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D

Decompensation - Decrease in integration, inner organization or functioning after a period of stability. The deterioration of existing defenses, leading to an exacerbation of pathological behavior. Opposite of Recompensation.

Defense mechanisms - Unconscious, automatic processes to ward off anxiety by preventing conscious awareness of threatening feelings. Defense mechanisms mediate the individual's reaction to emotional conflicts and to external stressors. Some defense mechanisms (e.g., projection, splitting, and acting out) are almost invariabl«y maladaptive. Others, such as suppression and denial, may be either maladaptive or adaptive, depending n their severity, their inflexibility, and the context in which they occur.

Delirium - An acute altered state of consciousness, consisting of sudden confusion, distractibility, disorientation, disordered thinking and memory, defective perception, prominent hyperactivity, agitation, and autonomic nervous system over-activity; caused by a number of toxic structural and metabolic disorders.

Delirium tremens - Acute delirium associated with prolonged alcoholism; the term is now replaced by alcohol withdrawal delirium.

Delusion - Firm false belief opposed to reality but maintained in spite of strong evidence to the contrary. Not explicable on the grounds of the patients cultural or social background.

Delusion of doubles - Delusional belief that a person known to an individual has been replaced by a double.

Delusion of grandeur - Grandiose delusion, a delusion involving an exaggerated concept of one's importance, power, or knowledge or that one is, or has a special relationship with, a deity or a famous person; it is one of the subtypes of delusional disorder.

Delusion of persecution - False belief that one is being mistreated or interfered with by one’s enemies.

Delusional jealousy - The delusion that one's sexual partner is unfaithful.

Delusional perception - New and delusional significance is attached to a familiar real perception without any logical reason.

Delusions of infidelity - Delusional belief that one's spouse or lover is being unfaithful. Also known as pathological jealousy, delusional jealousy, Othello's syndrome.

Delusions of reference - The behavior of others or objects and event (e.g. television broadcasts) believed to refer to oneself in particular. When similar thoughts are held with less than delusional intensity they are called ideas of reference. See Ideas of Reference.

Dementia - An insidious, chronic, often irreversible brain syndrome. Global organic impairment of intellectual functioning without impairment of consciousness.

Dementia - The loss of intellectual function produced by brain damage.

Denial - A defense mechanism by means of which the person protects him- or herself from unpleasant aspects of reality by refusing to acknowledge them. Escaping unpleasant realities by ignoring their existence.

Dependency - The tendency to rely overly upon others.

Dependent Personality Disorder - A personality disorder marked by lack of self-confidence and feelings of acute panic or discomfort at having to be alone.

Depersonalization - A loss of sense of identity, often with a feeling of being something or someone else. The person experiences a sense of unreality of self-estrangement. For example, one may feel that one’s body has changed, that one is seeing oneself from a distance, feeling like one is in a dream

Depression - Emotional state characterized by dejection, gloomy ruminations, feelings of worthlessness, loss of hope, and apprehension.

Depressive retardation - Lesser form of psychomotor slowing that occurs in depression.

Derailment - A pattern of speech in which a person's ideas slip off one track onto another that is completely unrelated or only obliquely related. In moving from one sentence or clause to another, the person shifts the topic idiosyncratically from one frame of reference to another and things may be said in juxtaposition that lack a meaningful relationship. This disturbance occurs between clauses, in contrast to incoherence, in which the disturbance is within clauses. An occasional change of topic without warning or obvious connection does not constitute derailment. See also Loose Associations

Derealization - The false perception by a person that his or her environment has changed. For example: everything seems bigger or smaller, familiar objects become strange of unfamiliar, people may seem unfamiliar or mechanical.

Derogation - A communication that belittles somebody or something.

Desensitization - The reduction of intense reactions to a stimulus by repeated expose to the stimulus in a weaker or milder form.

Detachment - An interpersonal and intrapersonal dissociation from affective expression. Individuals appear cold, aloof and distant. May include intellectualization, denial, and superficiality.

Deterrence - A means of controlling a person's behavior through negative motivational influences, namely fear of punishment; something immaterial that interferes with or delays action or progress.

Detoxification - Treatment directed toward ridding the body of alcohol or other drugs.

Diagnosis - Determination of the nature and extent of a specific disorder.

Diagnostic and Statistical Manual of Mental Disorders (DSM) - Classification of mental disorders by the American Psychiatric Association that includes descriptions of diagnostic categories.

Differentiation - The degree to which an individual achieves a sense of unique identity apart from the group.

Diplopia - Double vision due to paralysis of the ocular muscles; seen in inhalant intoxication and other conditions affecting the nerve that controls the movement of the eyes.

Disinhibition - Freedom to act according to one's inner drives or feelings, with less regard for restraints imposed by cultural norms or one's superego; removal of an inhibitory, constraining, or limiting influence, as in the escape from higher cortical control in neurologic injury, or in uncontrolled firing of impulses, as when a drug interferes with the usual limiting or inhibiting action of GABA within the central nervous system.

Disorganized schizophrenia - A subtype of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders. This type is characterized by prominent disorganized behavior and speech (see formal thought disorder), and flat or inappropriate emotion and affect. Furthermore, the criteria for the catatonic subtype of schizophrenia must not have been met. This type of schizophrenia is also known as hebephrenia.

Disorientation - Confusion about the time of day, date, or season (time), where one is (place), or who one is (person).

Displacement - Defense mechanism in which emotions associated with a particular person, object or situation are transferred to another person, object, or situation that is non-threatening. This happens unconsciously. Process in which emotions, ideas, or wishes are transferred from their original object to a more acceptable substitute; often used to allay anxiety.

Dissociation - Separation or “isolation” of threatening thoughts or feelings in such a way that they become split off from the person before they trigger overwhelming and intolerable anxiety.

Dissociative disorder - Disorders that involve sudden temporary disturbances or loss of one’s normal ability to integrate identify or behavior.

Distractibility - Inability to maintain attention; shifting from one area or topic to another with minimal provocation or attention being drawn too frequently to unimportant or irrelevant external stimuli.

Dopamine - A neurotransmitter present in regions of the brain that regulate movement, emotion, motivation and feelings of pleasure. Dopamine appears to function as an inhibitor. Also critical to fine motor co-ordination, immune function, motivation, insulin regulation, physical energy, thinking, short-term memory, emotions such as sexual desire and autonomic nervous system balance. Lack of dopamine is the primary cause of Parkinson's symptoms. Excess dopamine has been associated with schizophrenia.

Double-bind message - A message that contains two contradictory messages given by the same person at the same time. The receiving person is unable either to comment on the incongruity or to escape from the situation.

Drive - A physiological state corresponding to a strong need or desire; the trait of being highly motivated. A term used to avoid confusion with the more purely biological concept of instinct.

Drug abuse - Use of a drug to the extent that it interferes with health and/or occupational or social adjustment.

Drug addiction - Physiological and/or psychological dependence on a drug. See Drug Dependence.

Drug dependence - Impaired control of drug use despite adverse consequences, the development of a tolerance to the drug, and the occurrence of withdrawal symptoms when drug intake is reduce or stopped.

Drug interaction - The effects of two or more drugs taken simultaneously, producing a change in the usual effects of either drug taken alone. Serious side effects may result.

DSM-IV - Fourth and current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, Washington DC (1994). Multi-axial classification with 5 axes.

Dual Diagnosis - See Co-Occurring Disorder

Dyad - A two-person relationship, such as the therapeutic relationship between doctor and patient in individual psychotherapy.

Dysarthri - Imperfect articulation of speech due to disturbances of muscular control or in coordination.

Dysfunction - Impairment or disturbance in the functioning of an organ.

Dyskinesia - Involuntary muscular activity, such as tic or spasms. Distortion of voluntary movements with involuntary muscular activity.

Dyspareunia - Persistent genital pain before, during or after sex.

Dysphoric mood - An unpleasant mood, such as sadness, anxiety, or irritability.

Dyssomnia - Primary disorders of sleep or wakefulness characterized by insomnia or hypersomnia as the major presenting symptom. Dyssomnias are disorders of the amount, quality, or timing of sleep.

Dysthymia - A depression that is mild or moderate in degree. Usually chronic and present for many years. The person has minimal social or occupational impairments.

Dystonia - Muscle spasms of the face, head, neck and back, usually an acute side effect of psychotropic medications.

Dystonia - Disordered tonicity of muscles.

Dystrophy - Degeneration, abnormal or defective development, insufficient nutrition.

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