Fourth Edition, September 2011

Least Restrictive Environment/Setting
The principle of treating a client in the least restrictive 
environment/setting possible recognises that all cli-
ents of public mental health services should be treated 
in an environment and manner that respects each 
client’s individual worth, dignity, and privacy, and en-
hances their personal autonomy.
Labile aff ect
An aff ect type that indicates abnormally sudden and 
rapid shifts in aff ect.
Long-term memory 
The fi nal phase of memory, in which information stor-
age may last from hours to a lifetime. 
Loosening of associations 
A disturbance of thinking shown by speech in which 
ideas shift from one subject to another that is unrelat-
ed or minimally related to the fi rst. Statements that 
lack a meaningful relationship may be juxtaposed, or 
speech may shift suddenly from one frame of reference 
to another. The speaker gives no indication of being 
aware of the disconnectedness, contradictions, or il-
logicality of speech.
Major Depressive Disorder (MDD)
Major depressive disorder (MDD) (also known as re-
current depressive disorder, clinical depression, major 
depression, unipolar depression, or unipolar disorder) 
is a mental disorder characterized by an all-encom-
passing low mood accompanied by low self-esteem, 
and by loss of interest or pleasure in normally enjoy-
able activities. The term “depression” is ambiguous. It 
is often used to denote this syndrome, but may refer 
to other mood disorders or to lower mood states lack-
ing clinical signifi cance. Major depressive disorder is a 
disabling condition which adversely aff ects a person’s 
family, work or school life, sleeping and eating habits, 
and general health.
Magical thinking 
A conviction that thinking equates with doing. Occurs 
in dreams in children, in primitive peoples, and in pa-
tients under a variety of conditions. Characterized by 
lack of realistic relationship between cause and eff ect.
Manic Episode
A state of elevated mood which is out of keeping with 
a person’s normal behaviour, and may vary from cheer-
fulness to almost uncontrollable excitement or irrita-
tion. It typically results in overactivity, rapid speech, 
decreased need for sleep, being easily distracted, and 
a loss of social inhibitions. A person may embark on ex-
travagant schemes, spend money recklessly, become 
aggressive or fl irtatious, or believe they possess extra-
ordinary powers.