Glossary of Key Terms in Culture and Mental Illness

acute stress disorder - Syndrome closely related to posttraumatic stress disorder characterized by anxiety and dissociative symptoms after exposure to extreme stress. The only major distinctions are in duration and point of onset. By definition, ASD has an onset within one month after the traumatic event and does not persist beyond four weeks after the event.

addictive personality - Personality development in which an individual generally feels the need to alter one's moods with substances, but is not necessarily addicted to any particular mood altering substance and thus will use whatever substance is available.

adolescence - The period between the onset of puberty and the attainment of adulthood. Determined by cultural factors that define behavior expected of the adolescent, and in the length of time spent in this period.

agoraphobia - Syndrome characterized by anxiety about being in places in which a panic attack or other anxiety reaction might occur, resulting in a pervasive avoidance of a variety of situations.

American Disease Model (of alcoholism) - Theoretical model in which alcoholism and other substance addictions are conceptualized as bodily diseases like cancer or heart disease.

amok - A Southeast Asian trance syndrome, usually characterized by a short-lived (a few minutes to several hours), sudden outburst of unrestrained violence, usually of a homicidal nature, preceded by a period of brooding, and ending with exhaustion. There is typically dissociative amnesia.

anomaly - A deviation from the usual or normal in scientific research. Something that cannot be explained according to the existing theory, model, or paradigm.

anorexia nervosa - Syndrome characterized by a refusal of the person to maintain a minimally normal body weight, an intense fear of being overweight, and a misperception of one's own body size or shape.

antisocial personality disorder - Personality characterized by a persistent pattern of victimizing others through theft or destruction of property, physical assault (including spouse or child abuse), or deceit to gain personal profit or pleasure.

anxiety - The emotion of fear linked to the anticipation of future danger or misfortune.

ataques de nervios - Latin American trance syndrome, is characterized by trembling, heart palpitations, heat in the chest rising to the head, faintness and seizure-like episodes, and sometimes hallucinations.

avoidant personality disorder - Personality characterized by extreme social anxiety, low self-esteem, and hypersensitivity to criticism to the point that they purposely avoid interpersonal contact.

biopsychosocial paradigm - The view that mental disorders are reactions of the personality to a combination of biological, psychological, and social factors.

bipolar disorders - Syndromes characterized by the presence of manic, hypomanic, or mixed episodes, including bipolar I disorder, bipolar II disorder, and cyclothymic disorder.

bipolar I disorder - Syndrome characterized by the presence of one or more manic or mixed episodes.

bipolar II disorder - Syndrome characterized by the presence of at least one major depressive episode accompanied by at least one hypomanic episode.

body dysmorphic disorder - Syndrome characterized by a persistent belief that the person's appearance is somehow seriously defective. Complaints commonly involve perceived defects in the face or head, but can involve any body part.

borderline personality disorder - Personality characterized by a persistent instability in social relationships, self-image, and emotions. Central to this instability is fear of abandonment and rejection.

brief clinical ethnography - A narrative summary of a patient's illness from the patient's point of view, including the patient's cultural background, cultural explanations of illness, cultural factors related to psychosocial environment and levels of functioning, clinician-patient relationship, and treatment options.

brief psychotic disorder - Syndrome characterized by a psychotic disturbance that lasts more than one day, but less than one month.

Briquet's syndrome (hysteria) - Alternative name for hysteria, an obsolete diagnostic category characterized by anxiety, somatoform, depressive, and dissociative symptoms.

bulimia nervosa - Syndrome characterized by binge eating and inappropriate methods of preventing weight gain including vomiting, misuse of laxatives, diuretics, or enemas.

category fallacy - The reification of one culture's diagnostic categories and their projection onto patients in another culture, where those categories lack coherence and their validity has not been established.

clinical reality - The cognitive construction of reality in the clinical setting. Clinical reality is created by the clinician and the patient within a clinical context employing their learned cultural schemas.

cognitive schemas - Learned structures of cognition used by an individual to make sense of and construct to some extent his or her subjective experience of the world.

coherence (in healing) - Psychotherapeutic technique of convincing a patient that one's internal and external environments are predictable and reasonably under control. By gaining coherence the ill person gains hope and thereby avoids hopelessness. There are three components to the concept of coherence: comprehensibility, manageability, and meaningfulness.

comorbidity - Refers to the simultaneous existence of two or more disorders in the same individual.

competitive male dominance - A social organization characterized by males competing with each other through combat or other means for the exclusive sexual rights to a group of females. Thus, there is one dominant male controlling a harem of females.

comprehensibility (in healing) - Refers to a sense of order. It means the ill person can understand the source of the illness, the mechanism of illness, and its effects on the body and one's life. Thus the illness is known and understood.

constructive function (of cultural meaning systems) - The ability of cultural groups to make up explanations of the world, and thereby create the subjective and intersubjective world they inhabit. This function constructs things that would not exist without a particular cultural meaning system (e.g., tribal gods).

conversion disorder - Syndrome characterized by pseudoneurological (somatoform and dissociative) symptoms such as amnesia, paralysis, impaired coordination or balance, localized anesthesia, blindness, deafness, double vision, hallucinations, tremors, or seizures without medical explanation.

cooperative egalitarianism - Social organization in which the two genders are roughly equal and there is no gender dominance hierarchy. As a result, female sexuality is not controlled at all by male dominance, or by a female dominance hierarchy.

cooperative female dominance - Social organization in which females cooperate to control the lives of males. These societies are formed around large female family groups.

cooperative male dominance - Social organization characterized by high levels of cooperation among males to dominate females and control female sexuality. Competition between males is controlled through typically elaborate systems of rules and rituals, and sharing the sexuality of females is generally compulsory.

culture - The sum total of knowledge passed on from generation to generation within any given society. This body of knowledge includes language, forms of art and expression, religion, social and political structures, economic systems, legal systems, norms of behavior, ideas about illness and healing, and so on.

cultural congruency (of symptoms) - Degree to which symptoms of mental disorders are consistent with the norms of the prevailing cultural meaning system.

cultural constructionist - Philosophical view that adult human experiences depend upon cultural schemas that mediate between sensory stimuli and experience. Thus, the meaning of events and norms of behavioral responses for adult humans are not uniform across cultures.

cultural entities - Objects created by the social agreement that something counts as that entity.

cultural learning - Learning that occurs as a result of primary socialization such as native language, religion, norms of behavior, and so on, within specific cultural contexts. Cultural learning is presumed to have an effect on the brain in the formation of culture-specific neural networks.

cultural meaning systems - The organization of cultural knowledge in a semantic system. Analogous to scientific paradigms, but much larger. A cultural meaning system generally structures cognitive reality for an entire society.

cultural schemas - A set of culture-specific cognitive schemas formed within the mind-brains of individuals in cultural groups. These cultural schemas can result in cognitive differences across cultures. These differences in cognitive construction result from cultural learning and are stored in plastic neuronal structures.

cultural significance (of mental illness) - The meanings projected onto the mental patient by the surrounding society, which then structure the experience of suffering by the patient. These meanings include what the society thinks about the ill person, about his or her particular mental disorder, and about mental illness in general.

culture-based diagnosis - A diagnosis of a mental disorder based on a particular cultural meaning system.

culture-based idioms of distress - Refers to the ways culture structures patients' expressions of illness. This can include culture-based physical actions, including unusual behavior, seeking out clinical care, mannerisms, figures of speech, and cognitive emphasis on certain symptoms while ignoring others.

culture-based outcome - Refers to the outcome that occurs because an illness has been cognitively constructed and treated in a particular cultural fashion.

culture-based subjective experience - Refers to the tendency of cultural schemas to structure an individual's experience of illness.

culture-based treatment - Refers to the appropriate treatment for an illness as defined by a particular cultural meaning system.

culture-bound syndromes - Mental illnesses structured by indigenous sets of cultural schemas. Some of the mental illnesses are in fact cultural entities. They exist primarily in particular cultural contexts or are responses to certain precipitants in the indigenous meaning systems.

curing - Treating only the disease as defined by the clinician.

cyclothymic disorder - Syndrome characterized by numerous hypomanic symptoms alternating with numerous depressive symptoms not severe enough to warrant a diagnosis of a major depressive episode occurring over a two-year period.

delusional disorder - Syndrome characterized by at least one month of nonbizarre delusions, without other psychotic symptoms.

dependent personality disorder - Personality characterized by an excessive need to be taken care of, associated with submissive, clinging behavior, and fear of independence.

depersonalization - Mental condition based in divided consciousness characterized by a persistent or recurrent feeling of being detached from one's mental processes or body.

depersonalization disorder - Syndrome characterized by depersonalization accompanied by clinically significant emotional distress or impairment.

depressive disorders - Syndromes with dysphoria as their central feature, including major depressive disorder and dysthymic disorder.

dhat syndrome - A culture-bound semen-loss syndrome in South Asia. It is indigenously thought that a loss of semen leads to physical and mental weakness, and susceptibility to illness. Thus, excessive masturbation or sexual intercourse are thus thought to produce mental and physical illness. The most common symptoms are fatigue, weakness, body aches, severe headaches, depression, anxiety, loss of appetite, insomnia, heart palpitations, and suicidal feelings.

diagnostic ethnocentrism - Clinical diagnosis of a patient's problem according to professional training without regard to the patient's cultural identity or cultural differences in subjective experience of illness.

directive function (of cultural meaning systems) - The ability of culture-based semantic systems to impact on people's motivations and direct their behavior.

disease - In medical anthropology this refers to the diagnosis of the doctor or folk healer. It is the clinician's definition of the patient's problem, always taken from the paradigm of disease in which the clinician was trained.

disease-centered psychiatry - A biomedical paradigm in psychiatry in which mental disorders are conceptualized as brain diseases and therefore treatment is primarily aimed at treating the disease instead of the patient.

dissociation - Mental condition characterized by a loss of the integration of faculties or functions that are normally integrated in consciousness. Can affect memory, sensory modalities, motor functions, cognitive functions, and personal identity or sense of self.

dissociative amnesia - Syndrome characterized by divided consciousness in which there is an inability to recall important information that is held in a separate part of consciousness.

dissociative disorders - Syndromes characterized by divided consciousness including dissociative amnesia, dissociative fugue, dissociative identity disorder (formerly multiple personality disorder), depersonalization disorder, dissociative trance disorder, and dissociative disorder not otherwise specified.

dissociative fugue - Syndrome based in divided consciousness characterized by sudden, unexpected travel away from home or one's customary place of work, accompanied by an inability to recall one's past, and also a confusion about personal identity.

dissociative hallucinations and delusions - Psychotic-type symptoms based on the mental processes of trance.

dissociative identity disorder - Syndrome characterized by the presence of two or more distinct identities or personality states in consciousness that recurrently take control of the individual's behavior, accompanied by dissociative amnesia.

dissociative trance disorder - New diagnostic category included in appendix of DSM-IV to accomodate premodern dissociative syndromes, characterized by trance or possession trance symptoms.

dominance hierarchies - Systems of social stratification and social control based on physical or economic power, or political or religious legitimacy. In large scale societies there can be gender, class, age, race, and ethnic dominance hierarchies.

downward causation - The effects that thinking as an activity pattern has on the structure of the brain in altering dendritic branching and the strengths of neurotransmitter systems in individual synapses.

dyspareunia - Syndrome characterized by genital pain before, during, or after sexual intercourse. Closely related to sexual aversion disorder, hypoactive sexual desire disorder, and vaginismus.

dysthymic disorder - Syndrome characterized by a chronically depressed mood lasting for at least two years. Differs from major depressive disorder in that dysthymic disorder is a chronic illness with generally less severe depressive symptoms.

eating disorders - Syndromes characterized by obsessive-compulsive or addictive type behavior involving food. Persons are obsessed with ingesting or not ingesting food.

egocentric (personality or society) - Refers to personal identity centered in the self. Persons perceive themselves as autonomous individuals with personal choices, desires, and rights, and see dependence as undesirable. In an egocentric society the "self" becomes the primary object of interest, and personal freedom and power become the supreme values.

emic - Indigenous or native categories and interpretations of life experience.

etic - Nonindigenous or foreign categories and interpretations of life experience.

evocative function (of cultural meaning systems) - The ability of culture-based semantic systems to define life situations and evoke certain emotions.

exhibitionism - Syndrome characterized by a compulsion to expose one's genitals to a stranger. The typical case is a young man exposing his erect penis to unsuspecting females.

explanatory model (of mental illness) - Refers to the ways a set of cultural schemas explains the cause of mental illness, why the onset occurred when it did, the effects of the illness, what course the illness will take, and what treatments are appropriate. These meanings dramatically affect the lived experiences of mental patients, in many ways structuring their subjective experiences.

expressed emotion - Refers to criticism, hostility, and emotional over-involvement directed at a mental patient by his or her family members.

extraordinary science - The period when formerly standard scientific methods and expectations are called into question, and researchers begin looking outside the established paradigm for answers to unresolved problems.

falling out - A culture-bound syndrome among Southern blacks in the United States and the Bahamas, characterized by falling down in a trance, not being able to move, yet being able to hear and understand surrounding events.

female dominance - A social condition in which the lives of males are by and large controlled by females.

female orgasmic disorder - Syndrome characterized by a persistent absence of orgasm after normal sexual arousal that causes marked distress or interpersonal difficulty.

female sexual arousal disorder - Syndrome characterized by an inability of a woman to maintain sexual arousal during coitus. This typically results in pleasureless lovemaking, painful intercourse, avoidance of sexual activity, and marital or relationship problems.

fetishism - Syndrome involving the use of inanimate objects (the fetish) for sexual arousal. This is typically a male disorder. Commonly used fetishes are objects associated with females, for example, women's undergarments, stockings, shoes, or other articles of clothing

final common pathways (of behavior) - The theoretical idea that pathological behavior can be caused by genetic risk, emotional trauma, personality development, personal misfortune, social conflict, cultural custom, or any possible combination of these factors. What these factors have in common is the final pathway--the pathological behavior.

first-rank symptoms (of schizophrenia) - Particular forms of hallucinations and delusions considered by German psychiatrist Kurt Schneider to be central to the definition of schizophrenia.

frotteurism - Syndrome characterized by a compulsion to rub against or touch a nonconsenting person in a sexual way. It usually occurs in crowded public spaces such as buses or subway cars.

gender identity - The private subjective cognition of one's gender.

gender identity disorder - Syndrome characterized by an intense and persistent sense of identity as someone of the opposite gender, causing significant emotional distress and social or occupational impairment.

gender role behavior - The gender specific activities that are expected in any given society. This can include such things as wearing gender specific clothing, having a gender specific occupation, using gender specific forms of speech, mannerisms, hairstyles, jewelry and accesssories, cosmetics, performing gender specific recreational activities, sexual behavior, household duties, and holding gender specific sociopolitical-religious offices.

gender status - The gender that is publically ascribed and recognized for an individual.

generalized anxiety disorder - Syndrome characterized by excessive anxiety, restlessness, inability to concentrate, and worry occurring more days than not for period of at least six months.

grisi siknis - Culture-bound syndrome of the Miskito Indian culture of Nicaragua, found almost exclusively in teenage girls and young women. Characterized by trance, running wildly with a machete or other sharp instrument, with some assaultive behavior, self mutilation, and dissociative amnesia.

healing - In medical anthropology, the treatment of illness, that is, the patient's subjective experience of being sick.

histrionic personality disorder - Personality characterized by excessive emotionality and attention-seeking behavior.

hwa-byung - A Korean culture-bound syndrome characterized by prominent anxiety, somatoform, and mood symptoms such as insomnia, fatigue, panic, fear of impending death, indigestion, palpitations, "heat sensation," flushing, "pushing-up" sensations in the chest, irritability, epigastric mass, difficulty in concentration, dysphoria, and generalized aches and pains.

hypnosis - A modern form of trance.

hypoactive sexual desire disorder - Syndrome characterized by the absence of the desire for sexual activity resulting in emotional distress or interpersonal difficulty.

hypochondriasis - Syndrome characterized by persistent and unfounded fears of having a serious disease based on a misinterpretation of normal bodily functions or minor symptoms.

hypomanic episode - A period of at least four days in which the person experiences an abnormal and persistently elevated, expansive, or irritable mood, with at least three additional symptoms such as: nondelusional grandiosity, decreased need for sleep, pressure of speech, flight of ideas, distractibility, increased involvement in goal-directed activities. Differs from a manic episode in that a hypomanic episode does not cause social or occupational impairment, and there are no hallucinations or delusions.

hypotheses - The lowest level, most specific testable explanations for unanswered scientific problems.

hysteria - Obsolete diagnostic category used commonly in the latter half of the 19th century characterized by extreme anxiety, somatoform, depressive, and dissociative symptoms such as paralyses, anesthesias, blindness, seizures, and head and body aches, with no medical explanation, as well as dysphoria, hallucinations and multiple personalities.

icon - A sign that actually looks like the thing it represents. An example would be a photograph, a drawing, or a statue of a person.

illness - In medical anthropology, this refers to the subjective experience of being sick, including the experience of symptoms, suffering, help seeking, side effects of treatment, social stigma, explanations of causes, diagnosis, prognosis, as well as personal consequences in family life and occupation.

index - A sign that does not look like the thing it represents, but has a direct connection to it. In many cases, an index may be something that was physically connected to the represented object at some time.

indisposition - Haitian culture-bound syndrome in which the person falls to the ground in a trance and is not able understand anything said or heard.

intentionality - The processing that goes on in the brain between the intake of raw sensory data and the end product of cognition of an object. Intentionality is the primary object of study in phenomenology.

kindling effect - Theoretical effect in the brain related to traumatic emotional stress in which an original traumatic life event such as an important loss or personal assault could have a longterm effect on neural pathways in the brain making the individual hypersensitive to subsequent stressful events.

koro - Chinese and Malaysian culture-bound syndrome (although similar syndromes are found elsewhere) in which persons have the sensation of the their penises or breasts retracting into their bodies. They believe that if this retraction is allowed to proceed that they will die.

latah - Malay-Indonesian trance syndrome (although similar syndromes are found elsewhere) characterized by an extreme response to startling stimuli such as violent body movements, assumption of defensive postures, striking out, throwing or dropping held objects, the mimicking of observed movements, and sometimes extreme suggestibility or obedience.

liminality - Refers to a difficult period "betwixt and between" two social categories and states of being, for example, an adolescent has reached sexual maturity, but is not yet an adult until socially recognized as an adult.

long-term potentiation - An enduring increase in functional synaptic strength generally accepted to play important role in memory formation based on the repetitive, nearly synchronous coactivation of adjacent nerve fibers onto the postsynaptic membrane.

mahu - In Polynesian societies, a person born as a male, but raised from infancy as a female (mahu in Hawaii and Tahiti, fakaleiti in Tonga, faafafine in Samoa).

major depressive disorder - Syndrome characterized by one or more major depressive episodes without a history of manic, mixed, or hypomanic episodes.

major depressive episode - At least two weeks of depressed mood with at least four additional symptoms of depression which can include changes in appetite, weight, sleep, or psychomotor activity, fatigue, feelings of worthlessness or guilt, difficulty thinking, and recurrent thoughts of suicide or suicide attempts.

major depressive disorder with psychotic features -Syndrome in which hallucinations and delusions are occurring only within the context of major depressive episodes.

male dominance - A social condition in which the lives of females are by and large controlled by males.

male erectile disorder - Syndrome characterized by a persistent inability to attain or maintain an erection sufficient for the completion of coitus.

male orgasmic disorder - Syndrome characterized by a failure to achieve orgasm during coitus.

manageability (in healing) - Refers to a psychotherapeutic technique of providing a sense of control or competence to meet the demands of the illness.

manic episode - Episode characterized by an abnormally elevated, euphoric, or irritable mood lasting at least one week, or less if hospitalization is required, with at least three additional manic symptoms, which can include grandiosity, decreased need for sleep, pressure of speech, flight of ideas, distractibility, increased goal-directed activity, and excessive involvement in pleasurable activity with a high potential for painful consequences. There may be grandiose delusions and hallucinations.

masturbatory conditioning - Process in which the person becomes classically conditioned to experience sexual pleasure through repeated occurrences of masturbation associated with some object or situation.

meaningfulness (in healing) - Refers to a psychotherapeutic technique of providing a sense of purpose to the illness experience. Found in various forms of religious healing of mental illness.

mind-brain - Monistic theoretical view in which the mind and brain are not separate.

mixed episode - Episode characterized by a period of at least one week in which diagnostic criteria are met for both a manic episode and a major depressive episode.

models - General theories which explain a large part of the field of inquiry within a scientific discipline.

modernism - A philosophical school which views modernization (essentially westernization) as a type of universal social solvent that will transform all societies it contacts into something resembling a modern western society. Based on the assumption that western forms of thinking, social organization, and personality development are inherently superior.

modern personality - Personality development dependent on at least a minimum level of education in modern standards of literacy, science, technology, history, politics, and a general acceptance of the scientific view of the world. Also a sense of personal efficacy in controlling and being responsible for one's own life and independence from traditional (particularly religious or parental) sources of authority. Also, cognitive flexibility in order to accomodate new experiences and change.

modern society - A society with a relatively high level of technology, great specialization in social and economic organization, large-scale interdependency in the flow of goods and services, a permanent bureaucracy controlling many aspects of social life, a dependence on rationality and scientific reasoning for solving problems, and an attitude of expecting material progress and change.

mood disorders - Syndromes that have depressive or manic symptoms as their primary feature.

mood episodes - Episodes of emotional illness and distress characterized by depression, mania, or hypomania, or some combination of these, including major depressive episode, manic episode, mixed episode, or hypomanic episode.

moral career - Refers simultaneously to the moral status as well as to the morale of an individual. The moral status of an individual is an indication of that person's perceived value in society judged by the cultural definitions of morality within the context of a social dominance hierarchy. Someone in a stigmatized social group can be a "good" or "bad" person by definition of the cultural meaning system. By having one's moral status compromized in this fashion, the individual's morale or self-esteeem can also be negatively affected.

narcissistic personality disorder - Personality characterized by an obsession with grandiosity, an intense need for admiration, and a lack of empathy for others.

natural attitude - A societey's own unique cultural way of experiencing the world. Refers to the way someone "naturally" experiences the world. "Naturally" is put in quotes because the way the person is experiencing the world is not actually natural at all, but cultural.

nervios ("nerves") - A Latin American culture-bound syndrome characterized by a chronic and generalized sense of emotional distress with a range of symptoms including headaches, body aches, heart palpitations, heat in the chest, irritability, gastrointestinal disturbances, insomnia, nervousness, inability to concentrate, persistent worrying, trembling, and dizziness.

neurasthenia - A disorder referring to "tired nerves" and including symptoms of fatigue, anxiety, and various somatic complaints. Originated in the United States, but is no longer a part of the DSM classification system. A very common diagnosis in China.

neuroses - Mental disorders presumed to have psychodynamic origins existing toward the mild to moderate end of a spectrum of mental illnesses in the biopsychosocial paradigm.

noetic pole - A metaphorical conceptualization of a conscious experience as a physical pole with two ends--the noesis (cognizer) and the noema (cognized). Husserl used the Greek terms noesis and noema deliberately to avoid using the terms subject and object. Using the terms subject and object implies two separate entities. The noetic pole is a single thing, an experience with two ends.

normal science - Scientific research within an accepted paradigm. All researchers assume that the paradigm is an accurate description of the field of study, and do not question its basic premises. They only seek to refine problems and answer unanswered questions.

object-in-itself - An object free of all human intentionality or cognitive processing.

obsessive-compulsive disorder - Syndrome characterized by persistent thoughts or impulses that are experienced as intrusive and inappropriate (obsessions), and repetitive behaviors (compulsions) that are performed to reduce the emotional distress associated with obsessions.

obsessive-compulsive personality disorder - Personality characterized by a persistent preoccupation with order, perfection, attention to detail, rules, and control.

orgasmic reconditioning - Therapy technique for paraphilias in which the patient is gradually reconditioned by having orgasm repeatedly associated with an appropriate sexual object.

Outline for Cultural Formulation - Contained in the Appendix of DSM-IV, outlines factors for cultural assessment of mental disorders.

pain disorder - Syndrome characterized by the subjective experience of pain that does not have sufficient medical justification.

panic attacks - Experiences characterized by a discrete period of intense fear with at least four additional somatic or cognitive symptoms including: palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea or abdominal distress, dizziness, depersonalization, derealization, fear of going crazy, fear of dying, tactile sensations (paresthesias), and chills or hot flashes.

panic disorder - Syndrome characterized by recurrent and unexpected panic attacks.

paradigm - The highest, most general level in a hierarchy of scientific intellectual structures. A paradigm is a generally accepted view of the nature of a scientific discipline.

paradigm crisis - The period when anomalies last a long time and penetrate deeply into a pardigm, in effect, demanding the large scale alteration of the paradigm and major shifts in the problems and methods of normal science.

paradigm shift - At least a partial reconstruction of a scientific discipline that can include alterations in basic theoretical generalizations and methods of research.

paranoid personality disorder - Personality characterized by a pervasive distrust of other people such that others are virtually always perceived as threatening or hostile.

paraphilias - Syndromes characterized by recurrent sexual fantasies and behaviors involving objects, persons, or situations that are considered deviant in the prevailing cultural meaning system, causing significant emotional distress and/or social impairment.

paraphilia not otherwise specified - Syndromes closely related to the other paraphilias, but with somewhat different sexual objects. These include but are not limited to telephone scatologia (obscene phone calls), necrophilia (corpses), partialism (body parts), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), and urophilia (urine).

patient-centered psychiatry - The clinical perspective that diagnosis and treatment should be concerned with a patient with thoughts, emotions, a social context, and a cultural identity, rather than diagnosis and treatment of only a brain disease.

pedophilia - Syndrome characterized by a person 16 years or older having recurrent sexual activity with a prepubescent child (legally this is generally 13 years or younger).

personal and social meanings (of mental illness) - The interpersonal relations and social life of the mentally ill person. Interpersonal relationships, particularly family relations possess meanings that can add to or shape the suffering associated with mental illness.

personality disorders - Enduring patterns of pathological subjective experience and behavior based in personality development, rather than in some specific disease entity.

phenomenology - The study of phenomena, that is, the mental construction of cognition out of raw sensory data. A phenomenon is an experience of an object by a subject. In phenomenology, it is the experience of the object that is the focus of study, not the object itself.

pibloktoq (arctic hysteria) - Polar Eskimo trance syndrome characterized by short-lived episodes (5 minutes to 1 hour) of extreme agitation in which the person will tear off his or her clothes and go running into the snow or across the ice, screaming incoherently, accompanied by dissociative amnesia.

possession trance - Mental condition characterized by the replacement of the primary personality by a new identity, usually a ghost, demon, or deity.

postmodernism - A philosophical school which views modernism as being ethnocentric and tied to western intellectual and economic colonialism. The view that wholesale adoption of modern western cultural values, economic practices, social organizations, ways of thinking, and personality development are not necessary or even desirable for all peoples.

posttraumatic stress disorder - Syndrome characterized by prominent anxiety and dissociative symptoms following exposure to an extreme traumatic stressor.

premature ejaculation - Syndrome characterized by persistent ejaculation after minimal sexual stimulation and before the person or the person's sexual partner wishes it.

premodern personality - Individuals in a premodern society who lack a sense of personal efficacy to change conditions, who accept traditional (religious and familial) sources of authority, and who rely on divine intervention for any change of one's life. Causes of illness and healing are generally accepted as coming from supernatural sources.

premodern society - A society in which the level of technology is relatively low. There is little specialization in social or economic organization and a subsistence economy with the flow of goods and services occurring on a relatively small scale. Social organization is based primarily on kinship systems. There is a great reliance on traditional religious-familial authorities. There is the assumption of supernatural causation for life events consistent with the local religious tradition.

primary role identification - A particular status and correlated behavior assigned to an individual by a society structured in a dominance hierarchy. It structures elements of individual personality development in relation to positions in the social structure.

psychic unity of humankind - The assumption that all people have the same basic brain structure, and therefore universally have the same basic mental processes and ways of experiencing the world.

psychoses - Severe forms of the mental illness characterized by a loss of reality testing, such as hallucinations and delusions.

psychotic - The presence of delusions, prominent hallucinations, disorganized speech, and disorganized or catatonic behavior.

psychotic disorders - Syndromes characterized by a loss of reality testing, including schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, and shared psychotic disorder.

reality testing (loss of) - A disturbance in the experience of self and one's relationship with the external physical and social environments. The presence of hallucinations and/or delusions is usually viewed as a loss of reality testing.

reification - The collective projection onto an object of a level of reality it does not actually possess, yet the people themselves are not aware that it is their own collective cognitve process accomplishing this. The object invariably appears in cognition as a completely separate entity with its own qualities independent of the cognizers, even though the cognizers have been active participants in the construction of the experience, shaping the form, content, and meaning of the object.

reliability - The ability of separate clincians or researchers to consistently diagnose the same disorder after observing the same pattern of symptoms in patients.

representational function (of cultural meaning systems) - The ability of individuals within a cultural group to represent the world symbolically to themselves and to others.

satanic ritual abuse syndrome - North American culture-bound syndrome in which patients report dissociated memories of childhood abuse during satanic rituals that occurred years earlier.

schizoaffective disorder - Syndrome characterized by a combination of psychotic and mood symptoms in which psychotic symptoms occur in conjunction with either a manic or depressive episode, followed by at least two weeks of psychotic symptoms without prominent mood symptoms.

schizoid personality disorder - Personality characterized by a pervasive detachment from social relationships and a restricted range of emotions.

schizophrenia - Syndrome characterized by the presence of psychotic symptoms for a significant portion of the time during a one month period, and some signs of the disorder for at least a six month period.

schizophreniform disorder - Syndrome characterized by a psychotic disturbance that lasts at least one month, but less than six months.

schizotypal personality disorder - Personality characterized by anxiety in social relationships accompanied by eccentricities of behavior such as superstitiousness, preoccupation with paranormal phenomena, magical thinking, or use of rituals in everyday situations.

semicooperative male dominance - A social organization characterized by competition, aggression, and violence among males and toward females, but with somewhat more cooperation between males, larger social groups, and more sharing of sexual partners than in competitive male dominant societies.

semiotics - The study of signs. Signs are objects that represent something else. In semiotics, there are three kinds of signs: 1) icons; 2) indexes; and 3) symbols.

sexual aversion disorder - Syndrome characterized by an aversion to and active avoidance of genital contact with a sexual partner. The typical case is a female who experiences anxiety, fear, or disgust from genital or other explicitly sexual contact.

sexual dysfunctions - Syndromes characterized by psychophysiological problems impacting on one's ability to have satisfying sexual relations, causing marked emotional distress and interpersonal difficulties.

sexual masochism - Syndrome characterized by sexual arousal resulting from being humiliated, beaten, bound, or other forms of corporal punishment.

sexual preference - The gender(s) which an individual finds sexually arousing.

sexual sadism - Syndrome characterized by sexual arousal resulting from inflicting physical or psychological punishment on another person.

shared psychotic disorder - Syndrome characterized by a delusional belief in an individual who is influenced by someone else who has an established delusion.

social phobia - Syndrome characterized by a persistent fear of social situations in which extreme embarassment may occur. Exposure to these situations provokes an anxiety response.

sociobiology - Philosophical school that presumes all individuals want to maximize their chances of passing on their genetic material which in turn unconsciously controls their behavior.

sociocentric (personality or society) - A personality with an identity centered in the group or society. This individual derives his or her primary identity from membership in a social group, usually the extended family. In a sociocentric society there are strict rules of interdependence. Social obligations are of paramount importance and proper behavior is determined by one's position in the social structure.

somatization - The expression of emotional distress in somatic (bodily) symptoms.

somatization disorder - Syndrome characterized by chronic and recurrent somatoform symptoms such paralyses, anesthesias, blindness, seizures, and head and body aches, with no medical explanation.

somatoform disorders - Syndromes characterized by prominent somatic (bodily) symptoms as their central problem.

specific phobia - Syndrome characterized by a persistent fear of specific objects or situations, exposure to which almost invariably evokes an anxiety response.

state dependent - The observation that the presence or absence of alterations in brain biochemistry or behavior associated with a particular mental state such as depression are dependent on the presence or absence of that mental state.

structured diagnostic interview schedules - Diagnostic questionnaires with standardized lists of questions inquiring about the presence of specific symptoms.

substance abuse - Syndrome associated with repeated negative consequences resulting from a maladaptive pattern of substance use, such as multiple legal, social, and occupational problems.

substance intoxication - Condition characterized by clinically significant maladaptive behavioral or psychological changes resulting from ingestion of a specific substance, such as social or occupational impairment, mood instability, cognitive impairment, or belligerance.

substance-related disorders - Syndromes associated with substance intoxication, substance abuse, substance dependence, or substance withdrawal.

substance withdrawal - Condition characterized by negative cognitive, physiological, and behavioral changes that occur when bodily concentrations of a substance decline after cessation of prolonged use.

susto - A Latin American culture-bound syndrome characterized by loss of appetite and weight, physical weakness, restlessness in sleep, depression, introversion, and apathy. It is indigenously attributed to "soul loss" resulting from frightful or traumatic experiences.

symbol - A sign that has no logical connection to the thing it represents, an arbitrary sign. It is used simply out of convention, and its use results primarily out of historical accident.

symbolic healing - Refers to the use of transformational symbols used in healing rituals for purposes of therapeutically altering the meaning of life events, emotional experience, and mental disorders.

symptom as a symptom - Refers to the fact that a particular experience, for example, a sensation, thought, emotion, or behavior only becomes a symptom (an indication of illness), when it is cognized as such. Cognizing something as a symptom is an interpretation. This interpretation occurs within a cultural meaning system.

taijin kyofusho - Japanese culture-bound syndrome characterized by intense anxiety that one's appearance, body odor, or facial expressions will be found offensive.

theories - Specific explanations for large unanswered scientific problems.

therapeutic use of hope. Psychotherapeutic technique of providing hope to patients, thereby creating a therapeutic effect on the patients' emotions, and therefore on their mental disorders.

trance - Mental condition based on a narrowed focus of attention such that what is outside of attention is lost to consciousness.

transvestic fetishism - Syndrome characterized by males deriving sexual pleasure by intermittently wearing female clothing.

tuning - Refers to a longterm change in the central nervous system resulting from repeated experience of a particular condition of the nervous system that makes the individual more susceptible to reestablishment of that same condition

undifferentiated somatoform disorder - A residual category for persistent somatoform type illnesses that do not meet the full criteria for somatization disorder.

upregulation (of neurotransmitter systems) - The brain increasing the number of neurotransmitter receptors as well as increasing the avidity with which receptors seek the neurotransmitter. Can result from use of psychiatric medications such as neuroleptics.

vaginismus - Syndrome characterized by recurrent involuntary contraction of the muscles surrounding the vagina whenever vaginal penetration is attempted.

validity - Refers to the reality of diagnostic categories. A diagnostic category (e.g., schizophrenia) is valid when it refers to a real clinical entity independent of diagnosis, and is an appropriate means of naming that entity.

voyeurism - Syndrome characterized by a compulsion to achieve sexual arousal by observing unsuspecting persons who are getting undressed, naked, or are engaged in sexual activities.

yoga meditation - An ancient religious practice from India based on trance.