Addressing Barriers to Learning:
New Directions for
Mental Health in Schools

Key Terms Related to Mental Health and Psychosocial Problems
N - P

N

negativistic personality disorder

A type of passive-aggressive personality disorder characterized by passive resistance to demands for adequate social and occupational performance and a negative attitude. Typical manifestations include inefficiency, procrastination, complaints of being victimized and unappreciated, irritability, criticism of and scorn for authority, and personal discontent. The person with this disorder alternates between hostile assertions of independence and contrite, dependent behavior.

nitrites

"Poppers" or nitrite inhalants, including amyl, butyl, and isobutyl nitrite, that produce an intoxication characterized by a feeling of fullness in the head, mild euphoria, a change in the perception of time, relaxation of smooth muscles, and possibly an increase in sexual feelings. The nitrites may produce psychological dependence and may impair immune functioning, irritate the respiratory system, and induce a toxic reaction involving vomiting, severe headache, and dizziness.

O

obsessive-compulsive disorder

An anxiety disorder characterized by obsessions, compulsions, or both, that are time-consuming and interfere significantly with normal routine, occupational functioning, usual social activities, or relationships with others. See compulsion; obsession.

oppositional defiant order

A patten of negativistic and hostile behavior in a child that lasts at least 6 months. Symptoms may include losing one's temper; arguing with adults or actively refusing their requests; deliberately annoying others; being easily annoyed, angry, and resentful; and being spiteful or vindictive.

overanxious disorder

An anxiety disorder of childhood and adolescence, sometimes considered equivalent to the adult diagnosis of generalized anxiety disorder. Symptoms include multiple, unrealistic anxieties concerning the quality of one's performance in school and in sports; hobbies; money matters; punctuality; health; or appearance. The patient is tense and unable to relax and has recurrent somatic complaints for which no physical cause can be found.

P

panic attack

A period of intense fear or discomfort, with the abrupt development of a variety of symptoms and fears of dying, going crazy, or losing control that reach a crescendo within 10 minutes. The symptoms may include shortness of breath or smothering sensations; dizziness, faintness, or feelings of unsteadiness; trembling or shaking; sweating; choking; nausea or abdominal distress; flushes or chills; and chest pain or discomfort. Panic attacks occur in several anxiety disorders. In panic disorder they are typically unexpected and happen "out of the blue." In social phobia and simple phobia they are cued and occur when exposed to or in anticipation of a situational trigger. These attacks occur also in posttraumatic stress disorder.

phobia

Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety response or panic attack even though the subject recognizes that the fear is excessive or unreasonable. The phobic stimulus is avoided or endured with marked distress. In earlier psychoanalytic literature, phobia was called anxiety hysteria.

Two types of phobia have been differentiated: specific phobia (simple phobia) and social phobia. Specific phobia is subtyped on the basis of the object feared. The natural environment (animals, insects, storms, water, etc.); blood, injection, or injury; situations (cars, airplanes, heights, tunnels, etc.); and other situations that may lead to choking, vomiting, or contracting an illness are all specific phobias.

In social phobia (social anxiety disorder), the persistent fear is of social situations that might expose one to scrutiny by others and induce one to act in a way or show anxiety symptoms that will be humiliating or embarrassing. Avoidance may be limited to one or only a few situations, or it may occur in most social situations. Performing in front of others or social interactions may be the focus of concern. It is sometimes difficult to distinguish between social phobia and agoraphobia when social avoidance accompanies panic attacks. Avoidant disorder has been used to refer to social phobia occurring in childhood and adolescence.

Some of the common phobias are (add "abnormal fear of" to each entry):

achluophobia -- Darkness

acrophobia -- Heights

agoraphobia -- Open spaces or leaving the familiar setting of the home

ailurophobia -- Cats

algophobia -- Pain

androphobia -- Men

autophobia -- Being alone or solitude

bathophobia -- Depths

claustrophobia -- Closed spaces

cynophobia -- Dogs

demophobia -- Crowds

erhthrophobia -- Blushing; sometimes used to refer to the blushing itself

gynophobia -- Women

hypnophobia -- Sleep

mysophobia -- Dirt and germs

panphobia -- Everything

pedophobia -- Children

xenophobia -- Strangers

posttraumatic stress disorder (PTSD)

An anxiety disorder in which exposure to an exceptional mental or physical stressor is followed, sometimes immediately and sometimes not until 3 months or more after the stress, by persistent reexperiencing of the event, avoidance of stimuli associated with the trauma or numbing of general responsiveness, and manifestations of increased arousal. The trauma typically includes experiencing, witnessing, or confronting an event that involves actual or threatened death or injury, or a threat to the physical integrity of oneself or others, with an immediate reaction of intense fear, helplessness, or horror.

Reexperiencing the trauma may take several forms: recurrent, intrusive, and distressing recollections (images, thoughts, or perceptions) of the event; recurrent distressing dreams of the event; sudden feeling as if the event were recurring or being relived (including dissociative flashback episodes); or intense psychological distress or physiological reactivity if exposed to internal or external cues that symbolize or resemble some part of the event.

The affected person tries to avoid thoughts or feelings associated with the event and

anything that might arouse recollection of it. There may be amnesia for an important aspect of the trauma. The person may lose interest in significant activities, feel detached or estranged from others, or have a sense of a foreshortened future.

The person may have difficulty failing or staying asleep, be irritable or have angry outbursts, experience problems concentrating, and have an exaggerated startle response.