119 Appendix A: Glossary

This appendix standardizes shorthand and terms used throughout the manual. Most useful for fast reading and consistent documentation. Optional reference material; not required for routine use.

Purpose. Provide a shared language for patient-facing and clinician-facing terms. Reduce ambiguity across domains, prototypes, and notes.

119.1 Core Workflow Terms

Presenting problem: The patient-described reason for visit in their own words.
Atlas entry: A phenomenology description used to clarify experiences before labeling.
Domain: A dimensional construct rated 0-4.
Prototype: Optional syndrome label used when it adds communication value.
Specifier: Cross-cutting modifier that changes risk, course, or management.
Front door: Entry path (clinician workflow or reference navigation).
Recording format: Compact line summary of domains, prototypes, and specifiers.

119.2 Domain Rating Scale (0-4)

0: None or not present.
1: Mild, intermittent, manageable.
2: Moderate, persistent, noticeable functional impact.
3: Severe, frequent, significant impairment or distress.
4: Extreme, disabling, or unsafe.

119.3 Course and Trajectory Terms

Acute: Short duration, days to weeks.
Episodic: Discrete episodes with return toward baseline.
Chronic: Persistent over months or years.
Fluctuating: Symptoms vary but do not fully remit.
Trajectory: Improving, stable, worsening, or stuck.
Seasonal: Recurring at particular times of year.
Postpartum/perinatal: Onset linked to pregnancy or postpartum period.
Late-onset: First presentation in later life.

119.4 Documentation Shorthand

Threat 3: Domain rating for Anxiety and Threat Sensitivity of 3.
Mood/Drive 2-3: Domain rating range when variable or unclear.
Prototype (provisional): Label used with low or medium confidence.
Competing explanations: Alternative explanations explicitly documented.
Confidence: High, medium, or provisional based on evidence.
Rule-out first: Medical or substance explanations considered before primary labeling.
Distress vs impairment: Subjective suffering vs functional limitation.

119.5 Core Domains (shorthand)

Mood/Drive: sadness, anhedonia, low or high drive, irritability.
Threat: worry, fear, panic surges, avoidance.
Trauma/Stress: intrusions, hypervigilance, dissociation, threat-linked responses.
Compulsivity: intrusive thoughts, rituals, checking, perseveration.
Psychosis: hallucinations, delusions, disorganization, reality testing shifts.
Cognitive Control: attention, planning, working memory, impulsivity.
Social Communication: reciprocal interaction, social cognition, relatedness.
Arousal/Sleep: insomnia, hypersomnia, circadian shift, autonomic arousal.
Somatic Distress: pain, fatigue, bodily focus, symptom amplification.
Reward/Habit: craving, loss of control, compulsive use.
Eating/Feeding: restriction, bingeing, avoidance, body image distress.
Personality Functioning: identity stability, interpersonal patterns, self-direction.

119.6 Specifiers and Modifiers

Severity and impairment: intensity and functional impact tiers.
Course and time pattern: acute, episodic, chronic, fluctuating, seasonal, postpartum.
Etiologic contributors: substances, medications, medical conditions, sleep/circadian, trauma, adversity.
Risk modifiers: suicide, violence, self-neglect, exploitation vulnerability.
Context and culture: cultural idioms, migration, discrimination, language needs.

119.7 Risk and Safety Terms

Passive suicide ideation: thoughts of death without plan or intent.
Active suicide ideation: thoughts with plan, intent, or preparatory behavior.
Self-harm: non-suicidal self-injury used to regulate distress.
Violence risk: credible risk to others given context and access.
Self-neglect: inability to meet basic needs due to symptoms.
Safeguarding concern: risk to vulnerable dependents or adults.

119.8 Patient Language to Clinician Terms (examples)

“I cannot shut off my mind.” → worry or rumination.
“Everything feels unreal.” → derealization.
“I feel outside my body.” → depersonalization.
“Heart races, cannot breathe.” → panic surge or autonomic arousal.
“I am always on edge.” → hypervigilance or threat sensitivity.
“I cannot focus or finish.” → inattention or executive dysfunction.
“No pleasure in anything.” → anhedonia.
“I check and recheck.” → compulsive checking.
“I hear voices others do not.” → auditory hallucinations.
“My body feels broken.” → somatic distress.
“I keep replaying it.” → intrusive recollection or rumination.
“I feel numb.” → emotional numbing.
“I get stuck on details.” → perseveration.
“I eat to shut it off.” → binge or compulsive eating pattern.
“I cannot sleep until dawn.” → delayed sleep phase.
“Everything is too loud.” → sensory sensitivity.

119.9 Preferred Language

Use “patterns” or “prototypes” instead of fixed “disorders” when possible.
Use “expected overlap” instead of “comorbidity” when domains co-occur.
Use “competing explanations” instead of “rule-out” when framing uncertainty.
Use “provisional” when evidence is limited or evolving.

Usage. Use the glossary to standardize documentation and communication; Update terms as language norms change.