote well-being

coercive treatment
the non-consensual delivery of treatment or services to individuals who are either reluctant or refuse to enter treatment unless forced. See compulsory treatment

cognition
the act or process of knowing or thinking

Cognitive analytic therapy
a form of psychological therapy developed by Anthony Ryle in the UK in the 1980s and 1990s. It draws from both cognitive and psychoanalytic traditions, focusing on helping the client understand repetitive emotional and relational patterns in their life

cognitive-behavioural therapy (CBT)
a synthesis of both cognitive and behavioural therapies that aims to modify an individual's thought processes and behaviour

cognitive therapy
a form of psychotherapy in which thoughts and beliefs are seen as influencing emotion: consequently, a person's distress might be relieved by changing their thoughts and beliefs

Cold War
historically, a sustained state of political and military tension between the Eastern Bloc (i.e. the former Soviet Union and its allies) and the Western Bloc (i.e. the USA, NATO and its allies); often dated 1947-1991

collaborative empiricism
therapeutic strategies designed to exploit a client's ability to reason almost scientifically about what has happened in their life: clients are encouraged to weigh up and evaluate the evidence for distressing beliefs, propose alternative accounts of their experiences, and try simple behavioural experiments to test out their hypotheses

collectivist
societies (mainly non-industrial or developing societies) in which selfhood is largely seen to be invested in or derived from community and family activities and relations

College of Sexual and Relationship Therapists
a UK charity for sexual and relationship therapy

communication deviance (CD)
a form of vague communication associated with unfocused attention

communication theory
a theory concerning how information and meaning is conveyed and passed between people

community care
treating and caring for people in their homes rather than in an institution

Community Treatment Order (CTO)
a directive issued to those undertaking Supervised Community Treatment (e.g. to take medication, attend day centres, allow visits by mental health professionals) which they must adhere to so they can be treated at home

co-morbidity
the simultaneous diagnosis of more than one illness - e.g. a psychiatric disorder - in an individual

component studies
studies of the 'active' ingredients of cognitive behavioural therapies

compulsory treatment
treatment given without a person's consent. See coercive treatment

computerized axial tomography(CAT)
an imaging technique where a computer pictures a slice of body tissue using x-rays

conditions of possibility
the socio-culturally and historically specific conditions which make a particular experience and its interpretation possible; often identified by analysing the discourses commonly used to construct and situate this experience

conscientization
a term referring to the development of a critical awareness of society, whereby one understands the political roots of one 's own oppression. A concept developed by Paolo Freire

consumer
a term used to refer to those who use mental health services, now seen by many activists as giving the misleading impression that they are freely choosing consumers of services when, for instance, compulsory treatment is not a choice

consumer culture
a term referring to societies in which the purchasing of material goods is driven by desire rather than need

consumerism in individuals, the socially and economically driven desire to purchase goods and services in ever greater amounts; in a culture, the tendency to emphasize people's social role as consumers as a significant element of their identity and status, or to explain their actions largely on this basis

contingently
dependent for existence, occurrence, character and so on something not yet certain and therefore somewhat unpredictable

control group
a comparison group in an experiment, against which the efficacy of the experimental intervention can be compared; the members of this group receive either no treatment or one whose efficacy is already established

convenience samples
research participants who happened to be readily available, and whom we imagine are suitable

convergence zone
in neuroscience, a term sometimes used to refer to brain regions where information from many neural networks and systems gets collated together

conversion therapy
also termed reorientation/reassignment therapy: a therapeutic technique designed to reorient an individual from a homosexual or bisexual sexual orientation to a heterosexual orientation

correspondence bias
a tendency to make assumptions about a person's dispositions from behaviours that can be explained entirely by the situations in which they occur

cosmetic surgery
procedures designed to enhance an individual's physical appearance

cothymia
a single diagnosis that encompasses experiences of mixed sadness and worry

counter-narrative
an alternative narrative or story running counter to a more dominant narrative

couples therapy
a therapeutic approach which aims to give couples the tools to communicate more eff ectively, negotiate differences, problem solve and even argue in a healthier way

cross-dressing
the adoption of the dress code of the opposite gender

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D

decompensation
the functional deterioration of a previously working structure or system in the human body; this can occur as a result of trauma, fatigue, stress, disease or ageing

degenerationist theories
theories popular in the 19th and early 20th century but now discredited, which argue that the unrestricted reproduction of people with disabilities or psychiatric diagnoses will result in hereditary degradation, i.e. a cumulative process where each subsequent generation is seen as descending further into imbecility

de-institutionalization
the closing down of large mental hospitals and the development of new forms of treatment for distress in the community

delusion
a belief sincerely held by a person (e.g. a service user) which is considered false or impossible by mental health professionals or by wider society

delusional dominating personality disorder (DDPD)
a psychiatric diagnosis proposed ironically by Caplan and Margrit as a response to self-defeating personality disorder to describe men who comply enthusiastically with male gender norms, and including criteria like 'a tendency to feel inordinately threatened by women who fail to disguise their intelligence'

de-personalization or de-realization
where either the self, the surrounding world, or both, are experienced as fundamentally strange or unreal and the person feels profoundly detached from things that are happening; frequently includes physiological dimensions such as palpitations, hyperventilation, heightened muscular tension, dry mouth, tight chest, difficulty breathing, frequent need to urinate, hot flushes, sweating, tremors, numbness and tingling around the mouth and in the fingers and toes

developing countries
countries of lower economic wealth, usually corresponding with less industrialization and technology

deviance model
a model of behaviour which frames that behaviour as deviant or as a criminal act

diagnostic categorizations
defi nitions of diff erent categories of distress with lists of indicative symptoms

dialectical behaviour therapy (DBT)
a third wave behavioural therapy which draws on cognitive behavioural theories, dialectical philosophy and Zen Buddhist practice; that recognizes the signifi cance of invalidating early environments, and in which therapists try to balance an overall validating approach with encouragement to make therapeutic changes

diathesis
a vulnerability or impairment, typically organic in character

dichotic listening
where two different audio stimuli are presented simultaneously to each ear

dimensional models
models of distress that do not presume a sharp dividing line between mental health and mental illness, instead seeing distressing experiences as existing along a continuum

Discourse
A way of looking at the world (e.g. a set of images, texts, beliefs and metaphors) that acts as a cultural resource from which people may draw to understand and represent their experiences (e.g. of distress).For Michel Foucault, discourses are not simply narratives, rather they are embedded into institutions like the Church, the academy and so on and so he saw them as 'practices that systematically form the objects of which they speak' - in other words they construct particular versions of reality (e.g. that distress is a medical illness)

discriminant validity
the extent to which a measure diff erentiates between two or more constructs

disease-centred model
the view that psychiatric drugs work by correcting a defective or diseased brain; according to this model, drug treatment renders the brain more normal by helping to reverse an underlying biological abnormality that leads to experiences of distress

disorganized attachment relationship
an attachment relationship in which, rather than simply being the main source of comfort and security, carers themselves become a source of fear and anxiety for their infants

dissociation
a partial or complete disruption or disintegration of an individual's conscious or psychological functioning; a common response to trauma, sometimes seen as a way of coping that allows people to 'space out' or 'switch off '

dissociative identity disorder
a psychiatric diagnosis give to individuals who seemingly display a number of distinct identities or personalities (sometimes known as alters or alter egos) each with its own unique perspective and ways of behaving; this diagnosis used to be called Multiple Personality Disorder

dissociative states
states in which people experience dissociation

distress
a non-medical concept, used in this book in place of terms like 'mental illness' or 'psychopathology'; a general term for all of the kinds of mental health diffi culties for which people might receive clinical psychological or psychiatric interventions

divination
a religious process or ritual carried out by a healer to read signs of future events, including illness and spirit possession

dose-response relationship
the change in effect on an organism caused by differing levels of exposure (or doses) to an agent (e.g. a drug) or a stressor (i.e. they have a tendency to co-vary)

double-blind
a clinical trial in which neither the research participant nor the health professional is aware of whether the participant is in the intervention or control (comparison) group double-blind randomized controlled trials
double-blind
clinical trials where participants are randomly allocated to the intervention or control (comparison) group - designed to minimize the influence of things like selection and the effects of expectation; often referred to as the 'gold standard' of treatment research

drapetomania
a purported (and discredited) mental disorder associated with the desire to escape from slavery

drug-centred model
the view that psychiatric drugs, like all psychoactive drugs, modify the functioning of the nervous system and so produce altered mental states; this model suggests that drugs can sometimes be helpful because the features of the altered drug-induced state can be functional in some circumstances (but not in others)

DSM
The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association: one of the two major works defining the diagnostic criteria used by psychiatrists (the other is the International Classification of Diseases). Each successive version until now has been denoted by a Roman numeral e.g. DSM III, but the forthcoming version is currently being referred to as DSM 5.

dual representation theory
the theory that we have one memory system that stores consciously processed verbal or narrative aspects of a traumatic event, and a separate system that stores images, sounds, and feeling states or bodily reactions: in essence, all of the sensory, non-verbal aspects

dynamic
pertaining to or characterized by energy or effective action; vigorously active or forceful; not fixed and stable

dysfunction
when a system - whether understood as psychological or cognitive (e.g. memory), or as bodily and biological (e.g. the dopamine system) - fails to function in the normal manner

dyspareunia
experience of pain during sexual penetration

dysregulates
impairs the capacity for control and regulation

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E

early maladaptive schemas
in cognitive psychology, unhelpful ways of viewing the world which develop in response to aversive experiences in early childhood

eating disorders
a group of psychiatric diagnoses characterized by unusual eating habits, including restrictive or excessive food intake, which may have negative consequences for mental and physical health

eating disorders not otherwise specified (EDNOS)
a psychiatric diagnosis given to people whose eating patterns are considered unusual but who do not meet the criteria for the main eating disorders diagnoses; by far the most common diagnosis in this area of psychiatry

ecological model of systems
Bronfenbrenner's (1979) model which conceptualizes systems as having four levels: micro, meso, exo, and macro

effectiveness
the study of whether a therapy 'works' in a real-life clinical setting

efficacy
the study of whether a therapy 'works' in an experimental setting

electro-convulsive therapy (ECT)
a form of therapy whereby an epileptic seizure is induced via the administration of electricity to the brain; typically given when people are experiencing profound sadness, sometimes described by psychiatrists as a 'treatment of last resort', for example when it is considered that a person is at immediate risk of committing suicide and has not responded to other treatments

electromyography
a procedure of recording the tiny electrical impulses in muscle tissue

embodied
an aspect of experience that is shaped by the character of our physical bodies

embodiment
the location and the character of our bodies within the world; those aspects of experience shaped by the location and character of our bodies in the world

emic
an approach prioritizing the meanings a person attributes to their beliefs, experiences and behaviours, using their own cultural and community reference points

emotion work
a sociological concept that refers to the ways people are sometimes expected to manage, cultivate, refine and display their emotions in line with the expectations of employers or others

empowerment
ways in which groups with less power - for example, those with little access to economic resources - attain greater power

epidemiology
a branch of medicine that involves the study of how frequently different diseases occur in different populations

epigenetics
the study of how environmental influences can produce heritable changes in off spring without changing their genes

equal environment assumption (EEA)
the assumption that environmental influence operates equally for both monozygotic (MZ) and dizygotic (DZ) twins: typically, that MZ twin pairs are treated no more similarly than DZ twin pairs

etic
an approach prioritizing a universal (as opposed to local) definition of beliefs, experiences and behaviours, offered by a scientific observer, with the aim to be culturally neutral and objective

eugenics
a movement in politics and social policy popular in the 19th and early 20th century but now discredited, which advocated the use of practices aimed at improving the genetic composition of a population, usually human; based on the idea that certain groups of people were genetically inferior and that if they were allowed to reproduce freely they would weaken the genetic composition of the general population. See degenerationist theories

existentialist philosophy
a philosophy derived from the view that life is essentially meaningless and that we need to strive to create meaning in our own lives

exo
level of Bronfenbrenner's ecological model of systems involving more distal systems which influence proximal systems (e.g. local authorities and school governing bodies), which impact on the micro and meso systems

experience
something that happens within the life and subjective awareness of a person

expressed emotion (EE)
the amount of emotion (usually hostile or negative) displayed in a family

external locus of control
where one believes that causal agency for events is located outside - rather than inside - oneself

external validity
the ability to generalize to the real world from the artificial circumstances of an experimental situation

externalizing attributional bias
the specific tendency to attribute events to the actions of others - e.g. when negative events are seen as caused by others rather than oneself

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F

family blaming
holding families morally responsible for the development of the distress of a member of the family

family therapy
a form of psychotherapy in which individual distress is seen to arise from problems in relationships and communication between family members; the therapist therefore uses a range of strategies to help family members change the way they relate to one another

feminism
a collection of social movements with a shared aim of promoting equal rights for women

feminist
a person who upholds or proclaims the principles of feminism

feminist family therapy
uses feminist theories to explore the relationship between wider cultural messages about gender (as well as a variety of socio-political and socio-economic factors, such as race, class and disability that can impact on family life) in the generation and maintenance of family difficulties and psychological distress. The approach advocates the establishment of egalitarian relationships within the family and a non victim-blaming position

fetishism
recurrent sexual arousal from inanimate objects

first rank symptoms
a variety of hallucinations and delusions (see Schneiderian)

five factor model
a personality model which proposes that all human personalities contain greater or lesser degrees of the same five traits: openness to experience, conscientiousness, extraversion, agreeableness and neuroticism

flashbacks
moments where vivid memories of trauma get re-lived involuntarily, and are accompanied by severe emotional impacts

flooding
introduction of a feared stimuli in its full form in behavioural therapy, whilst the person is in a relaxed state

formulation
an individual summary of someone's difficulties, based on psychological theory; it can be seen as a kind of a story or narrative which attempts to link the person's difficulties to the relationships and events in their lives, and the sense they have made of their experiences: see Chapter 5

free association
a psychotherapeutic strategy used in psychoanalysis in which people are encouraged to say whatever words come to mind in relation to a topic

function creep
where an original goal is revised to include additional goals

functional diagnoses
psychiatric diagnoses in which behaviour is judged to be dysfunctional but no consistent organic basis for the dysfunction has been shown

functional MRI (fMRI)
an imaging technique which uses magnetic fields to generate measures of blood oxygen levels in the brain; these are thought to be consistently related to neural activity

functional redundancy
a frequent feature of complex systems where there are many possible pathways to what is, functionally, much the same outcome

fundamental attribution error
a common tendency to over-emphasize internal or dispositional factors (such as personality or motivation) in accounting for the actions of others

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G

gamma-aminobutyric acid or GABA
an inhibitory neurotransmitter that dampens down the rate of neural fi ring

gay affirmative therapy
a form of psychotherapy that encourages gay or bisexual clients to learn to accept and celebrate their sexual orientation rather than attempt to change it to a heterosexual orientation

gender identity disorder
a psychiatric diagnostic category describing a person who views their current biological sex as contrary to their perceived gender identity (usually opposite to the one they were assigned at birth)

gender inequalities
the discrepancy between access to rights and resources as a function of one's membership of a gender category (male/female)

gender roles
the set of prescribed norms (relating to emotions, behaviour and thinking) considered to be socially and culturally appropriate for individuals of a designated gender (male/female)

gender variance
holding gender traits that are contrary to one's biological sex (according to culturally prescribed norms of gendered behaviour)

general paralysis of the insane
neurological condition, commonly diagnosed in the 19th century; subsequently found to be caused by syphilis

generalizable
the capacity to infer a general principle, trend and so on from particular facts, statistics, or the like

genome scan
an analysis of the entire genome of an individual that compares its character to established markers for diseases and disease characteristics

genome-wide association studies
molecular genetic studies which compare the prevalence of putative genetic markers between groups of unrelated individuals given a diagnosis, and control groups of similar people without a diagnosis

glial cells
brain cells which support the neuronal tissue

good enough parenting
from the work of Donald Winnicott, where parents and carers meet their child's basic needs for nutrition, warmth, and comfort; are responsive to their child's emotional needs, offering comfort and reassurance that is fairly consistent across time, communicated sufficiently clearly, pitched at the right kind of level, and arrives relatively soon after it is first needed

graded exposure
a therapeutic strategy in behavioural therapy where a person employs coping strategies as they expose themselves to feared objects or situations, working through a hierarchy from the least feared to most feared level

grandiose beliefs
when an individual seems to think that they are uniquely special in some way (e.g. that they are Jesus)

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H

habituation
how, over time, we become used to responding to something - such as distress - in a particular way that may become somewhat familiar and even reassuring

hallucination
a general term for the perception of a stimulus that is not present

hearing voices
a form of auditory hallucination

heteronormativity
the view that men and women should adhere to a biologically prescribed set of gender-specific behaviours (e.g. women as exclusive care givers). Within this, heterosexuality is viewed as the only 'natural' and 'normal' form of sexual orientation

heterosexual
an individual who is sexually attracted to a member of the opposite gender

historicism
a mode of thinking that assigns a central and basic significance to a specific context, such as historical period, geographical place or local culture

holistic
a perspective which emphasizes the interrelationships between different elements of the self

homeodynamics
the striving of the body-brain system to maintain certain key variables within strict limits; the equilibria produced are always fluctuating around an optimal point; this optimal point itself fluctuates somewhat, according to environmental circumstances: sometimes called homeostasis

homicide
the act of a human killing another human

homosexual
an individual who is sexually attracted to a member of the same gender

homosexuality
sexual attraction to one's own gender

human sexual response cycle (HSRC)
a model of sexual stimulation and activity developed by sexologists William Masters and Virginia Johnson. The model involves four stages of sexual response: excitement, plateau, orgasm and resolution

humanist philosophy
a philosophy which asserts that those without religious faith can still act ethically and morally because of their faith in human values

humanistic psychotherapy
a form of psychotherapy based on humanist philosophy

hyperkinetic form
a form of encephalitis lethargica, the symptoms of which include restlessness and involuntary movements

hypervigilance
a general sensory state referring to an individual's exaggerated senses and behaviours, used to check for perceived threat, which usually results in fatigue

hypnotism
the practice whereby a person is put into a trance-like and suggestible state

hypomania
a psychiatric term to describe milder experiences of mania, in which mood is elevated, expansive or irritable but not to such an extent or for such a length of time as to meet the criteria for a manic episode

hypothalamic-pituitaryadrenal (HPA) axis
a term that summarizes a complex set of interactions and feedback loops between the hypothalamus and the pituitary and adrenal glands

hysteria
a purported disorder - now discredited - said to occur largely in women, supposedly signified by a wide range of symptoms including anything from anxiety and fainting to insomnia and loss of appetite for food or sex

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I

iatrogenic problem
a problem created by the treatment itself

ICD
The International Classification of Diseases, produced by the World Health Organization, which includes a section on psychiatric diagnoses. Each successive version is numbered e.g. ICD 10

impotence
the inability to develop or maintain an erection; also called male erectile dysfunction

incidence
the number of new cases of something during a fixed time period (e.g. over the course of a year) and the occurrence of this within a population

individualism
a philosophical tradition which emphasizes the properties, experiences and agency of the individual

industrialization
the historical shift from a broadly agricultural and rural society to an industrial and urban society, signalling technological and economic advances

ineffable
incapable of being fully expressed or described in words

inner speech
the unspoken commentary that we experience accompanying the actions of ourselves and others; how language is part of the way that we think

insecure-ambivalent attachment relationship
an attachment relationship in which carers are somewhat inconsistent in their responses: sometimes they respond appropriately to their infant's needs, but at other times fail to do so; infants respond to this kind of care by coping relatively well with short periods of separation, but when the carer returns they display anger and reluctance, before eventually showing any degree of warmth

insecure-avoidant attachment relationship
an attachment relationship in which carers show relatively little emotional response to their infant's distress, encouraging independence and self-reliance, and infants respond by becoming relatively autonomous when separated from their carers; they show relatively little distress when left briefly alone, but relatively little joy when their carers return

institutionalization
the process whereby, over time, a person begins to structure their life according to the routines of an institution, gradually losing their independence and becoming more dependent on the institution's routines and practices

insulin coma therapy
a form of therapy in which temporary comas were induced in patients through the administration of insulin

internal validity
a characteristic of experiments that enables experimenters to be confident that any observed outcomes are produced by the experimental variables

internalized stigma
where the discriminatory attitudes of others are adopted - internalized - by service users themselves

interpenetrate
when two or more things (e.g. humans and their environments) come to include aspects of each other

interpersonal
thoughts and emotions communicated between individuals; pertaining to relationships between people

interpersonal therapy
a style of therapy that focuses on the interpersonal context in which a person lives, such as their intimate relationships and family, and concentrates on building a set of interpersonal skills with the client to enable the establishment of stronger and more fulfilling relationships and a greater sense of personal well-being

intersex
term used to describe individuals with gender characteristics that may be indistinguishable as being typically either male or female or typically both male and female

intrapersonal
thoughts and emotions taking place within the individual

introspection
the reporting by a participant of their conscious thoughts, memories, feelings and experiences

involuntary commitment
US term referring to compulsory admission to hospital (also termed civil commitment)

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K

Kingsley Hall
a therapeutic community in the East end of London, which ran for five years from 1965 to 1970

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L

labelling theory
the notion that mental illness is actually the end result of a series of social processes whereby 'abnormal' behaviour is subtly reinforced

leucotomy
a surgical procedure in which the connections to and from the prefrontal cortex are cut; sometimes called a lobotomy

liberalism
a political and economic philosophy, associated with capitalism, which emphasizes tolerance and equal rights

lifeline
from the work of biologist and neuroscientist Steven Rose: the trajectory of a living creature as it grows, develops and ages, as it constantly modifies, and is modified by, the various environments it occupies

lifetime prevalence
how many people would meet diagnostic criteria over the course of their lifetime

limbic kindling
where the limbic system enters into a continuously hyperactive state

linkage studies molecular genetic studies which try to identify genetic markers associated (linked) with specific diseases, using statistical analyses to estimate whether the linkage might have occurred by chance

lobotomy
The pre-frontal leucotomy technique after being adapted by the American surgeon Walter Freeman

locus coeruleusnorepinephrine (LC-NE) system
a brain system that begins in the pons and radiates upward, and has close connections with the

hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system

low sexual desire or hypoactive sexual desire
the absence of sexual thoughts, fantasies or desire for sex; considered to be a sexual dysfunction in the DSM macro level of Bronfenbrenner's ecological model of systems involving large-scale systems characterized by social structures and ideologies, such as policies of governments and multinational companies, aspects of capitalism such as the maximization of profits and off -loading of costs, unemployment rates and the role of gender and religion in society

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M

madness
an ordinary language term used in this book to collectively describe the more severe forms of distress, typically characterized by experiences such as hallucinations or delusions

magnetic resonance imaging (MRI)
an imaging technique where images of the brain or body are produced through the use of magnetic fields and radio waves

major tranquillizers
drugs marketed by pharmaceutical companies as addressing an underlying biological disorder, used when a calming effect is desired and often given to people with a diagnosis of schizophrenia

male erectile dysfunction (MED)
the inability to develop or maintain an erection during sexual activity, also called impotence

mandatory treatment
Canadian term referring to compulsory treatment and admission to hospital

manic episode
in psychiatry, an experience of persistently elevated, expansive or irritable mood, lasting for at least a week

mass media
the broad range of technologies used to communicate information, news and entertainment to a population (within and across countries): mostly television, the internet, newspapers, fi lm and radio

Maudsley method
in psychiatric practice associated with the diagnosis of anorexia, involving parents in the initial phase of treatment, mainly emphasizing the restoration of weight and the regulation of dieting behaviour

medical definition of normality
a definition of normality which classes as abnormal those activities, behaviours and characteristics that are associated with danger to life or well-being or which cause harm to bodily organs or tissues

medicalization
the tendency to view problems of living and everyday difficulties and stresses as the symptoms of medical problems

melancholy (melancholia)
a state of distress believed, in Ancient Greek thought, to be caused by an excess of black bile and characterized by anguish and distress

Mental Health Act
the law in England and Wales governing the compulsory treatment of mental health difficulties

mental illness
a medical concept of distress which views it as a matter of disease or sickness

Mental Patients Union
a mental health activist group established in the UK in the 1970s

meso
level of Bronfenbrenner's ecological model of systems where links exist between an individual's proximal systems, such as between home and school

meta-analysis
a quantitative comparison of the results of a number of different trials of the same treatment or intervention

metabolite
a substance produced by the biological processes of metabolism

metacognition
'thinking about thinking' or higher cognitive functions and processes

micro
level of Bronfenbrenner's ecological model of systems involving the individual and their immediate/proximal systems, such as home, school and work

migration
when a group of people (sometimes large groups) move from one place to another, sometimes over large distances; this can be either voluntary or involuntary

mind-body dualism
a way of thinking about the relationship between mind and body which presumes that they are distinct, separate entities or substances: sometimes referred to as Cartesian Dualism

mindfulness-based cognitive therapy (MBCT)
monitoring and other techniques that encourage clients to develop different relationships with their negative feelings: to treat them as passing events rather than the beginning of a trend, to minimize rather than maximize their significance and import, to recognize that their feelings are not necessarily an accurate representation of their actual situation, and so on

mixed episode
in psychiatry, an experience where moods fluctuate between mania and profound misery

molecular genetic research
statistical analyses of DNA sequences

monoamine
any of various biogenic amine neurotransmitters having a single amino group: for example dopamine, epinephrine and norepinephrine

monoamine oxidase inhibitors (MAOI's)
a class of drugs usually prescribed to people given diagnoses of depression, with similar effects to stimulants

monogamous
a relationship that is exclusive, involving only two sexual or intimate partners

motherese
a tone of voice and way of speaking specially adapted for one's infant

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N

nasogastric feeding
treatment in which a plastic tube is inserted through the nose, past the throat and into the stomach: a medical technique used to administer food or medication when a person is unable to eat, or refuses to feed themselves. It is controversially used to force-feed individuals given a diagnosis of anorexia, who are of a very low body weight and dangerously close to death

necessary causes
influences or events that must be present for distress to arise

negative schema
a collection of interrelated beliefs about the self, negative in character and acquired in childhood, usually as a result of adverse life experiences; in cognitive theory, negative self-schemas cause individual cognitive biases toward pessimistic, negative or critical interpretations of events and experiences

negative symptoms
in people who have or might be given a diagnosis of schizophrenia, the presence of experiences such as apathy, or difficulty in motivating oneself to engage in activities, anhedonia (an inability to experience pleasure) and flat affect (where one's emotions seem flattened)

negative triad
in Aaron Beck's cognitive theory of depression, the notion that people given this diagnosis have negative thoughts about themselves, their experiences in the world, and the future

neurasthenia
a clinical diagnosis previously common in the West, the symptoms of which may include anxiety, low mood, muscular weakness, fatigue, dizziness, insomnia, poor appetite and a lack of energy; today in the West, people who formerly received this diagnosis might now be described as having chronic fatigue syndrome

neuroleptics
literally, 'taking hold of one's nerves'; an alternative term for the psychiatric drugs also called major tranquillizers; a term in common psychiatric usage in the first few decades of the use of these drugs

neurological
of or relating to the nervous system (neurological conditions are disorders of the nervous system)

neurosis
in psychiatry, a collective term for forms of distress that involve exaggerations of everyday responses (e.g. excessive worrying) but do not involve distorted perceptions or unusual beliefs

neurosurgery see psychosurgery

non-monogamous
individuals who, whilst in a romantic relationship, also form emotional and/or sexual bonds and/or romantic relationships with other individuals. The arrangement is usually an open one (i.e. each partner is aware of and in agreement with the arrangement)

norm of reaction
the pattern of phenotypic expression of a single genotype across a range of environments

normalizing approach
one in which experiences are explained as within the range of normal responses, and emphasis is placed instead on the typically unusual circumstances that may have produced these experiences (e.g.sleep deprivation or social isolation)

number needed to treat
the number of persons with whom a practitioner would need to conduct an intervention before, on average, the intervention might yield more benefit than if the people treated had been in the control group

Nuremberg Code
a set of ethical principles which require that research participants give full voluntary consent, the research should be of value to society, the results not be attainable in any other way, and studies should not result in death or serious injury: introduced after World War Two and the discovery that horrific medical experiments had been carried out on inmates of the Nazi concentration camps

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O

obesity
a medical term for excess body weight, to the extent that health and life expectancy is threatened

obsessive compulsive personality disorder (OCD)
a psychiatric diagnosis given to people who are said to be preoccupied with perfectionism and orderliness and in whom this is thought to be an enduring element of their personality. There are many sub-categories of personality disorder diagnosis, see Table 13.2.

Oedipus complex
a term from Freudian psychoanalysis to describe when a child is in love with their mother but jealous of their father

oestrogen
a hormone found in both sexes but more commonly described as a 'female' sex hormone. It is responsible for the regulation of the reproductive cycle in women and the generation of typical female sexual characteristics

open
the ability of a system to continuously respond to external, environmental influences

operant conditioning
the behaviourist principle of shaping voluntary responses by the use of reinforcement (rewards or punishments) to encourage desired responses and discourage others

organic diagnoses
diagnoses such as dementia, syphilis, and Huntington's Chorea where a biological cause of the dysfunction has been clearly demonstrated

outer speech
fragments of conversations with others that we later speak out loud to ourselves, using them to monitor and guide our actions

outpatient commitment/assisted outpatient treatment
US term for Community Treatment Order/Supervised Community Treatment

over-determined
the idea that a single observed effect is determined by multiple causes at the same time (any one of which alone might be enough to account for the effect)

over-generalization
assuming that, for example, all future events will go badly because one event has

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P

panic attacks
relatively brief but intense periods of overwhelming anxiety accompanied by pronounced physiological effects such as breathlessness and dizziness

paranoia
a term in general use to refer to an unwarranted belief that others intend to harm us - also referred to as a persecutory delusion in diagnostic manuals

paranoid beliefs
those characterized by a feeling of threat and the belief that others are actively conspiring to harm one - see also paranoia

paranoid personality disorder
a psychiatric diagnosis given to people who are said to be persistently hostile and suspicious, when this is thought to be an element of their personality. There are many sub-categories of personality disorder diagnosis, see Table 13.2.

paraphilia
a term used to describe sexual attraction to unusual objects, or sexual activities that are deemed unusual in nature

Parental Bonding Instrument
a retrospective measure of one's childhood relationships with one's parents

Parkinson's disease
a degenerative neurological disease caused by reduced activity of dopamine in a part of the brain called the basal ganglia, which controls movement and also influences thought, emotion and motivation

passing
the ability to conceal one's identity (e.g. as transgender) and 'pass' without being recognized as belonging to this category. This act of concealing may also be a source of stress for individuals - where authenticity does not exclude acknowledging one's past reality

pathologizing approach
where experiences are seen as symptoms of an illness, and are seen as lying outside of normal human experience

pathoplastic
the various influences (biological, social, cultural, psychological) on the form of a disease once it has developed

patient
someone who receives medical treatment; the term is frequently used in medical contexts to describe people experiencing distress. See service user

patriarchal
of or pertaining to a patriarch, the male head of a family, tribe, community, church, order, etc.; characteristic of an entity, family, church, society etc., controlled or dominated by men

perfectionism
a firmly held belief that perfection can be achieved; in relation to distress, failing to achieve perfection can be a threat to worth and esteem

persecutory delusion
the term used in psychiatric diagnostic manuals for an unwarranted belief that others intend to harm us - also known as paranoia

personality disorders (PD)
a group of psychiatric diagnoses in which enduring distress, problems in relating to others and engaging in behaviour which breaches social norms are seen as primarily caused by a person's personality. There are many sub-categories of personality disorder diagnosis, see Table 13.2.

personality disorder not otherwise specified
a psychiatric diagnosis given to people who meet some of the criteria for personality disorder sub-categories but may not fully meet the criteria for any single diagnosis

pharmacological revolution
a historical period beginning in the 1950s in the West, in which new and advanced medicines of all types were coming to the forefront of medical and mainstream culture

phenomenology
what an experience is like subjectively, its character; in philosophy, a form of analysis that frequently emphasizes experience and the body

phobias
intense worries that seem to be tied to very particular objects, places or situations; phobias can be triggered by creatures such as spiders or moths, activities such as flying or travelling in cars, or events such as dental appointments

placebo
a false medical intervention used in clinical trials. Patients given a placebo can sometimes experience a perceived or actual improvement in their medical condition - this is known as the placebo effect. Placebo conditions are often included in randomized controlled trials to assess the effects of psychological suggestion on medical intervention

plasticity
the capacity to be moulded, receive shape, or be made to assume a specific form

point prevalence
the number of people meeting diagnostic criteria at a particular point in time

political dissidents
those who question the prevailing political system under which they live

positron emission tomography(PET)
an imaging technique in which positron-emitting radioisotopes - short-lived radioactive substances - are introduced into the body in order to produce three-dimensional coloured images of their concentration in body tissue

positive symptoms
in people who have or might be given a diagnosis of schizophrenia, the presence of unusual experiences, notably hallucinations and delusions

post-encephalitic Parkinsonism
a condition causing nerve damage similar to Parkinson's disease, thought to be the result of a viral infection

postpsychiatry
not a new theory or therapy, but a call to open up spaces 'in which other perspectives can assume a validity previously denied them', in particular the voices of service users

post-traumatic stress disorder (PTSD)
a psychiatric diagnosis frequently given to people experiencing ongoing distress as a result of a traumatic event; for example, experiencing flashbacks of the event and avoiding situations which are reminiscent of it

predicatives
verbal terms or phrases that index or point to aspects of the current situation

prefrontal leucotomy
a surgical technique for severing the connections to and from the prefrontal cortex. See lobotomy

Present State Examination
a questionnaire designed in the 1960s to assess an individual's present mental state (questions refer to the past month only) in order to identify whether they have a psychiatric disorder

presentism
historical accounts written through the lens of the present, judging the past according to our current knowledge and values

prevalence
in epidemiology, the total number of cases of a disease or disorder in a population at any given time

primary prevention
targeting and ameliorating the proximal causes of distress

prodrome
in psychiatric practice, the period of time immediately before the point where somebody might reach the threshold to be given a diagnosis (for example of schizophrenia)

professionalization
the establishment, within a field of interest, of specific professional disciplines with their own training, rules and regulations

prolactin
a hormone involved in the regulation of lactation

prospective
a stance of anticipating events in the future: prospective studies are those in which participants are interviewed, observed or measured before an event occurs

pseudo-patients
people playing the role of a psychiatric patient usually in the context of a research study

psychiatric system survivor
someone who receives or uses mental health services; this term is preferred by some organizations of service users and campaigning groups, as it conveys that those in distress have to survive services, not just distress

psychoanalysis
a branch of psychotherapy interested in the conscious and unconscious drives that motivate people. Psychoanalysts believe that mental health difficulties and other problems with living arise as a result of unconscious conflicts that need to be brought into conscious awareness, in order to be sufficiently dealt with and disposed of. Talking freely (free association) under the skilled guidance of an analyst is one way to reveal these unconscious conflicts

psychogenic model
a model of distress which views its causes as arising out of the mind

psychological types
the Jungian categorization of people into primary types of psychological function

psychologize
to emphasize the individual, emotional and cognitive aspects of an experience, as opposed to its social, physical and somatic aspects

psychopathic personality disorder (PPD)
a psychiatric diagnosis given to people described as having a personality characterized by shallow emotions (in particular reduced fear), reduced empathy, superficial charm, manipulativeness, impulsivity and other antisocial behaviours. There are many sub-categories of personality disorder diagnosis, see Table 13.2. See psychopathy

psychopathology
a medical concept of distress which views it as a matter of disease or sickness (pathology: disease or impairment)

Psychopathy
This notion has been developed by Hervey Cleckley and Robert Hare and refers to a constellation of behavioural and personality characteristics including shallow emotions, a lack of empathy, superficial charm, manipulativeness and anti-social behaviour. Although in common parlance this term is not used in either the DSM or ICD classifications although it is similar to the categories of anti-social (DSM) and dissocial (ICD) subcategories of personality disorder (see Table 13.2)

psychosis
a term for psychiatric diagnoses in which there is an assumed loss of contact with reality, usually characterized by hearing or seeing things others cannot hear or see (hallucinations) or holding beliefs that others consider strange and unusual (delusions);in this book, called madness

psychosocial model
a model of distress which views the psychological processes involved as caused and maintained by adverse life events and circumstances

psychosomatic
a medical term for the effects of social, psychological and behavioural factors on bodily processes

psychosurgery
a surgical operation in which brain tissue is destroyed for the treatment of mental health problems (also known as neurosurgery for mental disorder). For example, a lobotomy

psychotherapy
a broad term referring to the 'talking therapies'. Its aim is to provide a person with the opportunity to explore and gain insight into their difficulties and distress. Through a greater understanding of the person's underlying difficulties, psychotherapy is said to equip the person with a set of coping skills that can lead to long-term changes in thinking, feeling and behaviour

publication bias
the trend that published literature is likely to overstate the benefits of an intervention because it is more difficult to publish studies that fail to demonstrate significant effects

purging
behaviours that serve the purpose of controlling weight, such as the removal of food from the body by vomiting, the use of laxatives, enemas, diuretics and over exercising

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Q

qualitative
qualitative research is interested in the meanings provided by individuals for their beliefs, experiences and behaviours: the aim is not to standardize or mathematically measure meaning, but to understand the meaning making process

quantitative
quantitative research adopts standardized measurements of phenomena so that the relationships between them can be measured and analysed mathematically

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R

random allocation
in experimental method, the allocation of people by chance to either control or experimental groups

randomized controlled trial
research study involving randomly allocating study participants to experimental conditions and including a control group which receives a placebo; devised to control for a number of factors that could influence the outcome of treatment studies

rational emotive behaviour therapy
a form of psychotherapy which focuses on resolving emotional and behavioural problems and disturbances, based on rationalist principles

rationalist
pertaining to any view appealing to reason and logic as a source of knowledge or justification

recipient
a term for service users that emphasizes the often passive or involuntary nature of the relationship; it is preferred by some commentators who consider that terms like 'consumer' and 'client' imply a person's active consent

recovery movement
a social movement rejecting the idea that people with psychotic experiences are suffering from an irreversible or chronic condition; the model emphasizes optimism, empowerment and interpersonal support, and focuses on collaborative approaches, productive roles, peer support and stigma-reduction.

reductive
methods or ways of thinking that tend to reduce distress to a single dimension, typically the biological

rehabilitation
the process of restoration of community functioning and well-being of an individual experiencing distress

relapse rates
the extent to which, following either remission or an apparently successful intervention, persons experience a recurrence of their original difficulties

relationships
emotional, sexual or other connections, associations, or involvements between people

repressed memories
significant memories, usually of a traumatic nature, that have become unavailable for recall; also called 'motivated forgetting' in which a subject blocks out painful or traumatic times in their life

reproductive fitness
the ability to pass on genes to the next generation

response prevention
a therapeutic strategy found in behaviour therapy in which a person with a compulsion to conduct a particular behaviour (e.g. continually checking that one has switched the oven off ) learns to stay relaxed and manage the fear caused by not conducting the ritual

Responsible Clinician
the mental health professional responsible for organizing a service user's care under the English and Welsh Mental Health Act

retrograde amnesia
impaired recall of the past

retrospective
a stance of looking back at events that have already taken place

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S

sadomasochism
the process of administering or receiving acts of pain or humiliation for the purpose (usually) of sexual arousal and pleasure

schema-focused cognitive therapy (SFCT)
a form of cognitive psychotherapy that focuses on changing maladaptive schemas seen as developing as a result of early life experiences

schizophrenia
a psychiatric diagnosis given to people who experience auditory hallucinations, paranoid or bizarre delusions, chaotic or disorganized speech, and unusual emotional responses, typically accompanied by significant social or occupational dysfunction

Schneiderian
a term referring to the work of Kurt Schneider, who categorized the symptoms that make up a schizophrenia diagnosis into first and second rank symptoms, in order to differentiate diagnoses of schizophrenia from other psychotic diagnoses

secondary prevention
the practice of identifying and trying to ameliorate distressing experiences before they reach such a pitch that the person might be given a psychiatric diagnosis (as in early intervention services)

sectioned
an informal term used in the UK for when a person is taken into hospital without their consent for further assessment or treatment; usually occurring if the person is perceived to be a threat to themselves or others: from the relevant section of the Mental Health Act

secure attachment relationship
an attachment relationship in which carers respond to the emotional needs of infants appropriately, promptly and consistently, with the consequence that infants are better able to deal with potentially difficult situations such as being left alone for a short while

seduction theory
a hypothesis posited by Freud, who for a time believed that the origins of hysteria and obsessional neurosis lay in early childhood sexual abuse

selective abstraction
taking details out of context and magnifying them

selective placement bias
whereby the best potential adoptive parents are in a position to choose from a range of potential adoptees and may well have been put off from adopting children with a biological family history of mental health difficulties, since potential adopters are usually well-informed of any difficulties in the adoptee's family background

selective serotonin re-uptake Inhibitors (SSRI's)
a class of compounds which block the neurotransmitter serotonin, usually prescribed for people given diagnoses of depression; commonly reported effects include drowsiness, feelings of cognitive impairment, agitation (and other so-called 'activating' effects like anxiety), emotional blunting and emotional instability

self-defeating personality disorder (SDPD)
a proposed but discredited psychiatric diagnosis, purportedly characterized by a person failing to promote their own needs before those of others; often associated with experiences of domestic or childhood abuse. See delusional dominating personality disorder

self-esteem
a psychological concept describing an individual's overall appraisal of their self-worth. It can operate in a specific domain (I am worthless because I am fat) or be more global in presentation (I am simply worthless)

self-harm
the intentional, direct injuring of one's own body tissue, most often done without suicidal intentions; often seen by those who engage in it as a coping strategy. See Box 13.4

self-help movement
a contemporary trend for people to adopt coping strategies acquired from their own reading or from learning from others with similar problems rather than professionals

self-organizing
a system of synergistically co-operative elements whose patterns of global behaviour are distributed and self-limiting in nature

sensate focus
a therapeutic technique developed by sexologists Masters and Johnson in couples therapy. Partners are instructed to sensually touch each other without touching genitals and progressing to full sexual activity, with the aim of gradually reducing anxiety regarding sex

sensory deprivation
where a person's sensory input is reduced, for example by lying in a dark and soundproofed cubicle; after continuous isolation in this manner, participants begin to experience hallucinations and a degraded ability to think clearly

service user
someone who receives or uses mental health services: the most commonly used term in UK mental health policy and the term we mainly use in this book to describe people experiencing distress

service user/survivor movement
self-organized groups of mental health service users who collectively develop and promote coping strategies for distress and campaign for a more enlightened approach to distress

sex therapists
therapists who predominantly treat difficulties with having sex

Sexologist
a scientist who studies sexual behaviour in humans

sexual abuse
the coercion of an adult person (using either psychological pressure or physical force) by another to engage in sexual activity. See also child sexual abuse

sexual and gender identity disorder
a psychiatric diagnostic category that covers both sexual disorders (with psychological as opposed to physiological causes) and gender identity disorders

sexual arousal
sexual excitement at the thought, or anticipation, of sexual activity

sexual disorder
a general term referring to diagnoses of either sexual dysfunction, paraphilia and/or gender identity disorder

sexual dysfunction
a diagnostic term referring to a difficulty an individual or couple may experience with any aspect of the human sexual response cycle, including desire, arousal or orgasm

sexual functioning
the ability for the person to be able to experience desire, to be aroused, to physically engage in a sexual act and experience orgasm

sham ECT
a placebo form of electro-convulsive therapy (ECT) involving the participant in a clinical trial going through a procedure identical to that of ECT, including receiving anaesthetic and muscle relaxants and even having the electrodes placed on the head, but with no electric current passed through the brain

shellshock
in the First World War, a purported psychiatric illness presumed to result from injury to the nerves during combat; most people experiencing this kind of distress would probably be given a diagnosis of post-traumatic stress disorder

side-effects
the unintended or unwanted effects of a drug

signs
in medical diagnosis, signs are biological phenomena that can be objectively observed and verified by other people, and that can be compared to an objective norm

single blind
a clinical trial in which participants are not informed about (i.e. are 'blind' to) whether they are in the intervention or control (comparison)group

single nucleotide polymorphisms (SNPs)
in molecular genetic research, markers of genetic variation

single photon emission computed tomography (SPECT)
an imaging technique that produces a computerized cross-section of physical structures in the body based on their differential absorption of gamma-rays

social capital
both the number of social networks (community organizations like churches and youth groups) there are in a community, and how strong the links between them are; the social glue that binds a community together

social causation
an explanation for the higher prevalence of distress in more deprived sections of the community, which proposes that the greater stresses of such lifestyles and environments cause mental health problems to develop

social construction (social constructionism)
a paradigm within which how something is talked about produces it in a particular form or version; these versions are associated with socio-cultural norms of knowledge and understanding and often seen to be organized in discourses

social Darwinism
an interpretation of Darwin's notion of 'survival of the fittest' as a moral injunction to prefer the strong over the weak

social definition of normality
a definition of normality which classes as abnormal those activities, behaviours and characteristics disapproved of in a particular time and place

social distance
a measure of how comfortable people feel with members of a particular social group; used to study the extent to which members of a group may be treated differently as a result of prejudice and discrimination

social drift
an explanation for the higher prevalence of distress in more deprived sections of the community, which proposes that people experiencing distress tend to move down the social scale as their ability to cope with more highly skilled jobs diminishes, and lower salaries or unemployment force them to move to cheaper neighbourhoods

Socialist Patients' Collective (SPK)
an activist political group founded in Heidelberg in February 1970 by Wolfgang Huber, which argued that mental and physical illness was a revolt against an insane world of capitalism, alienation, pollution and repressive sexual morals

socio-cultural
the complex, bi-directional relationships between the organization of a society (e.g. its institutions for work, family life and education) and the production of cultural values, identities, beliefs and rituals

sociogenic model
a model of distress which views distress and disturbing conduct as the result of a person's social location (e.g. suffering, poverty and abuse), events in the world (e.g. particular negative life events), and their relationships with others

socio-therapy
treatment emphasizing modification of the environment and improvement in interpersonal relationships rather than intrapsychic factors

Socratic dialogue
in cognitive therapies, a systematic attempt to help the client to question and challenge their unhelpful beliefs about themselves

somatization
the tendency to understand psychological stress or distress in terms of bodily or physical complaints

somatogenic model
a model of distress which views it as caused by the body

somato-psychic
a medical term for the effects of the body on the mind

somnolent-opthalmoplegic form
a form of encephalitis lethargica, the symptoms of which included expressionless faces and sleepiness, often leading to coma and death

source monitoring
the skill of distinguishing between self-generated thoughts and perceptions of the external world

specificity
the quality or state of being specific, in which outcomes are much less open to fluctuation and variation

spell-binding
from the work of Peter Breggin, a term that describes how, when people are under the influence of a psychoactive substance, they may not be able to judge their actions and behaviours very well

split-brain patients
people who have had the fibres joining the two halves of their cortex (the corpus callosum) severed, usually to control intractable epilepsy which would otherwise cause brain damage

spontaneous remission
the phenomenon of improvement without any treatment over a period of time

start/stop squeeze techniques
the standard techniques used to tackle male premature ejaculation

statistical definition of normality
a definition of normality which classes as abnormal those activities, behaviours and characteristics that are numerically unusual in a given population (e.g. which lie at the extremes of a continuum)

sterotactic subcaudate tractotomy
the use of micro-surgical techniques to sever connections between areas including the basal ganglia, the caudate nucleus and the amygdala

stigma
from the work of sociologist Erving Goff man, the outcome of processes of discrimination that cast someone as deviant and link them to negative stereotypes

straitjacket
a jacket used to control persons experiencing madness, made of strong material and with overly long sleeves which were secured behind the person's back so they could not move their arms

stress-vulnerability model
assumes that we inherit varying degrees of genetic susceptibility to mental illnesses. The greater this inherited vulnerability, the smaller the amount of stress required to trigger the illness

Stroop test
an experimental procedure to assess the amount of information processing associated with different kinds of stimuli by comparing the reaction times associated with them in alternate conditions

subvocalization
a process related to voice-hearing in which one's vocal chords make minute movements accompanying inner speech

sufficient causes
influences or events that do not have to be present for distress to arise, but which always result in distress occurring if they are present

suffocation alarm
a theory which holds that when levels of carbon dioxide and oxygen are altered, as occurs during hyperventilation, a neural message is sent that there is a danger of suffocation, which results in panic

suicide
the act of intentionally causing one's own death

supervised community treatment
where a person no longer has to stay in hospital to be given treatment compulsorily, but may now be treated at home provided they agree to follow their Community Treatment Order. See mental health act

survivor
a term used to refer to those who use mental health services, which carries an explicit criticism of services, although what is being survived may differ (e.g. distress or psychiatric services)

symptoms
a medical term for subjective reports by the person of a departure from normal function or feeling which is seen as indicating the presence of disease or abnormality; can be contrasted with signs

synergistically
when one cause and its effects magnify the influence of another cause and its effects

syphilis
a sexually transmitted infection which can cause a range of physical and neurological symptoms

systematic desensitization
a strategy used in behaviour therapy in which a person with an unwarranted fear or phobia gradually learns to remain relaxed in the presence of an object of which they were previously frightened

systems theory
a theory which emphasizes the way in which different elements in a system - like members of a family or a society - interact with each other

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T

tardive dyskinesia
a recognized effect of antipsychotic drugs, in which abnormal repetitive twitching type movements (similar to Parkinson's disease) occur, usually affecting the face; may be due to over-compensation of dopamine and other neurotransmitter systems

temporal organization
the organization of phenomena (e.g. in terms of plasticity and specificity) over time

testosterone
a hormone found in both sexes but often described as a 'male' sex hormone, and involved in the production of male sex characteristics such as enlargement of the testes and the growth of facial hair

test-retest approach
where people are assessed and then re-assessed after the passage of some period of time

the interpreter
from the work of neuroscientist Michael Gazzaniga, a collection of left hemisphere brain systems which functions to provide a continuous, running narrative upon our lives and activities

theory of mind (ToM)
the ability to understand the mental states of others

theory of shattered assumptions
the theory that the shock of trauma can be so great that it thoroughly challenges and changes pre-existing core beliefs about the basically benevolent character of the world; consequently, people who experience trauma may be left struggling to understand their relation to the world, to such an extent that they may sometimes experience both themselves and the world as somewhat unreal

therapeutic alliance
the development of a trusting relationship between a client and a therapist

therapeutic communities
a participative, group-based approach to treatment of long-term distress, where people live together as a community often according to a democratic philosophy

third force in psychotherapy
humanistic psychotherapy
; developed as a reaction against the dominance of psychoanalysis and behaviour therapy in the mental health field during the 1960s

third wave behavioural therapies
in psychotherapy, a movement away from cognitivism and back toward radical behaviourism, functional analysis and behavioural models of verbal behaviour, sometimes drawing on elements of Eastern philosophy

thought disorder
where a person's thoughts are presumed to be incoherent and confused on the basis of incoherent and confusing speech

token economy
a technique in behaviour therapy in which the desired behaviour is rewarded with tokens which can be exchanged for desired activities or other rewards

tonic immobility
responses characterized by simultaneous sympathetic and parasympathetic nervous system activity

trans
an umbrella term to include all transvestite, transgender and transsexual identities

transdiagnostic approach
a perspective which acknowledges that many overlapping dimensions exist across psychiatric diagnoses, and which emphasizes these overlapping behavioural or psychological dimensions

transference
in psychoanalysis when a person acts towards their psychotherapist in a manner reminiscent of how they have been treated by or related to others: in other words, they transfer their feelings from others onto the therapist

transference-focused psychotherapy (TFP)
a psychodynamic psychotherapy designed especially for people given a diagnosis of borderline personality disorder (BPD: the sub-categories of personality disorder diagnosis are explained in Table 13.2).

transformative
the transforming of an individual's or community's social circumstances - more fundamental and paradigmatic than ameliorative change

transgender
refers to a group or groups of individuals who differ from or completely transcend culturally prescribed gender roles. This can include individuals who have undertaken gender corrective surgery to transfer from the gender they were assigned at birth to the gender which fits their personal identity

transitional form
a stage in a transformation

transsexual
the term with which most people will be familiar to describe individuals who alter their bodies to reflect a different gender than that which was assigned to them at birth

transvestic fetishism
a diagnostic term describing sexual arousal as a result of cross-dressing

transvestite
a person who cross-dresses (dressing in clothing traditionally associated with the opposite gender), whether for emotional or psychic reasons or as sexual fetish

traumagenic neurodevelopmental model
a model which emphasizes the contribution of early traumatic events in the development of psychosis

tricyclic antidepressants
heterocyclic chemical compounds, such as amitriptyline, which are chemically similar to early neuroleptic
drugs, and share many of their effects: they are sedating, impair mental functioning and some have been shown to block dopamine in animal studies

triple-blinding
a clinical trial in which the participant, health professionals and the researcher are all unaware of whether the participant is in the intervention or control (comparison) group

Twelve Step programmes
an adaptation of the Alcoholics Anonymous model of intervention to help people cope with other kinds of problem; the term refers to the number of stages in the original programme

tyramine
a naturally-occurring monoamine

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U

unblind
the process in which participants, professionals or researchers guess who is in the intervention group (e.g. by noticing the effects of an administered drug)

unconscious libidinal desires
sexual desires outside conscious awareness

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V

vaginismus
diagnosis made on the basis of a reported involuntary vaginal spasm that occurs when penetration is attempted

Viagra
the commercial name for the drug sildenafil, used to treat male erectile dysfunction

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W

weight control behaviours
behaviours that support the maintenance of a desired body weight, for example calorie control, food restriction and purging

withdrawal symptoms
effects that occur when a drug intervention is stopped because the drug is no longer present to oppose the adaptations the body has made to its presence